Case definition and European surveillance for COVID-19, as of 2 March 2020

Case definition

For EU level surveillance, ECDC requests EU/EEA countries and the UK to report laboratory-confirmed cases of COVID-19 within 24 hours after identification. This should be done through the Early Warning and Response System (EWRS).

ECDC and the WHO Regional Office for Europe – in collaboration with their surveillance networks in the Member States – are coordinating the rapid reporting of data as requested in the WHO case reporting form.

Case reporting forms will be collected using The European Surveillance System - TESSy.   

Case definition for EU surveillance

Suspected case requiring diagnostic testing (not to be reported at the European level)

Laboratory testing for COVID-19 should be performed for suspected cases according to the following criteria, based on the updated WHO case definition:

1) a patient with acute respiratory tract infection (sudden onset of at least one of the following: cough, fever, shortness of breath) AND with no other aetiology that fully explains the clinical presentation AND with a history of travel or residence in a country/area reporting local or community transmission* during the 14 days prior to symptom onset;

OR

2) a patient with any acute respiratory illness AND having been in close contact with a confirmed or probable COVID-19 case in the last 14 days prior to onset of symptoms;

OR

3) A patient with severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease (e.g., cough, fever, shortness breath)) AND requiring hospitalisation (SARI) AND with no other aetiology that fully explains the clinical presentation.

* according to WHO classification, see respective daily updated Coronavirus disease (COVID-2019) situation reports at  https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/

However, once local or community transmission has been reported in the country or area, all patients presenting with symptoms of acute respiratory infection in primary care or the accident and emergency department of a hospital (first contact with the healthcare system) will be considered as suspected cases.

Probable case 

A suspected case for whom testing for virus causing COVID-19 is inconclusive (according to the test results reported by the laboratory) or for whom testing was positive on a pan-coronavirus assay. 

Confirmed case 

A person with laboratory confirmation of virus causing COVID-19 infection, irrespective of clinical signs and symptoms 

Definition of close contact for the purpose of the case definition

Close contact of a probable or confirmed case is defined as:

  • A person living in the same household as a COVID-19 case;
  • A person having had direct physical contact with a COVID-19 case (e.g. shaking hands);
  • A person having unprotected direct contact with infectious secretions of a COVID-19 case (e.g. being coughed on, touching used paper tissues with a bare hand);
  • A person having had face-to-face contact with a COVID-19 case within 2 metres and > 15 minutes;
  • A person who was in a closed environment (e.g. classroom, meeting room, hospital waiting room, etc.) with a COVID-19 case for 15 minutes or more and at a distance of less than 2 metres;
  • A healthcare worker (HCW) or other person providing direct care for a COVID-19 case, or laboratory workers handling specimens from a COVID-19 case without recommended personal protective equipment (PPE) or with a possible breach of PPE;
  • A contact in an aircraft sitting within two seats (in any direction) of the COVID-19 case, travel companions or persons providing care, and crew members serving in the section of the aircraft where the index case was seated (if severity of symptoms or movement of the case indicate more extensive exposure, passengers seated in the entire section or all passengers on the aircraft may be considered close contacts).

The epidemiological link to a probable or confirmed case may have occurred within a 14‐day period before the onset of illness in the suspected case under consideration.

Laboratory support for COVID-19 in the EU/EEA

Laboratory support (for primary/and or confirmatory testing) by Coronavirus specialised laboratories in the EU