Example syndrome definitions:

Example 1:
{
  "title": "Open Syndrome Confirmed Case of Cholera",
  "description": "Laboratory confirmation with positive fecal culture for toxigenic Vibrio cholerae O1 or O139",
  "scope": "specific",
  "category": "confirmed",
  "version": "1.0.0",
  "open_syndrome_version": "1.0.0",
  "published_in": "https://opensyndrome.org",
  "published_at": "2025-02-27T16:16:26Z",
  "published_by": [
    "Open Syndrome Initiative"
  ],
  "location": "Colombia",
  "language": "English",
  "organization": "Instituto Nacional de Salud",
  "inclusion_criteria": [
    {
      "type": "criterion",
      "name": "Confirmation by Laboratory with Positive Culture of Stool",
      "logical_operator": "OR",
      "values": [
        {
          "type": "diagnostic_test",
          "name": "Confirmation by Laboratory with Positive Culture of Stool for Vibrio cholerae O1"
        },
        {
          "type": "diagnostic_test",
          "name": "Confirmation by Laboratory with Positive Culture of Stool for O139 Toxigenic"
        }
      ]
    }
  ],
  "references": [
    {
      "citation": "Colombia. Instituto Nacional de Salud. Protocolo de Vigilancia\nen Salud P\u00fablica de C\u00f3lera. versi\u00f3n 4. [Internet] 2022.\nhttps://doi.org/10.33610/infoeventos.5",
      "url": "https://www.ins.gov.co/buscador-eventos/Lineamientos/Pro_C%C3%B3lera.pdf"
    }
  ],
  "notes": [
    "Human-readable definition was automatically translated from Spanish to English."
  ],
  "status": "draft",
  "human_readable_definition": "This is a suspect case that meets any of the following criteria.\n   Confirmation by laboratory with positive stool culture for toxigenic Vibrio cholerae O1 or O139.\n   Confirmation by epidemiological link:\n    \u2022 Individual who fits the definition of a suspect case, and has history of contact with a confirmed cholera patient within a period of five days\n    \u2022 or a history of active circulation of V. cholerae serotype O1 or O139 toxigenic in the workplace or residence of the case.\n   An area of active circulation is considered one where toxigenic Vibrio cholerae O1 or O139 has been isolated from biological or environmental samples (water, food or food remains).",
  "target_public_health_threats": [
    "Cholera"
  ],
  "keywords": [
    "Latin America",
    "Cholera"
  ],
  "definition_type": "case_definition"
}

Example 2:
{
  "title": "Open Syndrome Dengue",
  "description": "Case definition for dengue surveillance based on chief complaints and multiple diagnostic coding systems",
  "scope": "broad",
  "category": "suspected",
  "version": "1.0.0",
  "open_syndrome_version": "1.0.0",
  "published_in": "https://opensyndrome.org",
  "published_at": "2025-01-29T12:00:00Z",
  "published_by": [
    "Open Syndrome Initiative"
  ],
  "location": "United States",
  "language": "English",
  "organization": "CDC",
  "inclusion_criteria": [
    {
      "type": "criterion",
      "logical_operator": "OR",
      "values": [
        {
          "type": "diagnosis",
          "name": "Dengue in chief complaint",
          "description": "Dengue word in chief complaint field",
          "operator": "regex",
          "regex_pattern": "dengue",
          "regex_flags": "i"
        },
        {
          "type": "diagnosis",
          "name": "Dengue fever",
          "description": "Dengue fever (A90) or Dengue hemorrhagic fever (A91)",
          "code": {
            "system": "ICD-10",
            "code": "A90"
          }
        },
        {
          "type": "diagnosis",
          "name": "Dengue hemorrhagic fever",
          "code": {
            "system": "ICD-10",
            "code": "A91"
          }
        },
        {
          "type": "diagnosis",
          "name": "Dengue",
          "code": {
            "system": "ICD-9",
            "code": "061",
            "display": "Dengue"
          }
        },
        {
          "type": "diagnosis",
          "name": "Dengue",
          "code": {
            "system": "SNOMED-CT",
            "code": "38362002",
            "display": "Dengue"
          }
        },
        {
          "type": "diagnosis",
          "name": "Severe Dengue",
          "code": {
            "system": "SNOMED-CT",
            "code": "20927009",
            "display": "Severe Dengue"
          }
        },
        {
          "type": "diagnosis",
          "name": "Dengue shock syndrome",
          "code": {
            "system": "SNOMED-CT",
            "code": "409671005",
            "display": "Dengue shock syndrome"
          }
        },
        {
          "type": "diagnosis",
          "name": "Myelitis caused by Dengue virus",
          "code": {
            "system": "SNOMED-CT",
            "code": "866057003",
            "display": "Myelitis caused by Dengue virus"
          }
        },
        {
          "type": "diagnosis",
          "name": "Encephalitis caused by Dengue virus",
          "code": {
            "system": "SNOMED-CT",
            "code": "1163101003",
            "display": "Encephalitis caused by Dengue virus"
          }
        }
      ]
    }
  ],
  "references": [
    {
      "citation": "Dengue Case Definition v1",
      "url": "https://knowledgerepository.syndromicsurveillance.org/dengue-v1"
    }
  ],
  "notes": [
    "Case definition based on Chief Complaint Discharge Diagnosis (CCDD) parsed field",
    "No exclusion terms or codes are used in this query"
  ],
  "status": "draft",
  "human_readable_definition": "",
  "target_public_health_threats": [
    "Dengue"
  ],
  "keywords": [
    "Dengue",
    "North America",
    "Arbovirus"
  ],
  "definition_type": "case_definition"
}

Example 3:
{
  "title": "Open Syndrome Acute Intussusception in infants",
  "description": "Case definition for acute intussusception in infants",
  "scope": "specific",
  "category": "suspected",
  "version": "1.0.0",
  "open_syndrome_version": "1.0.0",
  "published_in": "https://opensyndrome.org",
  "published_at": "2025-01-29T12:00:00Z",
  "published_by": [
    "Open Syndrome Initiative"
  ],
  "location": "Vietnam",
  "language": "English",
  "organization": "Vietnam Ministry of Health",
  "inclusion_criteria": [
    {
      "type": "criterion",
      "logical_operator": "OR",
      "values": [
        {
          "type": "criterion",
          "logical_operator": "AT_LEAST",
          "logical_operator_arguments": [
            2
          ],
          "values": [
            {
              "type": "criterion",
              "name": "Evidence of intestinal obstruction",
              "logical_operator": "AND",
              "values": [
                {
                  "type": "symptom",
                  "name": "bile-stained vomiting"
                },
                {
                  "type": "criterion",
                  "logical_operator": "OR",
                  "values": [
                    {
                      "type": "symptom",
                      "name": "examination findings of acute abdominal distension and abnormal or absent bowel sounds"
                    },
                    {
                      "type": "symptom",
                      "name": "fluid levels and dilated bowel loops on plain abdominal radiograph"
                    }
                  ]
                }
              ]
            },
            {
              "type": "criterion",
              "name": "Features of intestinal invagination",
              "logical_operator": "AT_LEAST",
              "logical_operator_arguments": [
                1
              ],
              "values": [
                {
                  "type": "symptom",
                  "name": "abdominal mass"
                },
                {
                  "type": "symptom",
                  "name": "rectal mass"
                },
                {
                  "type": "symptom",
                  "name": "intestinal prolapse"
                },
                {
                  "type": "diagnostic_test",
                  "name": "plain abdominal radiograph showing a visible intussusceptum or soft tissue mass"
                },
                {
                  "type": "diagnostic_test",
                  "name": "abdominal ultrasound showing a visible intussusceptum or soft tissue mass"
                },
                {
                  "type": "diagnostic_test",
                  "name": "abdominal CT scan showing a visible intussusceptum or soft tissue mass"
                }
              ]
            },
            {
              "type": "criterion",
              "name": "Evidence of intestinal vascular compromise",
              "logical_operator": "OR",
              "values": [
                {
                  "type": "symptom",
                  "name": "blood per rectum"
                },
                {
                  "type": "symptom",
                  "name": "stool containing red currant jelly material"
                },
                {
                  "type": "symptom",
                  "name": "blood on rectal examination"
                }
              ]
            }
          ]
        },
        {
          "type": "criterion",
          "logical_operator": "AND",
          "values": [
            {
              "type": "criterion",
              "logical_operator": "AT_LEAST",
              "logical_operator_arguments": [
                1
              ],
              "values": [
                {
                  "type": "criterion",
                  "name": "Evidence of intestinal obstruction",
                  "logical_operator": "AND",
                  "values": [
                    {
                      "type": "symptom",
                      "name": "bile-stained vomiting"
                    },
                    {
                      "type": "criterion",
                      "logical_operator": "OR",
                      "values": [
                        {
                          "type": "symptom",
                          "name": "examination findings of acute abdominal distension and abnormal or absent bowel sounds"
                        },
                        {
                          "type": "symptom",
                          "name": "fluid levels and dilated bowel loops on plain abdominal radiograph"
                        }
                      ]
                    }
                  ]
                },
                {
                  "type": "criterion",
                  "name": "Features of intestinal invagination",
                  "logical_operator": "AT_LEAST",
                  "logical_operator_arguments": [
                    1
                  ],
                  "values": [
                    {
                      "type": "symptom",
                      "name": "abdominal mass"
                    },
                    {
                      "type": "symptom",
                      "name": "rectal mass"
                    },
                    {
                      "type": "symptom",
                      "name": "intestinal prolapse"
                    },
                    {
                      "type": "diagnostic_test",
                      "name": "plain abdominal radiograph showing a visible intussusceptum or soft tissue mass"
                    },
                    {
                      "type": "diagnostic_test",
                      "name": "abdominal ultrasound showing a visible intussusceptum or soft tissue mass"
                    },
                    {
                      "type": "diagnostic_test",
                      "name": "abdominal CT scan showing a visible intussusceptum or soft tissue mass"
                    }
                  ]
                },
                {
                  "type": "criterion",
                  "name": "Evidence of intestinal vascular compromise",
                  "logical_operator": "OR",
                  "values": [
                    {
                      "type": "symptom",
                      "name": "blood per rectum"
                    },
                    {
                      "type": "symptom",
                      "name": "stool containing red currant jelly material"
                    },
                    {
                      "type": "symptom",
                      "name": "blood on rectal examination"
                    }
                  ]
                }
              ]
            },
            {
              "type": "criterion",
              "name": "Evidence of intestinal vascular compromise",
              "logical_operator": "AT_LEAST",
              "logical_operator_arguments": [
                3
              ],
              "values": [
                {
                  "type": "criterion",
                  "name": "Predisposing factors: age <1 year and male sex",
                  "logical_operator": "AND",
                  "values": [
                    {
                      "type": "demographic_criteria",
                      "name": "Less than one year old",
                      "attribute": "age",
                      "operator": "<=",
                      "value": 1,
                      "unit": "years"
                    },
                    {
                      "type": "demographic_criteria",
                      "name": "Male gender",
                      "attribute": "gender",
                      "operator": "==",
                      "value": "male"
                    }
                  ]
                },
                {
                  "type": "symptom",
                  "name": "abdominal pain"
                },
                {
                  "type": "symptom",
                  "name": "vomiting"
                },
                {
                  "type": "symptom",
                  "name": "lethargy"
                },
                {
                  "type": "symptom",
                  "name": "pallor"
                },
                {
                  "type": "symptom",
                  "name": "hypovolemic shock"
                },
                {
                  "type": "diagnostic_test",
                  "name": "Plain abdominal radiograph showing an abnormal but non-specific bowel gas pattern",
                  "value": "abnormal but non-specific bowel gas pattern"
                }
              ]
            }
          ]
        }
      ]
    }
  ],
  "references": [
    {
      "citation": "Validation of clinical case definition of acute intussusception in infants in Viet Nam and Australia",
      "url": "https://iris.who.int/handle/10665/269695"
    }
  ],
  "status": "draft",
  "human_readable_definition": "Level 1 of diagnostic certainty\nSurgical criteria:\nThe demonstration of invagination of the intestine at surgery;\nand/or\nRadiological criteria:\nThe demonstration of invagination of the intestine by either air or liquid contrast enema;\nor\nThe demonstration of an intra-abdominal mass by abdominal ultrasound with specific characteristic featuresb that is proven to be reduced by\nhydrostatic enema on post-reduction ultrasound;\nand/or\nAutopsy criteria:\nThe demonstration of invagination of the intestine.\nLevel 2 of diagnostic certainty\nClinical criteria:\nTwo major criteria (see table for major and minor criteria for diagnosis below);\nor\nOne major criterionc and three minor criteria (see table for major and minor criteria for diagnosis below).\nLevel 3 of diagnostic certainty\nClinical criteria:\nFour or more minor criteria (see minor criteria for diagnosis below).\nAny level of diagnostic certainty\nIn the absence of surgical criteria with the definitive demonstration of an alternative cause of bowel obstruction or intestinal infarction at surgery\n(e.g., volvulus or congenital pyloric stenosis).\nMajor and minor criteria used in the case definition for the diagnosis of intussusception\nMajor criteria\n1. Evidence of intestinal obstruction: 2. Features of intestinal invagination 3. Evidence of intestinal vascular\ni. History of bile-stained vomiting; One or more of the following: compromise or venous congestion:\nand either i. abdominal mass; i. Passage of blood per rectum;\nii. Examination findings of acute ii. rectal mass; or\nabdominal distension and abnormal iii. intestinal prolapse; or absent bowel sounds; iv. plain abdominal radiograph showing a ii. Passage of a stool containing\n\u201cred currant jelly\u201d material;\nor visible intussusceptum or soft tissue mass; or\niii. Plain abdominal radiograph showing v. abdominal ultrasound showing a visible iii. Blood detected on rectal\nfluid levels and dilated bowel loops.\nintussusceptum or soft tissue mass; examination.\nvi. abdominal CT scan showing a visible\nintussusceptum or soft tissue mass.\nMinor criteria\ni. Predisposing factors: age <1 year and male sex; ii. Abdominal pain; iii. Vomiting;d v. Pallor;e\nvi. Hypovolemic shock;\nvii. Plain abdominal radiograph showing an abnormal but non-specific\niv. Lethargy;e bowel gas pattern.",
  "target_public_health_threats": [
    "Intussusception"
  ],
  "keywords": [
    "Intussusception",
    "Asia"
  ],
  "definition_type": "case_definition"
}

Example 4:
{
  "title": "Open Syndrome Fever and Rash",
  "scope": "specific",
  "version": "1.0.0",
  "open_syndrome_version": "1.0.0",
  "published_in": "https://opensyndrome.org",
  "published_at": "2025-09-21T21:21:46Z",
  "location": "Brazil",
  "language": "Portuguese",
  "organization": "Minist\u00e9rio da Sa\u00fade",
  "inclusion_criteria": [
    {
      "type": "criterion",
      "name": "Sintomas ou hist\u00f3rico de viagem",
      "logical_operator": "OR",
      "values": [
        {
          "type": "criterion",
          "name": "Febre e exantema maculopapular com algu",
          "logical_operator": "AND",
          "values": [
            {
              "type": "symptom",
              "name": "Febre"
            },
            {
              "type": "symptom",
              "name": "Exantema maculopapular"
            },
            {
              "type": "criterion",
              "name": "Acompanhados de um ou mais dos seguintes sinais e sintomas",
              "logical_operator": "AT_LEAST",
              "logical_operator_args": [
                1
              ],
              "values": [
                {
                  "type": "symptom",
                  "name": "Cough"
                },
                {
                  "type": "symptom",
                  "name": "Runny nose (coryza)"
                },
                {
                  "type": "symptom",
                  "name": "Conjunctivitis"
                }
              ]
            }
          ]
        },
        {
          "type": "epidemiological_history",
          "name": "Viagem ao contato com algu\u00e9m que viajou",
          "description": "Hist\u00f3ria de viagem ao exterior nos \u00faltimos 30 dias ou contato, no mesmo per\u00edodo, com algu\u00e9m que viajou ao exterior"
        }
      ]
    }
  ],
  "references": [
    {
      "url": "https://bvsms.saude.gov.br/bvs/publicacoes/guia_vigilancia_epidemiologica_7ed.pdf"
    }
  ],
  "status": "draft",
  "human_readable_definition": "Todo paciente que, independente da idade e da situa\u00e7\u00e3o vacinal, apresentar febre e exantema\nmaculopapular, acompanhados de um ou mais dos seguintes sinais e sintomas: tosse e/ou coriza\ne/ou conjuntivite; ou todo indiv\u00edduo suspeito com hist\u00f3ria de viagem ao exterior nos \u00faltimos 30\ndias ou de contato, no mesmo per\u00edodo, com algu\u00e9m que viajou ao exterior.",
  "published_by": [
    "Minist\u00e9rio da Sa\u00fade"
  ],
  "category": "",
  "definition_type": "case_definition"
}
