International Health Regulations (2005)
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The revised International Health Regulations are known as IHRs or IHR (2005). These international laws protect the health of people around the world without interfering with travel and trade. 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.
Overview
Under the revised Regulations, Member States must notify the WHO Secretariat of public-health emergencies of international concern (PHEICs). They must also identify and respond to these events better. In addition, new routine public health measures affect the entry of people and goods into a country.
The 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.
Reporting Diseases and Events
Under the IHRs, Member States must report outbreaks of these four diseases as public-health emergencies of international concern:
- Smallpox
- Polio (wild type)
- New strains of human influenza
- Severe Acute Respiratory Syndrome (SARS)
In some cases, Member States must report outbreaks of additional diseases:
- Cholera
- Pneumonic plague
- Yellow fever
- Viral hemorrhagic fever
- West Nile fever
- and others
IHR Decision Tool
Countries will use an IHR decision tool to determine whether to report other events. These are the criteria for the event:
- Is the public-health impact serious?
- Is the event unusual or unexpected?
- Is there a significant risk of international spread?
- Is there a significant risk of restricting international travel or trade?
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.
How the United States Will Respond
The United States will carry out the revised IHRs in conformance with our 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 potential public-health emergencies that are occurring in other countries (when possible)
- There is no separate, private right to legal action against the U.S. Federal Government
Cooperation by Federal, State, and Local Officials
The U.S. already has strong State and local reporting networks. It will use these networks to receive information about events of concern and meet IHR requirements. The U.S. Department of Health and Human Services (HHS) leads the execution of the updated IHR requirements. 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
- U.S. Postal Service
Related Information
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- Read the full text of the revised International Health Regulations (2005) (PDF-391KB)
(World Health Organization) - Read details on the current status of the revised IHRs (2005)

IHR in the WHO Regional Offices
If you have questions about the IHR, please email: IHR Questions@cdc.gov
