OPHEP LOGBOOK IHR ART. 6 · 24H NOTIFICATION IHR ART. 10 · 24H VERIFICATION ANNEX 2 · 48H ASSESSMENT GATE INDEPENDENT HISTORICAL LOGBOOK
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Outbreak and Public Health Event Portal IHR (2005) Annex 2 Bilingual Signal Logbook
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Decision Instrument · IHR (2005) Annex 2

IHR (2005) Annex 2 Decision Instrument & Notification Rules

Structured operational scoring across Box A always-notifiable pathogens, Box B high-threat agents, and unusual events under Articles 6, 7, and 8.

Public health emergency operations center shelving with numbered surveillance binders and dispatch landline telephone
PHEOC archival binders and dedicated NFP dispatch line used for 48h assessment logging and 24h WHO notification.
Algorithm Summary

Annex 2 splits public health events into two pathways: four Box A diseases that trigger immediate Article 6 WHO notification upon a single confirmed or suspected case, and all other Box B or unusual events, which require at least two affirmative answers across four standardized risk questions within 48 hours.

Statutory source: WHO IHR (2005) Annex 2 Official Text.

Interactive Decision Instrument

IHR (2005) Annex 2 Four-Dimensional Event Evaluator

STATUTORY GATE · 48H ASSESS / 24H NOTIFY

Select the pathogen category first, then toggle the four statutory Annex 2 criteria to determine whether the National IHR Focal Point must notify WHO within 24 hours under Article 6.

1. Serious Public Health Impact
High case fatality, severe clinical presentation, rapid community spread, or potential overwhelm of hospital surge capacity.
2. Unusual or Unexpected
Atypical pathogen, unexpected season or geographic focus, unknown etiology, or suspected deliberate/accidental release.
3. Significant Risk of International Spread
Cross-border land/maritime corridor exposure, international aviation hub index case, or shared vector/food supply chain.
4. Significant Risk of Travel or Trade Restrictions
Historical border closures, export embargoes on livestock/food, or high international media/regulatory sensitivity.
SINGLE CRITERION MET (1 YES) · ARTICLE 8 CONSULTATION / 48H WATCH (1/4)
Continue 48-hour verification and EWARN triangulation

One criterion alone does not mandate Article 6 notification. Maintain active signal verification (Article 10) and initiate confidential Article 8 consultation if field evidence shifts.

Box A vs. Box B Triage Architecture

National IHR Focal Points frequently encounter edge cases where a Box B pathogen exhibits local endemicity. Box B listing does not exempt an event from assessment; rather, it flags pathogens that carry documented potential for rapid escalation and therefore require structured four-question scoring whenever cluster geometry or clinical severity departs from seasonal baselines.

Annex 2 Tier Pathogens & Scope Criteria Needed Assessment Clock WHO Action
Box A (Always Notify) Smallpox, wild-type poliomyelitis, human influenza (new subtype), SARS 0 criteria needed (1 case suffices) Immediate Mandatory Article 6 notification within 24 hours
Box B (Priority List) Cholera, pneumonic plague, yellow fever, viral haemorrhagic fevers (Ebola, Lassa, Marburg), West Nile fever, regional threats (e.g., MERS-CoV, Rift Valley fever) ≥ 2 of 4 criteria answered Yes ≤ 48 hours Notify WHO within 24 hours of affirmative assessment
General Event Track Unusual respiratory clusters, chemical/radiological incidents, unknown etiology syndromes ≥ 2 of 4 criteria answered Yes ≤ 48 hours Notify WHO within 24h; if 1 Yes, re-assess or consult (Art. 8)

Statutory Escalation Funnel

IHR (2005) Early Signal Verification and Notification Funnel STAGE 01 · T+0H Raw Signal Capture EWARN clinics, lab alerts, border desks & media triangulation intake Art. 5 Capacity STAGE 02 · <=24H Field Verification Rule out false rumors, confirm case definition & specimen transport Art. 10 Response STAGE 03 · <=48H Annex 2 Gate Screen Box A mandatory diseases or score 4 statutory risk criteria 48h Assessment STAGE 04 · <=24H WHO Notification NFP formal dispatch to WHO Contact Point & PHEOC mobilization Art. 6 Mandatory NFP assesses within 48h and notifies WHO within 24h once >= 2 Annex 2 criteria or Box A match.
Figure 1. Four-stage epidemic intelligence verification and IHR (2005) Article 6 / Article 10 statutory escalation funnel.
Archival Note: /annex2 Pathway Continuity

Requests directed to historical /annex2 decision documentation resolve permanently to this workbench so practitioners and researchers retain single-hop access to the four-question statutory threshold logic.