
Article 1 
The Annex to Decision 2002/253/EC is completed by the additional case definition contained in the Annex to the present Decision.
Article 2 
This Decision is addressed to the Member States.
Done at Brussels, 30 April 2009.
For the Commission
Androulla VASSILIOU
Member of the Commission
ANNEX

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

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).

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.
 A. 
Any person meeting the clinical and epidemiological criteria.
 B. 
Any person meeting the clinical AND epidemiological criteria AND with a laboratory result showing positive influenza A infection of an unsubtypable type.
 C. 
Any person meeting the laboratory criteria for confirmation.
'.
