Criterion Reporting Reporting Reporting Disease or Condition Disease or Condition Disease or Condition Subtype Subtype Subtype Clinical Evidence Laboratory Evidence Epidemiological Evidence Notes: Each alternative disease or condition subtype is listed in a separate column. Each criterion (symptom, sign, lab result, immunization status, occupation, travel history, etc.) is listed in a separate row. Meeting the criteria listed under any single column of this table is sufficient to identify a case for reporting. [Change the or condition to the appropriate term, which can be a clinical generic “Disease subtype” language distinction (e.g., cutaneous anthrax, inhalational anthrax), or an agent (e.g., a type of arbovirus), or a route of exposure (e.g., foodborne botulism, wound botulism). Delete unnecessary columns. Use letter codes provided. Where the action of ordering a laboratory test meets a criterion for reporting, indicate by use of asterisk.] S = This criterion alone is Sufficient to report a case. N = All criteria in the same column are Necessary to report a case. “N” O = At least one of these criteria in each category (e.g., clinical evidence and laboratory “O” (Optional) evidence) in the same column—in conjunction with all criteria in the same column—is required to “N” report a case. (These optional criteria are alternatives, which means that a single column will have either no O criteria or multiple O criteria; no column should have only one O.) * A requisition or order for any of the laboratory tests is sufficient to meet the reporting criteria. “S” Table VII-B. Criteria for defining a case of [condition]. NOTE: Please remember to incorporate the criteria specified in Section VII above to titled “Criteria distinguish a new case of this disease or condition from reports or notifications which should not be enumerated as a new case for which should be considered in determining whether to count surveillance,” this as a new case. This section is not applicable if not relevant to the condition. Criterion Suspected Probable Confirmed Clinical Evidence Laboratory evidence Epidemiologic evidence
Criterion Reporting Disease or Condition Subtype Reporting Disease or Condition Subtype Reporting Disease or Condition Subtype Clinical Evidence Laboratory Evidence Epidemiological Evidence Notes: Each alternative disease or condition subtype is listed in a separate column. Each criterion (symptom, sign, lab result, immunization status, occupation, travel history, etc.) is listed in a separate row. Meeting the criteria listed under any single column of this table is sufficient to identify a case for reporting. [Change the generic “Disease or condition subtype” language to the appropriate term, which can be a clinical distinction (e.g., cutaneous anthrax, inhalational anthrax), or an agent (e.g., a type of arbovirus), or a route of exposure (e.g., foodborne botulism, wound botulism). Delete unnecessary columns. Use letter codes provided. Where the action of ordering a laboratory test meets a criterion for reporting, indicate by use of asterisk.] S = This criterion alone is Sufficient to report a case. N = All “N” criteria in the same column are Necessary to report a case. O = At least one of these “O” (Optional) criteria in each category (e.g., clinical evidence and laboratory evidence) in the same column—in conjunction with all “N” criteria in the same column—is required to report a case. (These optional criteria are alternatives, which means that a single column will have either no O criteria or multiple O criteria; no column should have only one O.) * A requisition or order for any of the “S” laboratory tests is sufficient to meet the reporting criteria. Table VII-B. Criteria for defining a case of [condition]. NOTE: Please remember to incorporate the criteria specified in Section VII above titled “Criteria to distinguish a new case of this disease or condition from reports or notifications which should not be enumerated as a new case for surveillance,” which should be considered in determining whether to count this as a new case. This section is not applicable if not relevant to the condition. Criterion Suspected Probable Confirmed Clinical Evidence Laboratory evidence Epidemiologic evidence
PSTemplateStandardizedSurve.docx