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International Health Regulations (2005)

The United States must comply with the updated International Health Regulations as of July 17, 2007, but compliance dates for other World Health Organization (WHO) Member States vary. These international laws, known as the revised International Health Regulations (IHRs), or IHR (2005), protect the health of people around the world without interfering with travel and trade.


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Under the revised Regulations, Member States must notify the WHO Secretariat of public-health emergencies of international concern (PHEICs), and better identify and respond to these events. In addition, there are new routine public health measures in place when people and goods enter a country.


The revised IHRs define PHEICs as extraordinary events that pose a public-health risk through the international spread of disease to the rest of the world. A successful response to these events requires many countries to work together.


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Reporting Diseases and Events

Under the updated Regulations, Member States must report outbreaks of four diseases as public-health emergencies of international concern:

  • Smallpox;
  • Polio (wild type);
  • New strains of human influenza; and
  • Severe Acute Respiratory Syndrome (SARS).


In some cases, Member States must report outbreaks of additional diseases: cholera, pneumonic plague, yellow fever, viral hemorrhagic fever, and West Nile fever, among others.


IHR Decision Tool

Countries will use an IHR decision tool and the following criteria to determine whether to report other events that must be reported.

  • Is the public-health impact of the event serious?
  • Is the event unusual or unexpected?
  • Is there a significant risk of international spread?
  • Is there a significant risk of international travel or trade restrictions?


Once a Member State determines an event is of concern, it has 48 hours to assess the risk of the event. If authorities determine a potential public-health emergency of international concern exists, the country has 24 hours to report the event to the WHO Secretariat.


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How the United States Will Respond

The United States will carry out the revised Regulations in conformance with our federal form of Government, which divides powers between the Federal Government and the States. The United States also interprets the updated regulations to mean that:

  • Countries must report incidents that involve the natural, accidental, or deliberate release of chemical, biological, or radiological materials;
  • Countries must report, when possible, potential public-health emergencies that are occurring in other countries; and
  • Under the Regulations, there is no separate private right to legal action against the Federal Government.


Cooperation by Federal, State, and Local Officials

To meet the requirements of the revised regulations, the United States will use already strong State and local reporting networks to receive information about events of concern. The U.S. Department of Health and Human Services (HHS) has assumed the lead role in carrying out the requirements of the updated IHRs. The HHS Operations Center is the central body responsible for reporting events to the WHO Secretariat.


Other U.S. Federal Departments and agencies supporting the effort include the following:

  • U.S. Department of Agriculture;
  • U.S. Department of Commerce;
  • U.S. Department of Defense;
  • U.S. Department of Energy;
  • U.S. Department of Homeland Security;
  • U.S. Department of Justice;
  • U.S. Department of State;
  • U.S. Department of the Treasury;
  • U.S. Department of Transportation;
  • U.S. Department of Veterans Affairs;
  • Environmental Protection Agency;
  • Joint Chiefs of Staff;
  • Nuclear Regulatory Commission;
  • Office of Management and Budget;
  • Office of Science and Technology Policy;
  • U.S. Agency for International Development;
  • U.S. Central Intelligence Agency;
  • U.S. Trade Representative; and
  • U.S. Postal Service.


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Related Information

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If you have questions about the IHR, please email:


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Last revised: August 07, 2007