DISEASES, SYNDROMES &

HEALTH EVENTS UNDER

SURVEILLANCE
TUBIGON COMMUNITY HOSPITAL
 OBJECTIVES OF THIS LECTURE:

 To know PIDSR and its purpose

 Recognize the importance of having a
disease surveillance in the Philippines
 Be able to identify factors for a successful
active surveillance system for each
institution
 WHAT IS INTEGRATED DISEASE
SURVEILLANCE?:

 A process of coordinating, prioritizing and

streamlining of multiple disease surveillance systems
into a unified national disease surveillance system that
combines core surveillance activities and support
functions into a single, integrated activity for the
purpose of making the system more efficient and
effective in providing timely, accurate and relevant
information for action.
 PURPOSE OF SURVEILLANCE:

 Disease surveillance is recognized as the cornerstone

of public health decision-making and practice.
 There was a need to strengthen the disease surveillance
in the Philippines
 It aims at coordinating and streamlining all
surveillance activities and ensuring timely provision of
surveillance information
 POLICIES THAT SUPPORT PIDSR:

 Guidelines on the Philippine Integrated Disease Surveillance and Response

(PIDSR) Framework (AO 2007-0036)
 Law of Reporting of Communicable Diseases (Republic Act 3573) •
 Resolution WHA48.13 (1995) •
 International Health Regulations of 2005, Article 5-1 Surveillance  
 Implementing Guidelines for Formula One for Health as Framework for
Health Reforms (Administrative Order No. 2005-0023)
 Department Personnel Order No. 2005-1585
 GOALS & OBJECTIVES OF PIDSR:

 To reduce morbidity and mortality through an institutionalized, functional

integrated disease surveillance and response system nationwide.
 Objectives:
 To increase the number of LGUs able to perform
 To enhance capacities at the national and regional levels to efficiently and
effectively manage and support local capacity development for disease
surveillance
 To increase utilization of disease surveillance data for decision making, policy-
making, program management, planning and evaluation at all levels.
 FUNDAMENTALS SURVEILLANCE
PROCEDURES:

 Cases or events seen or detected from the health

facilities and communities should be reported.
 Case-based data collection shall be utilized
 Priority diseases/syndromes/conditions targeted for
surveillance
 Use of Standard Case Definitions for Surveillance
 HOSPITAL’S RESPONSIBILITY:

 Identify cases (active and passive)

 Report cases depending on its Category (I or II)
 Send samples for each suspect case
FLOW OF REPORTING:

ER/OPD

Collection of Data
(DISEASE SURVEILLANCE COORDINATOR)

CATEGORY I
(CASE CATEGORY II
INVESTIGATION; (FILL UP FORM)
FILL UP FORM)

PESU/RESU
CATEGORY I
(IMMEDIATE/WITHIN 24 HOUR REPORTING)

 ACUTE FLACCID PARALYSIS

 ADVERSE EFFECT FOLLOWING IMMUNIZATION
 MEASLES
 MENINGOCOCCAL DISEASE
 NEONATAL TETANUS
 PARALYTIC SHELLFISH POISONING
ACUTE FLACCID PARALYSIS

 Any child less than 15 years of age

with acute onset of floppy paralysis,
OR

 A person of any age in whom

poliomyelitis is suspected by a
physician.
LABORATORY CONFIRMATION:
Viral isolation from stool samples.
All AFP cases should have two stool
specimens collected 24–48 hours
apart and within 14 days of the onset
of paralysis.
Specimens arriving in the laboratory
must be of adequate volume (about
the size of an adult thumb or
approximately 8–10 g), have
appropriate documentation (i.e.
laboratory request form) and be in
good condition, i.e. with no leakage
or desiccation.
Hot Case description:
 An AFP case that is <5
years old with < 3 doses
of OPV and has fever at
the onset of
asymmetrical paralysis,
OR
 An AFP case or a person
of any age whose stool
specimen(s) has
poliovirus isolate.
ADVERSE EFFECT FOLLOWING
IMMUNIZATION (AEFI)

 Any individual that experience a serious

condition any time after he or she received an
immunization and is considered by a health
worker (e.g., midwife, nurse, physician) to be
possibly related to that immunization.
Causality of AEFI:
 Vaccine reaction: event caused or precipitated by the
vaccine when given correctly; caused by inherent properties
of the vaccine.
 Program error: event caused by an error in vaccine
preparation, storage, handling, or administration.
 Coincidental event: event that happens after immunization
but is not caused by the vaccine - a chance association.
 Injection reaction: event from anxiety bout, or pain from,
the injection itself rather than the vaccine.
 Unknown: whose cause cannot be determined.
MEASLES
SUSPECTED CASE:
An acute illness characterized by:
 Generalized, maculopapular rash
lasting ≥3 days; and
 Temperature ≥101°F or
38.3°C; and
 Cough, coryza, or conjunctivitis.
Laboratory-confirmed case:  Discarded or not measles
 Suspected case that is laboratory case: A suspect measles
confirmed. case with an adequate
Clinically-confirmed: specimen that is not
 A suspected measles case, that, serologically confirmed or
for any reason, is not completely is confirmed positive for
investigated* (e.g. death before other diseases such as
investigation, no blood sample) or rubella or dengue.
has equivocal laboratory test
results.
*Such cases represent
failures of the surveillance
system to adequately
classify a case.
ANTHRAX
Suspected case: A person with
acute onset of illness characterized
by several clinical forms as follows:
a. localized form:
 cutaneous: skin lesion evolving
over 1 to 6 days from a papular
through a vesicular stage, to a
depressed black eschar invariably
accompanied by edema that may
be mild to extensive;
b. systemic forms: Probable case: A suspected
 gastro-intestinal: abdominal distress case that has a positive
characterized by nausea, vomiting,
anorexia and followed by fever; reaction to allergic skin test
 pulmonary (inhalation): brief prodrome
(in non-vaccinated
resembling acute viral respiratory illness, individuals);
followed by rapid onset of hypoxia,
dyspnea and high temperature, with X-ray
evidence of mediastinal widening;
Confirmed case: A suspected
 meningeal: acute onset of high fever case that is laboratory-
possibly with convulsions, loss of
consciousness, meningeal signs and confirmed.
symptoms; commonly noted in all systemic
infections;
 AND has an epidemiological link to a
suspected or confirmed animal cases or
contaminated animal products.
MENINGOCOCCAL DISEASE
SUSPECTED CASE:
 A person with sudden onset of fever
(>38.5°C rectal or >38.0°C axillary)
and one or more of the following:
neck stiffness, altered
consciousness, other meningeal
signs, petechial or purpural rash.

 Note: In patients <1 year, suspect

meningitis when fever is accompanied by
bulging fontanels
Probable case: Confirmed case:
 A suspected case as  A suspected or probable
defined above and: Turbid case with laboratory
CSF (with or without confirmation.
positive Gram stain) or
ongoing epidemic and
epidemiological link to a
confirmed case.
NEONATAL TETANUS

Suspected Case:
 Any neonatal death
between 3-28 days of age
in which the cause of death
is unknown; or any neonate
reported as having suffered
from neonatal tetanus
between 3-28 days of age
and not investigated.
Confirmed Case: NOTE:
 Any neonate (≤ 28 days of life)  Since case classification is based
solely on clinical criteria. Any
that sucks and cries normally neonatal death occurring in babies
during the first 2 days of life, 3-28 days old with no apparent
and becomes ill between 3 to cause should be suspected as NT
28 days of age and develops and evaluated according to the
above criteria.
an inability to suck and diffuse
muscle rigidity (stiffness), which
may include trismus, clenched
fists or feet, continuously
pursed lips, and/or curved back
(opisthotonus). OR A neonate
diagnosed as a case of tetanus
by a physician.
 PARALYTIC SHELLFISH POISONING
Suspected case:
 A person who develops one or more of
the following signs and symptoms after
taking shellfish meal or soup:
– Sensory : paresthesias (tingling
sensations on skin), numbness (lack of
sensation) of the oral mucosa and lips,
numbness of the extremities
– Motor: difficulty in speaking, swallowing,
or breathing, weakness or paralysis of
the extremities
Confirmed case:
 A suspected case in which laboratory tests
(biologic or environmental) have confirmed
exposure.
RABIES
Suspected Case:
 A person presenting with an
acute neurological syndrome
(encephalitis) dominated by
forms of hyperactivity (furious
rabies) or paralytic syndromes
(dumb rabies) that progresses
towards coma and death,
usually by respiratory failure,
within 7 to 10 days after the first
symptom if no intensive care is
instituted.
Probable case: Confirmed case:
 A suspected case plus  A suspected case that is
history of contact with laboratory confirmed
suspected rabid animal.
 Note: Bites or scratches from
a suspected animal can
usually be traced back in the
patient medical history. The
incubation period may vary
from days to years but usually
falls between 30 and 90 days.
CATEGORY II
(WEEKLY REPORTING)
 ACUTE BLOODY DIARRHEA  DIPTHERIA
 ACUTE ENCEPHALITIS  INFLUENZA-LIKE ILLNESS
SYNDROME  LEPTOSPIROSIS
 ACUTE HEMORRHAGIC  MALARIA
FEVER SYNDROME
 NON-NEONATAL TETANUS
 ACUTE VIRAL HEPATITIS
 PERTUSSIS
 BACTERIAL MENINGITIS
 TYPHOID & PARATYPHOID
 CHOLERA
FEVER
 DENGUE
ACUTE BLOODY DIARRHEA

 A person with
acute diarrhea
with visible
blood in the
stool.
 TOTAL NUMBER OF ACUTE BLOODY DIARRHEA ADMITTED: 2019
TOTAL NUMBER OF CASES(ADMITTED): 238
160

148
140

120

100

80

60

40

20 26
17
14 14
0 3 3 5
1 1 2 2 2
O N O A EN Y O T A N PE IN A N
IA BI
A
ID
R ER M H
O
N
A
IS Y
A
LA
R N
G
G
O
IM G IS Q
U R O A V BA A LA BA BI
D TI N TE C
A G D A G C C A TU
C
A
SA N D
A EN SA IN
A BU
 TOTAL NUMBER OF ACUTE BLOODY DIARRHEA IN TUBIGON:
2019
25 TOTAL NUMBER OF CASES(ADMITTED): 148

22
20

15

13
12
10
9 9 9
8
7
5 6 6
5 5
4
3 3 3 3 3 3 3
2 2 2 2
0 1 1 1 1
. . . . S
ES A
N
A
N
V
A IS U
R
O
N
A
N
A
N IS O
N
A
N
O
N T E
A
D
A
N
A
N
C
C A
G
O
R A
N
U
R A TE R
O
A
N
A
N
A
N
IR R W E A S Y D S N G C N R T C N O Y N . S A R T H J IJ
S
A TA N-A N
U
N
W AN T A
A
N LA SA O
N
N
A
W
A N
O
E R
N
O
Y
A C H
A O
C
N
G IN A
C
. N
O
E N
T O BO UL
N U
N
O A
D A LA BA ILI
J
A
Y P A TA O
S
BU GU
I
A
N B
LI E N
O
W
A
P O
O
C
A PO N A
I
P M
IN
C PO A
B
E N T IL G N B B A B IJ A T P C
PA N PA G
BU V O IL C
G
BA
 MONTHLY DISTRIBUTION OF ACUTE BLOODY DIARRHEA CASES
IN TUBIGON: 2019

18
17
16 16 16

14
13 13
12 12 12
11 11
10 10
9
8 8

0
JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
 TOTAL NUMBER OF ACUTE BLOODY DIARRHEA ADMITTED: 2020
TOTAL NUMBER OF CASES(ADMITTED): 107
90

80
80

70

60

50

40

30

20

10 11

0 4 3
1 1 1 1 1 2 2
N O R O T A N A EN PE IN N
O
LA LA ID
R
IS Y
A
N
G
LA
R O
LO G I
BA
M
LA BI
G
N B IS A
V BA A
R A C
PA N EN
G A C C TU
SA SA IN
BU
 TOTAL NUMBER OF ACUTE BLOODY DIARRHEA IN TUBIGON:
2020
14 TOTAL NUMBER OF CASES(ADMITTED): 80
13
12

10

8
8
7 7 7
6

5
4
4
3 3 3 3 3
2
2 2 2
1 1 1 1 1 1 1 1
0
 MONTHLY DISTRIBUTION OF ACUTE BLOODY DIARRHEA CASES
IN TUBIGON: 2020

16
15
14 14

12

10
9 9
8 8

6 6 6

4 4
3 3
2 2
1
0
JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
18
17
16 16 16
15
14 14
13 13
12 12 12
11 11
10 10
9 9 9
8 8 8

6 6 6

4 4
3 3
2 2
1
0
JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
ACUTE ENCEPHALITIS SYNDROME

Suspected case:
 A person with acute onset
of fever and a change in
mental status (confusion,
disorientation, coma, or
inability to talk) and/or new
onset of seizures (excluding
simple febrile seizures)
“Acute encephalitis
syndrome” – other agent:
 A suspected case in which
diagnostic testing was
performed and an etiological
agent other than JE virus is
identified.
“Acute encephalitis
syndrome” – unknown:
 A suspected case in which
testing was performed but no
etiological agent was
identified or in which the test
results were indeterminate.
Probable JE:
 A suspected case that occurs in
close geographic and temporal
relationship to a laboratory-
confirmed case of JE, in the
context of an outbreak.
Laboratory-confirmed Japanese
Encephalitis (JE):
 A suspected case that has been
laboratory-confirmed as JE.
ACUTE HEMORRHAGIC FEVER
SYNDROME
 Any hospitalized person with acute
onset of fever of less than 3 weeks
duration and with any two of the
following:
- hemorrhagic or purpuric rash
- epistaxis (nose bleeding)
- hematemesis (vomiting of blood)
- hemoptysis (coughing out blood)
- blood in stools
- other hemorrhagic symptoms
AND the diagnosis is not Dengue
ACUTE VIRAL HEPATITIS
Suspected case:
 A person with acute illness
characterized by acute jaundice,
dark urine, loss of appetite, body
weakness, extreme fatigue, and
right upper quadrant tenderness.
Probable :
 Not applicable
Confirmed Case:
 A suspected case that is
laboratory confirmed.
BACTERIAL MENINGITIS

Suspected case:
 A person with sudden onset
of fever (≥ 38.5°C rectal or
38°C axillary) and one of
the following signs: neck
stiffness, altered
consciousness and other
meningeal sign.
Probable case:
 A suspected case with CSF
examination showing at least
one of the following: turbid
appearance, leukocytosis
(>100 cells/ mm3),
leukocytosis (10-100 cells/
mm3) AND either an
elevated protein (>100
mg/dl) or decreased glucose
(<40mg/dl)
Confirmed case:
 A suspected case that is
laboratory-confirmed.
 Note: Identified Neisseria
meningitides cases shall be
reported as confirmed
Meningococcal Disease
 CHOLERA
Suspected case:
 Disease unknown in the area: A
person aged 5 years or more with
severe dehydration or who died from
acute watery diarrhea, OR
 Disease endemic in the area: A
person aged 5 years or more with
acute watery diarrhea with or without
vomiting, OR
 In an area where there is a cholera
epidemic: A person with acute watery
diarrhea, with or without vomiting.
Confirmed case:
 A suspected case that is laboratory-
confirmed.
 DENGUE
Suspected Case:
 A person with an acute febrile illness of 2-7 days
duration with 2 or more of the following:
headache, retro-orbital pain, myalgia, arthralgia,
rash, hemorrhagic manifestations, leucopenia.
Probable Case:
 A suspected case with one or more of the
following: Supportive serology (reciprocal
hemagglutination-inhibition antibody titer ≥
1280), comparable IgG EIA titer or positive IgM
antibody test in late acute or convalescent-
phase serum specimen.
Confirmed Case:
 A suspected case that is laboratory confirmed
TYPES:
Dengue Fever (DF) Dengue Shock Syndrome (DSS):
Dengue Hemorrhagic Fever (DHF):  All the above criteria, plus evidence of
 A probable or confirmed case of circulatory failure manifested by rapid
dengue AND Hemorrhagic and weak pulse, and narrow pulse
tendencies evidenced by one or more pressure (20 mm Hg) or hypotension
of the following: for age, cold, clammy skin and altered
 positive tourniquet test, petechiae, mental status.
ecchymoses or purpura, Bleeding:
mucosa, gastrointestinal tract, injection
sites or other hematemesis or melena
AND thrombocytopenia (100,000 cells or
less per mm3)
AND evidence of plasma leakage due to
increased vascular permeability.
 TOTAL NUMBER OF DENGUE CASES ADMITTED: 2019
TOTAL NUMBER OF CASES(ADMITTED): 492
350

328
300

250

200

150

100

50
40 46
32
0 6 9 9 12
1 1 1 2 5
FE O
Y
A
N
O
N
R
O
A
O EN PE T A
A
N
R
IN G
A
O
N
A H BI LO ID N M LA IS Y N G
ET O G IS A R A V BA LA BA BI
G G TI N
D
C
A C A G C A TU
D
A
C
A
SA EN SA IN
BU
 TOTAL NUMBER OF DENGUE CASES IN TUBIGON: 2019
TOTAL NUMBER OF CASES(ADMITTED): 328

45

40 41

35
33
30 31

25 27
25
20

17 18
15 16
15
10 12
9 9 9 10
5 6 6
4 4 4 4 5
2 2 2 2 2 3 3 3
0 1. 1. 1.1
IS IS IS S
A RE
S D IS. N N IS. O A N TE R N G N N O N N N C. T E N N N N R AS R. N
Y N ER I A A A B A E V S A R S U A A A O T R A O A C R O J A JA A S U A O A
N T C R D A W Y C G N Y C O N O I N . C OH
SA BA SA C S A ER BO TA AN NW TA NU LA NO AN -A HA NA ON EN YA TA NO C . NO WA UB UL NG IN AC O T
TA U PA EN O
L IB CA AD P
B A MA LA AN AN LIJ AN CA BU OS C A AY
N
O OO N UI
I A
B
N
A P M PO PO
A L N B IJ W P C TI
BA G TA U E O
M PA
N
N
G
V
IL
L
I T B
C
A AN GE P G
N B O I P
PA A
G
B
 MONTHLY DISTRIBUTION OF DENGUE CASES IN TUBIGON: 2019

60

54
50 49
45
42
40 40
38

30

22
20
16

10 9
8
4
0 1
JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
 TOTAL NUMBER OF DENGUE CASES ADMITTED: 2020
TOTAL NUMBER OF CASES(ADMITTED): 213
200

180 188

160

140

120

100

80

60

40

20

9
0 2 2 3 5
1
DAGOHOY 1
DANAO 1
SAN ISIDRO 1
UBAY SAN ISIDRO DANAO CALAPE INABANGA CLARIN TUBIGON
 TOTAL NUMBER OF DENGUE CASES IN TUBIGON: 2020
TOTAL NUMBER OF CASES(ADMITTED): 188

35

30
30

25 26

20

15
14
10 12
9 9 9 9 9
8 8
5 7 7
5 5
4
3
0 2 2 2 2 2
1 1 1 1
. . S . . S .
N N IS A ES TE IS N N O A IS C N N N N O A R N N G N R TE
A O EV IR
A JA BA C JA A A O TR O A A A O U
C N C O
R N W O ER A O LI
D N Y C
A C H N Y G . S
O
R
N
O A BO N
U A N SA -A B TA C W C N A TA EN A O T O G A N IN
.N
IW A S
PA N U A EN
N O BU PA Y C O N H S O P
O U C LA O N
TA BA O A A
Y M P P O A A
BO
N
EN G O IL EN IJ
A A M L G P C
A
A
W N TI
N C PI
G M V BU IL N
G TA O
N C PA
PA G
BA
 MONTHLY DISTRIBUTION OF DENGUE CASES IN TUBIGON: 2020

60

52 51
50

40 41

30

20 20

10 9
5 4
3 2
0 1 0 0
JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
60

54
52
51
50
49

45
42
40 40 40
38

30

22
20 20

16

10
9
8 8
5
4 4
3
2
1 1
0 0 0
JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER
 DIPTHERIA
Probable case:
 A person with an illness of the upper
respiratory tract characterized by
laryngitis or pharyngitis or tonsillitis, and
adherent membranes on tonsils,
pharynx and/or nose
Confirmed case:
 A probable case that is laboratory
confirmed or linked epidemiologically to
a laboratory confirmed case
Note: Persons with positive Corynebacterium
diphtheriae cultures who do not meet the clinical
description (i.e. asymptomatic carriers) should not
be reported as probable or confirmed diphtheria
cases.
 INFLUENZA-LIKE ILLNESS
Suspected case:
 A person with sudden onset of fever
of ≥ 38°C and cough or sore throat
in the absence of other diagnoses.

Probable case:
 Not applicable

Confirmed case:
 A suspected case that is
laboratory-confirmed (used mainly
in epidemiological investigation
rather than surveillance).
Suspected Human Avian Suspected Severe Acute
Influenza: Respiratory Syndrome
 A suspect ILI case with (SARS) case:
exposure to sudden bird
deaths (sudden bird deaths
 A suspect ILI case with
in two or more households exposure to confirmed SARS
in a barangay or death of at case.
least 3% of commercial
flock increasing twice daily
for 2-3 consecutive days)
OR confirmed human avian
influenza case
 LEPTOSPIROSIS
Suspected case:
 A person who developed acute febrile illness with
headache, myalgia and prostration associated with
any of the following:
 conjunctival suffusion
 meningeal irritation
 anuria or oliguria and/or proteinuria
 Jaundice
 hemorrhages (from the intestines or
lungs)
 cardiac arrhythmia or failure
 skin rash
AFTER exposure to infected animals or an
environment contaminated with animal
urine (e.g. wading in flood waters, rice
fields, drainage).
Confirmed case:
 A suspect case that is laboratory confirmed
 MALARIA
Uncomplicated malaria:
 Signs and symptoms vary; most patients
experience fever. Splenomegaly and anemia
are common associated signs. Common but
non-specific symptoms include otherwise
unexplained headache, back pain, chills,
sweating, myalgia, nausea, vomiting.
Severe malaria:
 Coma, generalized convulsions,
hyperparasitemia, normocytic anemia,
disturbances in fluid, electrolyte, and acid-base
balance, renal failure, hypoglycemia,
hyperpyrexia, hemoglobinuria, circulatory
collapse/shock, spontaneous bleeding
(disseminated intravascular coagulation) and
pulmonary edema.
In areas WITHOUT access to laboratory-based diagnosis:

a. Probable uncomplicated malaria case: A person with signs (fever,

splenomegaly, anemia) and/or symptoms (unexplained headache, back pain,
chills, sweating, myalgia, nausea, vomiting) of malaria who receives anti-malarial
treatment.
b. Probable severe malaria case: A person who requires hospitalization for
symptoms and signs of severe malaria (coma, generalized convulsions, renal
failure, hyperpyrexia, circulatory collapse/shock, spontaneous bleeding, and
pulmonary edema) and receives anti-malarial treatment.
c. Probable malaria death: death of a patient diagnosed with probable severe
malaria
 In areas WITH access to laboratory-based diagnosis:

a. Asymptomatic malaria: A person with no recent history of symptoms and/or signs of

malaria who shows laboratory confirmation of parasitemia.
b. Confirmed uncomplicated malaria case: A person with signs (fever, splenomegaly,
anemia) and/or symptoms (unexplained headache, back pain, chills, sweating, myalgia,
nausea, vomiting) of malaria who receives anti-malarial treatment AND with laboratory
confirmation of diagnosis.
c. Confirmed severe malaria case: A person who requires hospitalization for symptoms and
signs of severe malaria (coma, generalized convulsions, hyperparasitemia, normocytic
anemia, disturbances in fluid, electrolyte, and acid-base balance, renal failure,
hypoglycemia, hyperpyrexia, hemoglobinuria, circulatory collapse/shock, spontaneous
bleeding, disseminated intravascular coagulation, and pulmonary edema) and receives anti-
malarial treatment AND with laboratory confirmation of diagnosis (microscopy or RDT).
d. Confirmed malaria death: death of a patient classified as confirmed severe malaria.
e. Malaria Treatment Failure: A patient with uncomplicated malaria without any clear
symptoms suggesting another concomitant disease who has taken a correct dosage of anti-
malarial treatment, and who presents with clinical deterioration or recurrence of symptoms
within 14 days of the start of treatment, in combination with parasitemia (asexual forms).
NON-NEONATAL TETANUS
Suspected case:
 Not applicable

Probable case:
 Not applicable

Confirmed case:
 Acute onset of hypertonia and/or
painful muscular contractions (usually
muscles of the neck and jaw) and
generalized muscle spasms without
apparent medical cause as reported by
a health care professional.
PERTUSSIS
Suspected case:
 A person with a cough lasting at least 2
weeks with at least one of the following:
– paroxysms (i.e. fits) of coughing
– Inspiratory “whooping”
– post-tussive vomiting (i.e. vomiting
immediately after coughing)
– without other apparent cause
Probable case:
 Not applicable
Confirmed case:
 A suspected case that is laboratory-
confirmed
 TYPHOID & PARATYPHOID FEVER
 Suspected case: A person with an
illness characterized by insidious onset
of sustained fever, headache, malaise,
anorexia, relative bradycardia,
constipation or diarrhea, and non-
productive cough.
 Probable case: A suspected case that
is epidemiologically linked to a
confirmed case in an outbreak or, a
suspected case positive for Typhidot
test.
 Confirmed case: A suspected or
probable case that is laboratory
confirmed.
Remember…
AN OUNCE OF PREVENTION IS
WORTH A POUND OF CURE.

THANK YOU! HAVE A GREAT DAY!