Under International Health Regulations (IHR) 2005, which of the following is classified as a Public Health Emergency of International Concern (PHEIC)?

• A An extraordinary event constituting a public health risk through international spread and potentially requiring a coordinated international response, as determined by the WHO Director-General ✓
• B Any outbreak causing >1000 deaths in a country within 30 days
• C Outbreaks of only Category A (NIAID) pathogens: smallpox, plague, anthrax, botulism, tularemia, viral haemorrhagic fevers
• D Any disease causing a Case Fatality Rate >5% in two or more WHO member states simultaneously

Explanation

A PHEIC under IHR 2005 is defined as 'an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response.' The declaration is made by the WHO Director-General based on advice from an Emergency Committee, applying a decision algorithm considering seriousness, unusualness, international spread potential, and travel/trade restrictions. It is not limited to specific pathogens or death thresholds. COVID-19, H1N1, Ebola (multiple), MERS-CoV (not declared), mpox, and poliovirus have been declared PHEICs.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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