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close this bookWHO Recommended Surveillance Standards (WHO; 1999; 157 pages)
View the documentAcknowledgements
View the documentAcronyms
View the documentIntroduction
View the documentNational Coordination of Communicable Disease Surveillance
View the documentExplanatory notes
View the documentSurveillance activities: criteria and WHO Department
View the documentCommunicable disease contacts in Regional Offices
close this folderDiseases
View the documentB20-B21-B22-B23-B24 AIDS
View the documentA22 Anthrax
View the documentA23 Brucellosis
View the documentA00 Cholera
View the documentA81.0 Creutzfeldt-Jakob disease
View the documentA90, A91 Dengue fever (A90) including Dengue haemorrhagic fever (DHF) & Dengue shock syndrome (DSS, A91)
View the documentA36 Diphtheria
View the documentB72 Dracunculiasis (Guinea worm disease)
View the documentA98.3, A98.4 Ebola-Marburg viral diseases
View the documentA83.0 Japanese encephalitis
View the documentB74 Lymphatic filariasis
View the documentB96.3 Haemophilus influenzae type b
View the documentB15-B17 Acute viral hepatitis
View the documentB20-B24 HIV infection
View the documentJ10, J11 Influenza
View the documentA96.2 Lassa fever
View the documentA48.1 Legionellosis
View the documentB55.1, B55.2 Cutaneous leishmaniasis
View the documentLeishmania / HIV co-infections
View the documentB55.0 Visceral leishmaniasis
View the documentA30 Leprosy
View the documentA27 Leptospirosis
View the documentB50-54 Malaria
View the documentB05 Measles
View the documentA39 Meningococcal disease
View the documentA87 Viral meningitis
View the documentB73 Onchocerciasis
View the documentA37.0 Pertussis
View the documentA20 Plague
View the documentA36 Poliomyelitis
View the documentA82 Rabies
View the documentA02.0 Salmonellosis
View the documentB65 Schistosomiasis
View the documentA50-52 Syphilis
View the documentA33 Tetanus, neonatal
View the documentB56-0, B56-1 African trypanosomiasis
View the documentB57 American trypanosomiasis
View the documentA15-A19 Tuberculosis
View the documentA75.3 Scrub typhus
View the documentA95.9 Yellow fever
open this folder and view contentsSyndromes
View the documentAnnex 1 Software free and in the public domain
View the documentAnnex 2 Proposed surveillance definitions
View the documentAnnex 3 Role and use of Geographic Information Systems (GIS) and mapping for epidemiological surveillance

A87 Viral meningitis


Viral meningitis occurs sporadically and also as an epidemic disease. Case-fatality rates are generally low; infection may have potential long-term sequelae in those affected (mostly children), but the disease is rarely severe and recovery is usually complete. The early detection of epidemics through epidemiological surveillance allows for identification of the causal agent and the institution of targeted control measures and effective case management.


Clinical case definition

A case with fever 38.5°C and one or more of the following:


• neck stiffness
• severe unexplained headache
• neck pain and 2 or more of the following


• photophobia
• nausea
• vomiting
• abdominal pain
• pharyngitis with exudates

For children <2 years of age a case is defined as


• A case with fever 38.5°C and one or more of the following


• irritability
• bulging fontanelle

Laboratory criteria for confirmation

The specific virus confirmed on cell culture.

Case classification

Suspected: A case that meets the clinical case definition.

Suspected: A suspected case with one or more of the following:


• normal CSF glucose and normal or mild increase in CSF protein (>50mg/dl), moderate increase CSF cells (<500/mm3) and lymphocyte predominance (>50%)

• CSF Positive for viral genomic sequences using PCR (Polymerase Chain Reaction)

• Epidemiological link to a confirmed case

Confirmed: A suspected or probable case with laboratory confirmation.


At peripheral level individual patient records should be maintained.

Immediate reporting of all suspected or probable cases from peripheral level to intermediate level and central level.

All cases must be investigated. Follow-up data on identified organism and patient outcome to be sought by the intermediate and central level.

Routine weekly reporting of aggregated or case-based data from intermediate to central level.

A parallel surveillance using reference laboratories for viral diseases may provide more detailed virological data on specific causal agents on a national basis; these are very useful for epidemiological analysis.



Case-based data for individual patient record and for reporting


• Case classification (suspect/probable/confirmed), unique identifier, age, sex, geographical information, date of onset, date of consultation, treatment received

Aggregated data for reporting


• Case by case classification (suspect/probable/confirmed), age group, week, geographical area, and outcome


Isolate-based data for reporting


• Unique identifier, age, sex, date of onset, date of specimen, specimen type, organism identified

Aggregated data for reporting


Cases by age group, specimen type, organism identified


Incidence by week, month, geographical area, age group, outcome.



• To detect and control epidemics of viral meningitis as early as possible
• To strengthen the capacity for emergency response to epidemics of viral meningitis




Regional Offices

See Regional Communicable Disease contacts on section "Communicable disease contacts in Regional Offices".

Headquarters: 20 Avenue Appia, CH-1211 Geneva 27, Switzerland

Communicable Diseases Surveillance and Response (CSR)


E-mail: tikhomirove@who.ch / outbreak@who.ch
Tel: (41 22) 791 2656/2850/2111
Fax: (41 22) 791 4878/0746 attn CSR
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