Supporting evidence of streptococcal infection within the last 45 days are prolonged PP-R interval on ECG, elevated or rising antistreptolysin-O or other antistreptococcal antibody; a positive throat culture; a rapid antigen test for group A strep, recent scarlet fever. Anthrax "Anthrax is an acute infectious disease caused by the spore-forming bacterium Bacillus anthracis. The disease most commonly occurs in wild and domestic animals such as cattle, sheep, goats, camels, antelope and other herbivores. Humans can also get anthrax when they are exposed to infected animals or tissue from these animals. Persons who may have been exposed to anthrax are not contagious, so quarantine is not appropriate Symptoms vary, depending on how the disease was contracted. Most (about 95 %) anthrax infections occur when the bacterium enters through skin lesions (cuts or abrasions) such as when handling contaminated wool, hides, leather or hair products (especially goat 2-7 days B. anthracis isolated from any clinical sample. Gram+ve Bacillus (thick rods with truncated ends, with possible endospore) detected by any test on any specimen type A person with either 1. Skin lesion evolving over 1-6 days from a papular through a vesicular to a depressed black eschar invariably accompanied by oedema that may be mild to extensive with fever, malaise and lymphadenopathy OR 2. Nausea, vomiting and anorexia followed by fever, vomiting of blood, bloody diarrhoeaOR 3. Rapid onset of hypoxia, shortness of breath and high temperature, with radiological evidence of mediastinal widening or pleural effusion OR 4. Acute onset of high fever, convulsions, loss of consciousness and meningeal signs and symptoms AND having A probable case is a suspected case with laboratory Gram+ve Bacillus culture (and possible presence of endospores). A confirmed case is a person with laboratory evidence of infection with Bacillus anthracis by (Culture isolation of Bacillus anthracis -like organisms or spores from any clinical specimen and PCR confirmation of cultured isolate).
dysfunction is seen in most patients and there may be spasms of the respiratory muscles and generalized convulsions. The illness progresses rapidly to paralysis, delirium, convulsions and death, usually within a week or two of the onset of illness. Respiratory disease caused by a novel respiratory pathogen** Not available as pathogens may vary. Not available as pathogens may vary. Not available as pathogens may vary. Clusters (e.g., 3 or more cases in 72 hours, or 5 or more cases in a 5-day period) of severe respiratory illness (hospitalised or warranting hospitalisation or ICU admission or death) with evidence of common exposure or epidemiologic link. Attention should be given to recent travel or exposure to animals implicated in zoonotic transmission of respiratory pathogens. Not available as pathogens may vary. Not available as pathogens may vary. Rift valley fever (human) Rift Valley fever is a viral disease affecting both domesticated ruminant animals and humans. Virus transmission is mosquito- borne amongst the animals (Culex and Aedes spp.) and occurs via zoonotic route to humans i.e. contact of blood or bodily secretions of infected livestock. There are vaccines available for 2-6 days Rift Valley or Slenkdalkoors virus or bunyavirus detected by any test on any specimen type *Exclude IgG serology and HAI A person with acute onset of fever > 38°C with at least one of the following signs and symptoms: headache, nausea, myalgia, arthralgia, neck stiffness, sensitivity to light, loss of appetite, vomiting, diarrhoea, abdominal pain with sometimes either of severe clinical A probable case is a suspected case with laboratory IgM antibodies against RVF virus. A confirmed case is a person with laboratory evidence of RVF virus infection by (a.PCR positive and virus isolation from the patient's first (single) specimen; OR b.PCR positive and IgM positive result on patient's first (single) specimen; OR c. PCR positive on two separate specimens from the same patient collected at least one day apart; OR d. PCR positive but IgM/IgG result in patient's
close contact with the blood, secretions, organs, or other bodily fluids of infected people. High risk exists for people when providing direct patient care or handling dead bodies (funerals). Transmission via infected semen can occur up to seven weeks after clinical recovery. Vaccines have been development and tried following the largest outbreak of Ebola in West Africa in 2014-2015. Generally, EVD is a severe febrile illness characterized by sudden onset of fever, and non-specific symptoms in the first 2 to 3 days e.g. severe headache, myalgia, intense weakness, sore throat, sometimes conjunctival injection, followed by 2 to 4 days period of deterioration with severe sore throat, chest, abdominal pain, maculopapular rash on trunk and shoulders, diarrhea, vomiting, impaired kidney and liver function and sometimes bleeding (petechiae, ecchymosis, from venepuncture sites, visceral hemorrhagic effusions), thrombocytopenia, leukopenia, elevated AST, ALT, abortion, hiccups, somnolence, delirium, shock, coma for fatal cases during with a suspected, probable or confirmed Ebola case or a dead or sick animal (bats, rodents, or primates) or residence in—or travel to—an endemic area within 21 days of illness onset or laboratory exposure or exposure to semen from a confirmed acute or convalescent case of EVD within the 10 weeks of that person's onset of symptoms). Ebola virus infection by (IgM positive result on patient's first specimen). "
mucosal exposure is generally moderate. The antiviral drug ribavirin seems to be an effective treatment for Lassa fever if given early on in the course of clinical illness.The disease has a gradual onset of fever with malaise, anorexia, headache, chest or retrosternal pain, sore throat, myalgia, arthralgia, lumbosacral pain, dizziness, erythemic or exudative pharynx, nausea, vomiting, epigastric, abdominal pain, tenderness, diarrhoea, morbilliform, maculopapular or petechial rash in fair-skinned people only, dry cough, no jaundice, edema, swelling of the face, and neck specific, bleeding (conjunctival injection or subconjunctival hemorrhage, facial flushing, hematemesis, melena, hematochezia, metrorrhagia, petechiae, epistaxis, bleeding from the gums and venepuncture sites, vaginal bleeding, hemoptysis or hematuria infrequent), mild-to moderate thrombocytopenia, hypotension, shock, moderate leukopenia, later leukocytosis, increased AST, ALT and AST> ALT, lactate level greater than 36 mg/dL, proteinuria common, spontaneous abortion, or vagina, swollen neck or face, conjunctivitis or subconjunctival bleeding, spontaneous abortion, petechial or hemorrhagic rash, new onset of tinnitus or altered hearing, persistent hypotension, elevated AST or ALT OR 2. at least two major signs or symptoms; AND having relevant epidemiological exposure (known contact to a person suspected, probably or confirmed to have lassa fever or have travelled to an endemic area in the past 21 days). Increase in IgM/IgGtitres between acute and convalescent specimens) OR is a suspected case with laboratory suggestive evidence of Lassa virus infection by (IgM positive result on patient's first specimen). "
rubella infection in pregnancy following: detection of immunoglobulin M antibody OR positive immunoglobulin G antibodies OR a specimen that is for rubella virus following: cataracts, glaucoma, congenital heart disease, hearing impairment, pigmentary retinopathy, purpura, hepatosplenomegaly, jaundice, microcephaly, developmental delay, meningoencephalitis, radioluscent bone disease least two of the following without a more plausible etiology: -cataracts or congenital glaucoma, -congenital heart disease -hearing impairment, -pigmentary retinopathy; 2)An infant with no laboratory confirmation of rubella infection but at least one of the following without a more plausible etiology; -cataracts or congenital glaucoma, -congenital heart disease -hearing impairment, -pigmentary retinopathy; AND one or more of the following: -purpura, -hepatosplenomegaly, -jaundice, -microcephaly, -developmental delay, -meningoencephalitis, -radiolucent bone disease. immunoglobulin M antibody OR positive rubella-specific immunoglobulin G antibodies whose titre does not drop by at least two fold within a 4 week period OR a specimen that is for rubella virus Congenital syphilis A condition affecting an infant or child (< 2 years) whose mother had untreated or inadequately treated syphilis. Early Congenital Syphilis: may present anytime in infancy or early childhood (< 2 years). Infant or child < 2 years who has a REACTIVE non-treponemal test on serum/ blood (RPR POSITIVE) ? Ante-natal clinic attendee who has a Infant or child < 2 years whose mother had untreated or *inadequately treated syphilis at delivery,regardless of signs in infant OR Probable case with confirmatory laboratory tests on placenta/ amniotic fluid/ autopsy material/ exudates from suspicious lesions/ body fluids e.g. nasal discharge, CSF motile treponemes seen on darkfield microscopy specific
An infected infant may be asymptomatic at birth and develop signs 4-8 weeks after birth. REACTIVE test on serum/ blood (RPR or rapid test POSITIVE) An infant or child who has a reactive test for syphilis (RPR) AND any one of the following: Any evidence of congenital syphilis on physical examination: skin rash, jaundice, anaemia, mucosal lesions, nasal discharge Any evidence of congenital syphilis on x-ray of long bones: e.g. periostitis, tibial erosions An elevated cerebrospinal fluid (CSF) white cell count and protein (without other cause) A reactive cerebrospinal (CSF) venereal disease research laboratory test (VDRL) test and/or Treponemapallidum DNA positive on PCR
serology (use final result POSITIVE - cut offs may differ; or flag if pertussis serology done, and interpret at NICD). All ages. symptoms: paroxysms of coughing; or inspiratory "whoop”; or post-tussive vomiting. 21 days before the onset of symptoms. Tetanus Tuberculosis: pulmonary Tuberculosis: Tuberculosis: multidrug-resistant (MDR-TB) Tuberculosis: extensively (XDR-TB) CATEGORY 3 NOTIFIABLE MEDICAL CONDITIONS To be notified through a written or electronic notification to the Department of Health within seven (7) days of diagnosis by private and public health laboratories Disease Short description Incubation period CDW/lab case definition Suspected case Probable case Confirmed case Endemic arboviral diseases chikungunya fever Chikungunya is caused by a virus transmitted by mosquitoes (certain Aedes species). Animal reservoirs of the virus include monkeys, birds, cattle, and rodents.No direct transmission occurs.There are no vaccines to prevent infection with chikungunya virus and the most effective protective measures are those that avoid mosquito bites. No specific 1- (2- 4) 12 days Chikungunya virus or alphavirus detected by any test on any specimen type *Exclude IgG serology and HAI A person with acute onset of fever >38.5°C and severe arthralgia particularly in wrist and ankles, with at least one of the following signs and symptoms rash, headache, myalgia AND having relevant epidemiological exposure (Residing in area known to be endemic or having travelled to chikungunya A probable case is a suspected case with laboratory IgM antibodies against chikungunya virus in the absence of IgM to other alphaviruses. A confirmed case is a person with laboratory evidence of chikungunya virus infection by (a.PCR positive and virus isolation from the patient's first (single) specimen; OR b.PCR positive and IgM positive result on patient's first (single) specimen; OR c. PCR positive on two separate specimens from the same patient collected at least one day apart; OR d. PCR positive but IgM/IgG negative result in patient's first specimen and PCR negative but IgM/IgG resistant
Ceftriaxone MIC >/= 0.25 Azithromycin MIC >/= 0.5 PLUS resistance to at least THREE **Class II antibiotics Penicillin MIC >/=2 Ciprofloxacin MIC >/= 0.12 Gentamicin MIC >/=8 Spectinomycin MIC >/=64 Tetracycline MIC >/=2 *Class I antibiotics: those currently recommended for gonorrhoea treatment (dual therapy used) **Class II antibiotics:used less frequently or proposed as salvage therapy NB: all MICs in µg/ml recommended dual treatment regimen for gonorrhoea (250mg ceftriaxone IM + 1g azithromycin stat PO) AND no likelihood of reinfection ocular discharge; sterile sites specimens (blood, synovial fluid)