Canada Communicable Disease Report

1 January 2008

Volume 34

Number 01


Final Report and Recommendations from the National Notifiable Diseases Working Group

Vol. 32, No. 19, 1 October 2006

Since the publication of the report entitled "Final Report and Recommendations from the National Notifiable Diseases Working Group"(1) in the October 2006 issue of the Canada Communicable Disease Report (CCDR), three errors have been noted that require correction.

The first error is in regard to the status of dengue (dengue virus infection and dengue hemorrhagic fever) as a notifiable disease in Canada. In the Key Recommendations section of the report (1), item no. 3 (p. 211) states that “Dengue virus infection should be deleted from the Nationally Notifiable Disease List (Dengue hemorrhagic fever should continue to be reported)”. It should be pointed out that neither dengue virus infection nor dengue hemorrhagic fever have ever been included in previously published Canadian National Notifiable Diseases lists(2,3).

The second error is in regard to the indication of "reportable to WHO" for several diseases listed in Table 1 (pp. 212-213)(1). In this table, it is stated that communicable diseases including anthrax, botulism, cholera, influenza (new subtype), invasive meningococcal disease, plague (pneumonic), poliomyelitis (wild type), SARS, smallpox, tularaemia, viral hemorrhagic fevers and yellow fever are reportable to the WHO. According to the 1969 International Health Regulations (IHRs)(4,5) only cholera, plague and yellow fever are notifiable, meaning Member States are required to notify the WHO if and when the diseases occur in their territory. However, obligations under the IHR's (1969) were replaced on June 15, 2007, with new obligations under the revised IHR's (2005)(6,7). For example, Annex 2 of the IHR's (2005) indicates the WHO shall be notified of the following four diseases regardless of the number of cases: smallpox, poliomyelitis (wild type), influenza (new subtype), and SARS. Further, an event involving the following communicable diseases shall always lead to the utilization of the algorithm reflected in Annex 2: cholera, pneumonic plague, yellow fever, viral haemorrhagic fevers (Ebola, Lassa, Marburg), West Nile fever; and other diseases that are of special national or regional concern (i.e. dengue fever, rift valley fever, and meningococcal disease). The algorithm is a decision instrument for the assessment and notification of events that may constitute a public health emergency of international concern. If the algorithm renders a positive outcome ("yes"), then the event shall be notified to the WHO under the IHR's (2005). In the interest of good public health practice, the decision of whether or not to report other communicable diseases (i.e. anthrax, botulism and tularaemia) should also be determined by employing the algorithm in Annex 2.

The third error is in regard to chlamydial infection. National surveillance is conducted on all cases of Chlamydia trachomatis infection (genital and extra genital across different age groups). Hence, “Chlamydia, Genital”, which is listed in Table 1 (p. 212)(1) and Table 2 (p.215)(1), should be written as “Chlamydia trachomatis Infection”.

It should also be emphasized that the October 2006 report in CCDR(1) presents recommendations made by the National Notifiable Diseases Working Group and that the revised list of nationally notifiable diseases will take effect upon publication of the associated case definitions. The process to review the case definitions is currently underway and these case definitions (along with any further changes to the list) will be published in 2008.


  1. Doherty J-A. Final Report and Recommendations from the National Notifiable Diseases Working Group. CCDR 2006;32(19):211-25.
  2. Advisory Committee on Epidemiology and the Division of Disease Surveillance, Bureau of Infectious Diseases, Laboratory Centre for Disease Control. Case Definitions for Diseases Under National Surveillance. CCDR 2000;26S3:1-133.
  3. Case Definitions for Diseases Under National Surveillance: Addition of Diseases Associated With Potential Bioterrorist Agents. CCDR 2002;28(21):173-78.
  4. Gostin LO. International infectious disease law. Revision of the World Health Organization's International Health Regulations. JAMA 2004;291(21):2623-27.
  5. World Health Organization (1983). International Health Regulations (1969). 3rd annotated edition. Downloaded from in June 8, 2007.
  6. World Health Organization (2005). Fifty-eighth World Health Assembly. Resolution WHA58.3:revision of the International Health Regulations. Downloaded from in June 8, 2007.
  7. Rodier G, Hardiman M, Plotkin B and Ganter B. Implementing the International Health regulations (2005) in Europe. Eurosurveillance. 2006;10-12:208-11.

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