COVID Exposure, Suspected and Confirmed Definitions

References

  1. “Coronavirus Disease 2019 (COVID-19) | 2020 Interim Case Definition, Approved April 5, 2020.” Accessed May 26, 2021. https://wwwn.cdc.gov/nndss/conditions/coronavirus-disease-2019-covid-19/case-definition/2020/
  2. CDC. “Health Departments.” Centers for Disease Control and Prevention, February 11, 2020. https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/appendix.html.
  3. CDC. "Interim Guidance for Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19." Accessed May 26, 2021. https://www.cdc.gov/coronavirus/2019-ncov/downloads/critical-workers-implementing-safety-practices.pdf
  4. “Contact Tracing in the Context of COVID-19.” Accessed May 26, 2021. https://www.who.int/publications-detail-redirect/contact-tracing-in-the-context-of-covid-19.
  5. “Public Health Surveillance for COVID-19: Interim Guidance.” Accessed May 26, 2021. https://www.who.int/publications-detail-redirect/who-2019-nCoV-surveillanceguidance-2020.8.


Definitions


Data ElementDefinition
COVID Suspected

WHO

Suspected case of SARS-CoV-2 infection (three options, A through C):


A. A person who meets the clinical AND epidemiological criteria:


Clinical criteria:

  1. Acute onset of fever AND cough;

OR

  1. Acute onset of ANY THREE OR MORE of the following signs or symptoms: fever, cough, general weakness/fatigue,1 headache, myalgia, sore throat, coryza, dyspnea, anorexia/nausea/vomiting, diarrhea, altered mental status.

AND


Epidemiological criteria:  


  1. Residing or working in a setting with high risk of transmission of the virus: for example, closed residential settings and humanitarian settings, such as camp and camp like settings for displaced persons, any time within the 14 days before symptom onset;

OR

  1. Residing in or travel to an area with community transmission anytime within the 14 days before symptom onset;

OR

  1. Working in health setting, including within health facilities and within households, anytime within the 14 days before symptom onset.


B. A patient with severe acute respiratory illness (SARI: acute respiratory infection with history of fever or measured fever of ≥ 38 C°; and cough; with onset within the last 10 days; and who requires hospitalization).


C. An asymptomatic person not meeting epidemiologic criteria with a positive SARS-CoV-2 antigen-detecting rapid diagnostic test (Ag-RDT).

COVID Exposure

CDC

One or more of the following exposures in the 14 days before onset of symptoms:

  1. Close contact** with a confirmed or probable case of COVID-19 disease; OR
  2. Close contact** with a person with:
    • clinically compatible illness AND
    • linkage to a confirmed case of COVID-19 disease.
  3. Travel to or residence in an area with sustained, ongoing community transmission of SARS-CoV-2.
  4. Member of a risk cohort as defined by public health authorities during an outbreak.

**Close contact is defined as being within 6 feet for at least a period of 10 minutes to 30 minutes or more depending upon the exposure. In healthcare settings, this may be defined as exposures of greater than a few minutes or more. Data are insufficient to precisely define the duration of exposure that constitutes prolonged exposure and thus a close contact.


WHO

A person who has experienced any one of the following exposures during the 2 days before and the 14 days after the onset of symptoms of a probable or confirmed case: 

  1. Face-to-face contact with a probable or confirmed case within 1 meter and for at least 15 minutes
  2. Direct physical contact with a probable or confirmed case
  3. Direct care for a patient with probable or confirmed COVID-19 disease without the use of recommended personal protective equipment

OR

  1. Other situations as indicated by local risk assessments
COVID Confirmed

CDC

Clinical Criteria

At least two of the following symptoms: fever (measured or subjective), chills, rigors, myalgia, headache, sore throat, new olfactory and taste disorder(s)

OR

At least one of the following symptoms: cough, shortness of breath, or difficulty breathing

OR

Severe respiratory illness with at least one of the following:

  • Clinical or radiographic evidence of pneumonia, OR
  • Acute respiratory distress syndrome (ARDS).

AND

No alternative more likely diagnosis

Laboratory Criteria

Laboratory evidence using a method approved or authorized by the U.S. Food and Drug Administration (FDA) or designated authority:

Confirmatory laboratory evidence:

  • Detection of severe acute respiratory syndrome coronavirus 2 ribonucleic acid (SARS-CoV-2 RNA) in a clinical specimen using a molecular amplification detection test

Presumptive laboratory evidence:

  • Detection of specific antigen in a clinical specimen
  • Detection of specific antibody in serum, plasma, or whole blood indicative of a new or recent infection*

*Serologic methods for diagnosis are currently being defined.


WHO

Confirmed case of SARS-CoV-2 infection (three options, A through C):

 

  1. A person with a positive Nucleic Acid Amplification Test (NAAT)
  2. A person with a positive SARS-CoV-2 Ag-RDT AND meeting either the probable case definition or suspected criteria A OR B
  3. An asymptomatic person with a positive SARS-CoV-2 Ag-RDT AND who is a contact of a probable or confirmed case.

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