PHEIC&DecisionInstrument

Dr Reuben Samuel
WHO Country Office India

What is a PHEIC?

PHIEC Public Health Emergency

of International Concern

An extraordinary event which is

determined, as provided in these
Regulations:
i.

to constitute a public health risk to other

Member States through international
spread of disease and

ii.

to potentially require a coordinated

international response.

Alert and Response Operations

Events that may constitute a

Public Health Emergency of International Concern need:

Detection
Verification
Risk assessment
Response

Verification of events

Value of unofficial sources of information for

early alert

WHO requests for verification of potential public

health events of international importance

Member States provide initial reply within 24

hours and provision of information

On-site assessment, when necessary

Event notification

Any event that may constitute a Public Health

Emergency of International Concern (PHEIC)

Within 24 hours of assessment

By the most efficient means of communication

Continue to provide WHO with detailed information

Does NOT mean a real PHEIC

Disease List

Four diseases (a single case is notifiable):

Smallpox, Poliomyelitis, human influenza (caused by a

new subtype), SARS

Utilization of the decision instrument:

Cholera, plague, viral haemorrhagic fevers, yellow

fever,

Diseases of regional concern: dengue fever,

meningococcal diseases

Decision Instrument
Criteriaforassessment
1.

Isthepublichealthimpactoftheeventserious?

2.

Istheeventunusualorunexpected?

3.

Isthereasignificantriskofinternationalspread?

4.

Isthereasignificantriskofinternationaltravelortrade
restrictions?
Answering "yes" to any two of the criteria
requires a member state to notify WHO

Is the event serious?

Yes

No

Is the event unexpected?

Yes

Is the event unexpected?

Yes

No

Could it (or has it) spread

internationally?

Yes

No

Could it (or has it) spread

internationally?
No

Yes
No

Risk for international

sanctions?
Yes

No

Notify the event under the International Health

Regulations

Not
notified
at this
stage.

Istheeventserious?

Morbidityandmortality
Doestheeventhavepotentialforhighimpact?
Populationatrisk
Casesinhealthstaff;highlyinfectious
Factorsaffectingresponsee.g.war,natural
catastrophe
Highpopulationdensity
Immediateorpotentialneedforexternal
assistance

Istheeventunexpected?

Is the cause of the event unknown?

Are the circumstances unusual?
Cases worse than usual
Treatment failures
Event unusual for place/season
Caused by eliminated/eradicated agent
Suspected or known intentional or accidental
release of chemical, biological or radiological
agent

Is the event likely to spread internationally?

Similar cases in other countries where it was

unexpected?
Factors alerting to cross-border implications?
Caused by epidemic-prone organism
Source suspected/ known to be related to food
import/export
Index case with international travel history
In area with international tourism/ traffic, person or
goods
In border areas with limited capacity for control

Is event likely to result in international travel

and trade restrictions?

Similar events previously led to restriction

on travel/ trade?
Source known or suspected food product/
goods known to be imported or exported?
In area with international tourism?
Attracted media attention?

Combinations of answers
requiring notification

Serious and unexpected

Serious and risk for international spread
Serious and risk for international
restrictions
Unexpected and risk for international
spread
Unexpected and risk for international
restrictions

Thanks