Table 2.
List of syndromes surveilled and their definition, target diseases, and public health actiona.
| Name of syndrome | Definition of syndrome | Target disease | Public health action or measures |
| Rash with fever | Temperature ≥38.0°C and generalized rash of any nature | Measles, rubella, varicella, smallpox, louse-borne diseases (relapsing fever due to Borrelia recurrentis, trench fever due to Bartonella quintana, epidemic typhus due to Rickettsia prowazekii). | Outbreak confirmation and investigation, contact tracing, isolation, vaccination |
| Rash without fever | N/Ab | Scabies. | N/A |
| Suspected acute upper respiratory tract infection | Fever, cough, sore throat, runny nose | Pharyngitis, tonsillitis caused by adenovirus, rhinovirus, respiratory syncytial virus, influenza, parainfluenza. | N/A |
| Suspected acute lower respiratory tract infection with fever | Temperature ≥38.0°C and at least one of the following signs or symptoms: breathing difficulties; chest rales or increased respiratory rate | Tracheitis, bronchitis, pneumonia, bronchopneumonia, or bronchiolitis, including those caused by, for example, adenovirus, streptococci, pneumococci, Mycoplasma , Legionella. | Outbreak investigation in case of clustering of cases |
| Meningitis or encephalitis | Temperature ≥38.0°C and at least one of the following signs or symptoms: severe, persistent headache; neck stiffness; altered consciousness; altered mental status; confusion; delirium; or disorientation | Bacterial, viral, fungal, or other infectious meningitis or encephalitis. This could be caused by meningococci, Haemophilus influenzae, pneumococci, Listeria, Leptospira, Mycobacterium tuberculosis, Treponema pallidum, enteroviruses, poliovirus, measles virus, mumps virus, rubella virus, influenza virus, West Nile virus, other arboviruses. | Outbreak confirmation and investigation, contact tracing, isolation |
| Fever and bleeding | Temperature ≥38.0°C and at least one of the following signs or symptoms: petechial rash with any purpuric areas; hemorrhagic exanthema; hematuria; conjunctival hemorrhage; gingival bleeding; epistaxis; bloody diarrhea; unexplained bleeding from other sites; or clinical suspicion of a viral hemorrhagic illness | Hemorrhagic fevers due to infectious disease agents. These could include yellow fever, dengue, or Crimean-Congo hemorrhagic fever and other arboviral diseases, Ebola. | Contact tracing, isolation |
| Non–bloody watery diarrhea | ≥3 watery stools per day, nausea, vomiting | Gastroenteritis caused by norovirus, rotavirus, bacterial toxins. Campylobacter, Salmonella, Escherichia coli, Yersinia, Vibrio cholerae. | Outbreak investigation for source and vehicle, and control in case of clustering of cases |
| Bloody diarrhea | Red blood in the stool | Amoebic dysentery, Shigella, Campylobacter, verotoxin-producing E coli. | Outbreak investigation for source and vehicle, and control in case of clustering of cases |
| Acute jaundice | Acute onset of jaundice and at least one of the following signs or symptoms: temperature ≥38.0°C; malaise or hepatomegaly | Acute viral hepatitis A and E; other hepatitis. | Outbreak investigation for source and vehicle |
| Skin, soft tissue, or bone abnormalities | Skin or soft tissue lesions, ulceration, inflammation | Cutaneous diphtheria, cutaneous tuberculosis, cutaneous leishmaniasis, bacterial wound infection. | N/A |
| Acute flaccid paralysis | Person under the age of 15 years with acute flaccid nonsymmetrical paralysis | Acute flaccid paralysis, or paralytic or poliomyelitis. | Contact tracing, immunization |
| High fever with no other signs | High fever up to 40°C or more, persisting, intermittent, long-lasting | Typhoid fever; malaria, or visceral leishmaniasis. | N/A |
| Unexplained death | N/A | N/A | N/A |