Annex

The following wording is inserted in the Annex to Decision 2002/253/EC:

‘NOVEL INFLUENZA VIRUS A(H1N1) (THE SO-CALLED SWINE INFLUENZA VIRUS A(H1N1) AND MEXICAN INFLUENZA VIRUS)^f1

Clinical criteria

Any person with one of the following three:

• fever > 38 °C AND signs and symptoms of acute respiratory infection,

• pneumonia (severe respiratory illness),

• death from an unexplained acute respiratory illness.

Laboratory criteria

At least one of the following tests:

• RT-PCR,

• viral culture (requiring BSL 3 facilities),

• four-fold rise in novel influenza virus A(H1N1) specific neutralising antibodies (implies the need for paired sera, from acute phase illness and then at convalescent stage 10-14 days later minimum).

Epidemiological criteria

At least one of the following three in the seven days before disease onset:

• a person who was a close contact to a confirmed case of novel influenza A(H1N1) virus infection while the case was ill,

• a person who has travelled to an area where sustained human-to-human transmission of novel influenza A(H1N1) is documented,

• a person working in a laboratory where samples of the novel influenza A(H1N1) virus are tested.

Case classification

A.

Case under investigation

Any person meeting the clinical and epidemiological criteria.

B.

Probable case

Any person meeting the clinical AND epidemiological criteria AND with a laboratory result showing positive influenza A infection of an unsubtypable type.

C.

Confirmed case

Any person meeting the laboratory criteria for confirmation.’.