The Ministry of Health recently updated the case definitions for infection with the new coronavirus, or the declaration of some people as suspected of infection, a document of the INSP stipulating all this new information for Romanians.
The Ministry of Health lists below all the information regarding the case definitions, and it would be good to look carefully to know what each one entails, and what situation you are in, depending on how you feel, or get in touch with certain people.
"Suspicious case
Anyone with acute respiratory infection (sudden onset with at least one of the following symptoms: cough, fever, difficulty in breathing (shortness of breath) / Anyone with pneumonia, bronchopneumonia +/- pleurisy / Anyone with severe acute respiratory infection (SARS) (fever or history of fever AND cough AND difficulty breathing (shortness of breath) AND requiring
overnight hospitalization)
For children up to 16 years of age who present gastrointestinal symptoms (vomiting, diarrhea) not associated with food, infection with SARS-CoV-2 can be suspected.
Definitions of community-acquired COVID-19 or IAAM
A COVID-19 case can be community-acquired or healthcare-associated (IAAM), depending on:
– the number of days prior to the date of onset or confirmation in the laboratory, after the date of hospitalization in a health facility (hospital, dialysis center), long-term residential center (day 1);
– the arguments from the epidemiological investigation regarding the community origin or IAAM (belonging of the case to outbreaks of infections with one or another of the origins)
The following situations may exist:
Community COVID-19 case
– symptoms present at admission or onset in the first 48 hours after admission;
– onset on days 3-7 after hospitalization and a strong suspicion of community transmission (belonging to an outbreak of community cases)
Healthcare-Associated Case of COVID-19 (IAAM)
– onset after 48 hours of admission and a strong suspicion of healthcare-associated transmission
- the cases of medical and sanitary personnel and auxiliary, if there are no strong arguments in favor of a community transmission
Cases with onset in the first 14 days after discharge from a health facility can be:
– IAAM, if the onset occurs within the first 48 hours after discharge
- with uncertain origin, in case of onset 3-14 days after discharge, if there are no strong arguments in favor of a community origin or IAAM.
Assignment to one transmission category or another should be made after a careful evaluation of each case.
Confirmed case
A person with laboratory confirmation of SARS-CoV-2 infection, regardless of clinical signs and symptoms.
Direct contact is defined as:
– Person who lives in the same household as a patient with COVID-19;
– Person who had direct physical contact with a case of COVID-19 (e.g. shaking hands without subsequent hand hygiene);
– Person who had unprotected direct contact with infectious secretions of a case of COVID-19 (e.g. during coughing, touching handkerchiefs with an unprotected hand
glove);
- Person who had face-to-face contact with a case of COVID-19 at a distance of less than 2 m and for a minimum of 15 minutes;
– Person who was in the same room (e.g. classroom, meeting room, hospital waiting room) with a case of COVID-19, for at least 15 minutes and at a distance of less than 2 m;
– A health care worker or other person who provides direct care to a patient with COVID-19 or a laboratory worker who handles samples collected from a patient with COVID-19 without wearing the correct protective equipment
The epidemiological link could have occurred in the 14-day period prior to the onset date.
Death of a confirmed patient with COVID-19
Death with COVID-19 is defined as death occurring in a confirmed patient with COVID-19, except in situations where there is another clear cause of death that cannot be related to COVID-19 (e.g. trauma, major acute hemorrhage, etc) and in which there was no period of complete recovery between the illness and the time of death.
Death in a patient with confirmed COVID-19 cannot be attributed to a pre-existing disease (eg, cancer, hematological disorders, etc.) and COVID-19 should be reported as the cause of death, independent of suspected pre-existing medical conditions have favored the severe evolution of COVID-19."
