Table 1.

Syndromic approach for investigations of suspected viral outbreaks in the state of Odisha reported between 2010 and 2019

Syndrome	Case definitions	Recommended samples	Diseases investigated	Techniques used
Acute febrile illness with rash	A fever of 38 °C or higher at presentation or history of fever that persisted for 2–7 days with no localizing source and maculopapular rash	Acute phase serum/plasma	Measles Rubella Chickenpox Chikungunya Dengue	IgM ELISA RT-PCR (for serotype and genotype)
Acute respiratory syndrome	Acute respiratory infection (ARI): sudden onset of respiratory infection symptoms (cough, sore throat shortness of breath, coryza) Severe ARI: ARI with history of fever or measured fever of ⩾38 C°; and cough; with onset within the last 10 days; and requires hospitalisation	Nasopharyngeal swabs, throat swabs, nasal aspirate (with cold chain)	Influenza A and B, H1N1, H3N2	Multiplex RT PCR
Viral hepatitis	An acute illness typically including acute jaundice, dark urine, anorexia, malaise, extreme fatigue and right upper quadrant tenderness. Biological signs include increased urine urobilinogen and >2.5 times the upper limit of serum alanine aminotransferase	Serum/plasma	HAV HEV	IgM ELISA RT-PCR
Viral encephalitis	Suspected case: Acute onset of fever, not more than 5–7 days duration Change in mental status with/without: New onset of seizures (excluding febrile seizures) (Other early clinical findings – may include irritability, somnolence or abnormal behaviour greater than that seen with usual febrile illness)	CSF blood/serum, Plasma	Dengue, JE, Chikungunya,	IgM-ELISA

Legend: HB/C/E/AV, JE, IgM, ELISA, PCR, RTPCR, RDK, DNAPCR, RNAPCR.