Assessment of Public Health Events through International Health Regulations, United States, 2007–2011

Abstract

People and goods travel rapidly around the world, and so do infectious organisms. Sometimes a disease has already become widespread before it is detected and reported, which makes control efforts much more difficult. In response to this threat, the World Health Assembly enacted International Health Regulations that require participating countries to report public health events of international concern to the World Health Organization within 72 hours of detection. These health regulations went into effect in 2007 for all WHO Member States including the United States. By December 2011, 24 events reported by the United States were posted on a secure WHO web site, 12 of which were associated with influenza. Others reported were salmonellosis outbreaks, botulism, E. coli infections, Guillain-Barré syndrome, contaminated heparin, Lassa fever, an oil spill, and typhoid fever. International Health Regulations have improved global connectivity through rapid information exchange and increased awareness of threatening situations.

Binational outbreak of Guillain–Barré syndrome associated withCampylobacter jejuniinfection, Mexico and USA, 2011

“…was positive in the one Arizona patient tested. On 28 June 2011, local, state, and federal health officials from the USA and Mexico launched a binational investigation, the first under a bilateral agreement complementing the new International Health Regulations (IHR) [17]. The aims were to confirm and characterize the outbreak, evaluate possible precipitants of GBS, and determine the source in order to limit further illnesses.…”

Prevention and Control of Rabies in an Age of Global Travel: A Review of Travel‐ and Trade‐Associated Rabies Events –UnitedStates, 1986–2012

“…Using the criteria in the 2005 revision of the IHR, CDC performed potential PHEIC assessments for two recent travel‐associated rabies events (Kohl et al., ; CDC, unpublished data). The case of the army soldier who completed international travel while ill with rabies was determined to not meet the criteria for reporting a potential PHEIC and was handled through routine communication channels using standard procedures for investigation of communicable disease exposures during air travel via established routes for direct communication to public health authorities in countries transited by the soldier (CDC, unpublished data).…”

“…Given the near 100% fatality of rabies infection, the fact that the incubation period can be long, and that effective delivery of PEP is time‐sensitive, CDC determined that contacting travellers for rapid and thorough risk assessment was imperative. Ultimately, WHO, CDC and the Kenya Ministry of Public Health and Sanitation agreed that this incident did not fully meet the intent for potential PHEIC reporting (Kohl et al., ; CDC unpublished data). Given the large number of countries (17 in total) that had one or more travellers involved in the incident, the event was instead communicated through the WHO regional IHR offices and National Focal Points for coordination of the international response.…”

Emerging and Reemerging Neglected Tropical Diseases: a Review of Key Characteristics, Risk Factors, and the Policy and Innovation Environment

“…Increasing globalization is linked to recent seminal infectious disease events as well as future concerns for global health emanating from large-scale population movement and migration. For example, the 2002 severe acute respiratory syndrome (SARS) outbreak and the 2009 H1N1 influenza pan-demic were considered to be directly related to globalization and international travel (1,27,28). Large-scale international gatherings such as the Hajj in Saudi Arabia may also represent newly recognized social mechanisms for rapid spread of infectious diseases, such as the emergence of Middle Eastern respiratory syndrome (MERS), caused by the second novel coronavirus that has been identified in just the past decade (29,30).…”