International Health Practice Questions

Q: Which of the following diseases is NOT included in the list of internationally notifiable diseases?

Tuberculosis (TB). The International Health Regulations (IHR), established by the WHO, aim to prevent the international spread of diseases. Historically, only three diseases were classified as "Quarantinable" or "Internationally Notifiable": **Cholera, Plague, and Yellow Fever.** **Why Tuberculosis (TB) is the correct answer:** While TB is a major global health threat and a "notifiable disease" under many national laws (including India’s NIKSHAY portal), it is **not** included in the specific list of internationally notifiable diseases under the traditional IHR framework. TB is a chronic infection with a long incubation period, making it unsuitable for the rapid "quarantine" measures applied to acute, epidemic-prone diseases like Plague or Yellow Fever. **Analysis of Incorrect Options:** * **Plague (A):** Caused by *Yersinia pestis*, it is a classic quarantinable disease due to its high fatality rate and potential for rapid international spread via maritime and air travel. * **Cholera (B):** An acute diarrheal infection that can cause large-scale outbreaks. It remains on the list to ensure rapid international reporting and sanitation control. * **Yellow Fever (D):** This is the only disease for which an International Certificate of Vaccination is currently required for travel between specific endemic zones. **High-Yield Clinical Pearls for NEET-PG:** * **IHR (2005) Revision:** The scope has expanded from the "Big Three" to include any **Public Health Emergency of International Concern (PHEIC)**, such as Polio, Ebola, and COVID-19. * **The "Big Three":** Always remember **CPY** (Cholera, Plague, Yellow Fever) as the traditional internationally notifiable diseases. * **Yellow Fever Vaccination:** Valid for **life** (as per 2016 WHO amendment), starting 10 days after administration.

Q: All of the following are WHO notifiable diseases EXCEPT:

Chickenpox. The International Health Regulations (IHR) established by the WHO mandate that certain diseases must be reported to the organization to prevent the international spread of disease. **Explanation of the Correct Answer:** **B. Chickenpox:** This is the correct answer because it is not a WHO-notifiable disease. Chickenpox (Varicella) is a common childhood illness with a generally low mortality rate and does not pose a significant threat to international public health security. Therefore, it does not fall under the mandatory reporting requirements of the IHR. **Explanation of Incorrect Options:** * **A. Cholera, C. Plague, and D. Yellow Fever:** These three diseases are the "classic" internationally notifiable diseases under the original IHR. They are characterized by their potential for rapid international spread and high case fatality rates. Under the revised IHR (2005), while the list has expanded to include "Public Health Emergencies of International Concern" (PHEIC) like Polio or Ebola, these three remain the core historical pillars of notification. **High-Yield NEET-PG Pearls:** * **The "Big Three":** Always remember **Cholera, Plague, and Yellow Fever** as the primary WHO-notifiable diseases. * **IHR 2005:** The scope was expanded. Now, any unusual or unexpected event (e.g., SARS, MERS, COVID-19, Smallpox, Wild-type Polio) that may constitute a PHEIC must be notified. * **National vs. International:** Do not confuse WHO-notifiable diseases with "National Notifiable Diseases" in India (which include conditions like Tuberculosis, Malaria, and HIV). Chickenpox is not mandatory for WHO, but surveillance may occur at local levels. * **Yellow Fever:** It is the only disease for which an international certificate of vaccination is still routinely required for travel between specific endemic zones.

Q: The Alma-Ata Conference was held in which year?

1978. **Explanation:** The **Alma-Ata Conference** (International Conference on Primary Health Care) was held in **September 1978** in Alma-Ata, USSR (now Almaty, Kazakhstan). This landmark conference, co-sponsored by WHO and UNICEF, established **Primary Health Care (PHC)** as the key strategy to achieve the goal of "Health for All by the Year 2000 AD." **Analysis of Options:** * **D. 1978 (Correct):** This is the year the Alma-Ata Declaration was signed, shifting the global focus from vertical disease control programs to a comprehensive, community-based approach. * **A. 1948:** This marks the year the **World Health Organization (WHO)** was officially established (April 7th, celebrated as World Health Day). * **B. 1956:** This year is significant in Indian history for the launch of the **Second Five-Year Plan**, but it holds no specific relevance to the Alma-Ata conference. * **C. 1977:** In this year, the 30th World Health Assembly launched the global target of **"Health for All by 2000 AD."** The Alma-Ata conference followed a year later to define the strategy to reach this goal. **High-Yield Clinical Pearls for NEET-PG:** * **The 8 Elements of PHC:** Remember the acronym **E.L.E.M.E.N.T.S.** (Education, Local endemic disease control, Expanded program on immunization, Maternal & Child health, Essential drugs, Nutrition, Treatment of common ailments, Sanitation & Water). * **Principles of PHC:** Equitable distribution, Community participation, Intersectoral coordination, and Appropriate technology. * **Astana Declaration (2018):** On the 40th anniversary of Alma-Ata, world leaders met in Astana to renew the commitment to PHC in the context of Universal Health Coverage (UHC).

Q: Where are the headquarters of the Food and Agriculture Organization (FAO) located?

Rome. **Explanation:** The **Food and Agriculture Organization (FAO)** is a specialized agency of the United Nations that leads international efforts to defeat hunger and improve nutrition and food security. It was established in 1945 and its permanent headquarters were moved from Washington, D.C., to **Rome, Italy**, in 1951. In the context of Community Medicine, the FAO is vital as it collaborates with the WHO on the **Codex Alimentarius Commission** to set international food standards, which is a high-yield topic for public health nutrition. **Analysis of Options:** * **A. New York:** This is the headquarters of the **United Nations (UN)** and **UNICEF** (United Nations Children's Fund). * **B. Geneva:** This is the "hub" for many health organizations, most notably the **World Health Organization (WHO)**, ILO, and Red Cross. * **C. Rome (Correct):** The seat of the FAO and the World Food Programme (WFP). * **D. San Francisco:** While the UN Charter was signed here in 1945, it does not serve as the headquarters for major UN specialized agencies. **NEET-PG High-Yield Pearls:** * **Motto of FAO:** *"Fiat panis"* (Let there be bread). * **World Food Day:** Celebrated on **October 16th** every year to commemorate the founding of the FAO. * **Joint Venture:** The FAO and WHO jointly run the **Expert Committee on Food Additives (JECFA)**. * **Key Objective:** Raising levels of nutrition and standards of living, particularly in rural populations.

Q: Which of the following diseases is a primary focus of international disease surveillance?

Polio. **Explanation:** The correct answer is **Polio**. This is because Poliomyelitis is one of the diseases specifically governed by the **International Health Regulations (IHR 2005)**. Under these regulations, certain diseases are classified as having the potential for international spread, requiring immediate notification to the World Health Organization (WHO). Currently, Polio (specifically Wild Poliovirus) is classified as a **Public Health Emergency of International Concern (PHEIC)**, making it a primary focus of global surveillance and eradication efforts. **Analysis of Options:** * **Hepatitis (A):** While Hepatitis A and E can cause outbreaks, they are generally managed through national surveillance programs rather than being the primary focus of mandatory international emergency reporting under IHR. * **Tuberculosis (C):** Although TB is a major global health burden and part of the WHO’s "End TB Strategy," it is a chronic infectious disease. It does not typically trigger the rapid, "real-time" international surveillance mechanisms designed for acute epidemic threats. * **Leprosy (D):** Leprosy is a neglected tropical disease with a very long incubation period. Surveillance is focused on regional elimination rather than international emergency monitoring. **High-Yield Clinical Pearls for NEET-PG:** * **IHR (2005) Mandatory Notification:** Four diseases **always** require notification to WHO: **Polio** (wild type), **Smallpox**, **SARS**, and **Human Influenza** (new subtype). * **PHEIC Status:** As of recent updates, Polio and COVID-19 have been the most prominent examples of PHEIC. * **Surveillance Type:** Polio surveillance utilizes **AFP (Acute Flaccid Paralysis) surveillance**, which is the gold standard for detecting the virus in a population. * **Target:** The global goal is the total eradication of Wild Poliovirus (Types 2 and 3 are already eradicated; Type 1 remains endemic in specific regions).

Q: Which of the following diseases is NOT under international surveillance?

Yellow fever. To understand this question, it is essential to distinguish between the **International Health Regulations (IHR)** and the list of diseases under **International Surveillance**. ### **Why Yellow Fever is the Correct Answer** Yellow fever is categorized as a **Quarantinable Disease** (along with Plague and Cholera) under the International Health Regulations. These diseases require immediate notification to the WHO because they have the potential for rapid international spread. While they are monitored globally, they are technically classified under "International Health Regulations" rather than the specific list of "Diseases under International Surveillance." ### **Analysis of Incorrect Options** The WHO established a specific list of diseases under international surveillance to monitor their global trends, even if they don't always require immediate quarantine measures. * **A. Paralytic Polio:** Included in the surveillance list to monitor the progress of the Global Polio Eradication Initiative. * **C. Louse-borne Typhus Fever:** Included due to its potential for outbreaks in crowded, unsanitary conditions (e.g., refugee camps). * **D. Relapsing Fever:** Specifically the louse-borne variety, it is monitored internationally to prevent cross-border transmission. ### **High-Yield Clinical Pearls for NEET-PG** * **Diseases under International Surveillance (WHO):** Louse-borne typhus, Relapsing fever, Paralytic polio, Malaria, Viral influenza, and SARS. * **Quarantinable Diseases (IHR 1969):** Cholera, Plague, and Yellow Fever. * **IHR 2005 Update:** The focus shifted from specific diseases to "Public Health Emergencies of International Concern" (PHEIC). Under IHR 2005, any unusual or unexpected health event (including new strains of Flu or Ebola) must be reported. * **Yellow Fever Vaccination:** The certificate becomes valid **10 days** after vaccination and lasts for **life** (as per 2016 amendments).

Q: Which of the following is the headquarters of the World Health Organization's South-East Asia Regional Office?

New Delhi. **Explanation:** The **World Health Organization (WHO)** operates through its headquarters in Geneva and six regional offices worldwide to address specific geographical health needs. The **South-East Asia Regional Office (SEARO)** is headquartered in **New Delhi, India**. It serves 11 member states, including India, Indonesia, Nepal, Sri Lanka, and Thailand. * **Why Option A is correct:** New Delhi has hosted the SEARO since its inception in 1948. It acts as the primary hub for coordinating health policies, disease surveillance (like TB and Malaria), and immunization programs across the South-East Asian region. * **Why Options B, C, and D are incorrect:** While Dhaka (Bangladesh), Colombo (Sri Lanka), and Bangkok (Thailand) are all prominent capital cities within the SEARO member states and host significant WHO country offices, they do not serve as the regional headquarters. **High-Yield Facts for NEET-PG:** * **WHO Headquarters:** Geneva, Switzerland. * **World Health Day:** April 7th (commemorating the day the WHO constitution came into force in 1948). * **Regional Offices Mnemonic:** 1. **SEARO:** New Delhi (India) 2. **AFRO (Africa):** Brazzaville (Congo) 3. **AMRO (Americas):** Washington D.C. (USA) 4. **EURO (Europe):** Copenhagen (Denmark) 5. **EMRO (Eastern Mediterranean):** Cairo (Egypt) 6. **WPRO (Western Pacific):** Manila (Philippines) * **Member States:** SEARO is unique as it has **11 member states** (notably, North Korea is part of SEARO, while Pakistan is part of EMRO).

Q: Which of the following countries is a member of the WHO South-East Asia Region?

India. **Explanation:** The World Health Organization (WHO) divides the world into six regional offices. The **South-East Asia Region (SEAR)**, headquartered in New Delhi, India, currently comprises **11 Member States**. India is a founding member and a central part of this regional block. **Why the other options are incorrect:** * **Japan:** It belongs to the **Western Pacific Region (WPR)**, which is headquartered in Manila, Philippines. * **Afghanistan and Pakistan:** Both countries are geographically in South Asia but are administratively part of the **Eastern Mediterranean Region (EMR)**, headquartered in Cairo, Egypt. This is a frequent point of confusion in exams. **High-Yield Facts for NEET-PG:** * **WHO SEAR Members (11):** Bangladesh, Bhutan, DPR Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, and Timor-Leste. * **Headquarters (HQ):** The Global HQ is in **Geneva, Switzerland**. * **Regional HQ for India:** The SEARO office is located in **New Delhi**. * **Recent Milestone:** The SEAR region was certified **Polio-free** on March 27, 2014. * **Key Distinction:** Do not confuse SEAR with the SAARC nations; while they overlap, the WHO regional classification is based on administrative and epidemiological groupings rather than just political alliances. **Clinical Pearl:** For the NEET-PG, remember that **Pakistan and Afghanistan** are the only two countries globally where Wild Poliovirus Type 1 remains endemic; both are grouped under the **EMR** region.

Q: Which of the following diseases is under WHO surveillance?

Rabies. **Explanation:** The World Health Organization (WHO) maintains a global surveillance system to monitor diseases that pose a significant public health threat, have potential for international spread, or require coordinated global control efforts. **Why Rabies is Correct:** Rabies is a fatal zoonotic disease included under the **WHO’s list of diseases under global surveillance**. It is a priority because it is 100% vaccine-preventable yet has a near 100% case-fatality rate. The WHO, along with the FAO and OIE, has launched the "Zero by 30" global strategic plan to end human deaths from dog-mediated rabies by 2030, necessitating rigorous surveillance and reporting. **Analysis of Incorrect Options:** * **Mumps:** While a common childhood vaccine-preventable disease, it is monitored by national immunization programs but is not part of the core WHO global surveillance mandate for international health security. * **Hepatitis:** While WHO has a global strategy for Viral Hepatitis (B and C), it is generally managed through regional control programs rather than the specific "International Health Regulations (IHR)" surveillance list. * **Tetanus:** Although Maternal and Neonatal Tetanus (MNT) elimination is a global goal, tetanus is not a communicable disease (it does not spread person-to-person) and therefore does not require the same type of international outbreak surveillance as Rabies. **High-Yield NEET-PG Pearls:** * **WHO Surveillance Categories:** Historically divided into **Quarantinable diseases** (Cholera, Plague, Yellow Fever) and **Diseases under International Surveillance** (Rabies, Influenza, Malaria, Polio, SARS, etc.). * **IHR (2005):** Requires countries to notify WHO of all cases of Wild Polio, Smallpox, SARS, and Human Influenza caused by a new subtype. * **Rabies Incubation:** Typically 1–3 months; characterized by Negri bodies (intracytoplasmic inclusions) in the hippocampus.

Question 1

Which of the following diseases is NOT included in the list of internationally notifiable diseases?

Accepted Answer

Tuberculosis (TB)

Answer

Plague

Answer

Cholera

Answer

Yellow fever

Question 2

All of the following are WHO notifiable diseases EXCEPT:

Accepted Answer

Chickenpox

Answer

Cholera

Answer

Plague

Answer

Yellow fever

Question 3

The Alma-Ata Conference was held in which year?

Accepted Answer

1978

Answer

1948

Answer

1956

Answer

1977

Question 4

Where are the headquarters of the Food and Agriculture Organization (FAO) located?

Accepted Answer

Rome

Answer

New York

Answer

Geneva

Answer

San Francisco

Question 5

Which of the following diseases is a primary focus of international disease surveillance?

Accepted Answer

Polio

Answer

Hepatitis

Answer

Tuberculosis

Answer

Leprosy

Question 6

Which of the following diseases is NOT included in WHO surveillance programs?

Accepted Answer

Viral encephalitis

Answer

Polio

Answer

Malaria

Answer

Relapsing fever

Question 7

Which of the following diseases is NOT under international surveillance?

Accepted Answer

Yellow fever

Answer

Paralytic polio

Answer

Louse-borne typhus fever

Answer

Relapsing fever

Question 8

Which of the following is the headquarters of the World Health Organization's South-East Asia Regional Office?

Accepted Answer

New Delhi

Answer

Dhaka

Answer

Colombo

Answer

Bangkok

Question 9

Which of the following countries is a member of the WHO South-East Asia Region?

Accepted Answer

India

Answer

Japan

Answer

Afghanistan

Answer

Pakistan

Question 10

Which of the following diseases is under WHO surveillance?

Accepted Answer

Rabies

Answer

Mumps

Answer

Hepatitis

Answer

Tetanus

International Health — MCQs

International Health — MCQs

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