Interim national case definition: Coronavirus disease (COVID-19)

Last Updated: April 2, 2020

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A. Preamble

At this time, the primary surveillance objective for COVID-19, is the detection of cases and identification of outbreaks in Canada. The secondary objective is to characterize the clinical and epidemiologic features of COVID-19 in order to better inform prevention and control efforts.

This document outlines surveillance case definitions for COVID-19 and provides instructions on reporting to the national level. Detailed information on detecting and reporting COVID-19 cases in Canada can be found in the Interim National Surveillance Guidelines for Coronavirus Disease (COVID-19).

Surveillance case definitions are provided for the purpose of standardized case classification and reporting to the Public Health Agency of Canada. They are based on the current level of epidemiological evidence and uncertainty, and public health response goals, and are subject to change as new information becomes available.

These surveillance case definitions are not intended to replace clinician or public health practitioner judgment in individual patient management, or intended to be used for the purpose of infection control triage.

Tests specific for COVID-19 can be performed in select laboratories (i.e. some provincial public health, hospital-based and community laboratories). During early stages of testing (e.g. until 10 positive specimens are encountered at an individual laboratory), conclusive diagnosis requires confirmation by Canada's National Microbiology Laboratory (NML) or a provincial public health laboratory by nucleic acid amplification tests (NAAT). Patients under investigation who meet the probable case definition remain so pending confirmation.

B. National surveillance case definitions for COVID-19

Provincial/Territorial public health authorities should report confirmed and probable cases of COVID-19 nationally to the Public Health Agency of Canada within 24 hours of their own notification.

Suspect case

A person with symptoms that include two or more of:

And

Note: COVID-19 may present as a co-infection with other pathogens.  At this time, the identification of one causative agent should not exclude COVID-19 where the index of suspicion Footnote 3 may be high.

Probable

A person (who has had a laboratory test):

Or

A person (who has not had a laboratory test):

Notes:

Confirmed

A person with laboratory confirmation of infection with the virus that causes COVID-19 performed at a community, hospital or reference laboratory (NML or a provincial public health laboratory) running a validated assay. This consists of detection of at least one specific gene target by a NAAT assay (e.g. real-time PCR or nucleic acid sequencing).

Notes:

C. Exposure criteria

In the 14 daysFootnote 1 before onset of illness, a person who:

Or

Or

Or

D. Mechanism of reporting

Notification of Confirmed and Probable cases can be made to phac.hsfluepi.aspc@canada.ca during regular business hours (8:00am - 5:00pm ET). After regular business hours please contact the Public Health Agency of Canada's Health Portfolio Operations Centre (HPOC) Watch Office by phone (1-800-545-7661) or through the single window email: phac-aspc.hpoc-cops@canada.ca.

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