Appendix B: Provincial Case Definitions for Reportable Diseases
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1 Infectious Diseases Protocol Appendix B: Provincial Case Definitions for Reportable Diseases Disease: Brucellosis Revised December 2014
2 Brucellosis 1.0 Provincial Reporting Confirmed and probable cases of disease 2.0 Type of Surveillance Case-by-case 3.0 Case Classification 3.1 Confirmed Case Laboratory confirmation of infection with clinically compatible signs and symptoms: Isolation of Brucella spp. from an appropriate clinical specimen (e.g., blood, tissue) A significant (i.e., fourfold or greater) rise in Brucella agglutination titre between acute and convalescent serum specimens obtained 2 or more weeks apart 3.2 Probable Case Clinically compatible signs and symptoms in a person in whom Brucella spp. deoxyribonucleic acid (DNA) is detected from an appropriate clinical specimen Clinically compatible signs and symptoms with supportive serology (i.e., Brucella agglutination test titre of 1:160 or higher in one or more serum specimens obtained after onset of symptoms) Clinically compatible signs and symptoms in a person with an epidemiologic link to a confirmed case or suspected source 4.0 Laboratory Evidence 4.1 Laboratory Confirmation Any of the following will constitute a confirmed case of brucellosis: Positive Brucella sp. culture with confirmation (See Section 4.2) A significant (i.e., fourfold or greater) rise in Brucella sp. antibody titre 4.2 Approved/Validated Tests Standard culture for Brucella sp. with confirmation Brucella serology 2
3 Confirmatory methods include traditional phenotypic and biochemical testing and/or nucleic acid amplification test (NAAT) 4.3 Indications and Limitations Additional tests may include NAAT for Brucella sp. based on availability. 5.0 Clinical Evidence Clinically compatible signs and symptoms are characterized by acute or insidious onset of fever, night sweats, undue fatigue, anorexia, weight loss, headache, and arthralgia. 6.0 ICD Code(s) ICD 10 Code A Comments N/A 8.0 Sources Advisory Committee on Epidemiology; Health Canada. Case definitions for diseases under national surveillance. Can Commun Dis Rep. 2000;26 Suppl 3:i-iv, Available from: Acha PN, Szyfres B. Zoonoses and communicable diseases common to man and animals. 3 rd ed. Vol. I, Bacterioses and mycoses. Washington DC: Pan American Health Organization; Heymann DL, editor. Control of communicable diseases manual. 19 th ed. Washington, DC: American Public Health Association; National Notifiable Diseases Surveillance System [Internet]. Atlanta, GA: Centers for Disease Control and Prevention; case definition: Brucellosis (Brucella spp.); [updated 2014 May 8; cited 2014 Jun 26]. Available from: 2:00:00%20AM Ontario. Ministry of Health and Long-Term Care. Timely entry of cases. iphis Bulletin. Toronto, ON: Queen s Printer for Ontario; 2014:17. 3
4 9.0 Document History Table 1: History of Revisions Revision Date Document Section Description of Revisions December 2014 General New template. Title of Section 8.0 changed from References to Sources. Section 9.0 Document History added. December Confirmed Case Second bullet, removed and testing at the same laboratory. December Probable Case New first bullet added, Clinically compatible signs and symptoms in a person in whom Brucella spp. deoxyribonucleic acid (DNA) is detected from an appropriate clinical specimen. December Approved/Validated Tests December Indications and Limitations Bullet one moved to bullet three. Addition of or suspected source. Addition of in front of bullet three. Bullet three, changed from Tbilsi phage susceptibility, dye tolerance testing to traditional phenotypic and biochemical testing and/or nucleic acid amplification test (NAAT). Bullet one, NAT replaced with NAAT. 4
5 2014 Queen s Printer for Ontario
Appendix B: Provincial Case Definitions for Reportable Diseases
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