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Title page 1

Contents 4

Acknowledgements 6

Abbreviations 7

Glossary 8

1. Introduction 11

1.1. Objective of this manual 11

1.2. Target audience 11

1.3. Objective of QIRA 11

1.4. QIRA as part of public health intelligence activities 11

1.5. QIRA and other risk assessment tools 13

2. How the algorithm and manual were developed 13

3. Structure of the algorithm 14

3.1. Domains 14

3.2. Questions 14

3.3. Risk classification 14

3.4. Predefined immediate actions 14

3.5. Footnotes 15

4. Key considerations in using QIRA 16

4.1. Defining high-threat hazards 16

4.2. Before using the algorithm: define the scope 16

4.3. After applying the algorithm: confidence level assessment 16

4.4. Results Recording Form: documenting the use of QIRA and its results 18

4.5. Updating the assessment when required 18

4.6. Considering the International Health Regulations (2005) 18

4.7. Limitations of QIRA 18

4.7.1. Methodological limitations 18

4.7.2. Limitations of use during events yet to occur within Member States 18

4.7.3. Limitations of use during disasters or complex emergencies 19

5. Guide to addressing the questions at each step of the QIRA algorithm 21

6. References 29

Annex 1. Results Recording Form for the QIRA algorithm and form for responding to questions 31

Annex 2. Example of how to use the QIRA algorithm 33

Dengue outbreak in Tripura country 33

Description of the situation 33

Information about dengue fever 34

Conducting a risk assessment for dengue in Tripura using the QIRA algorithm 36

Annex 3. Risk assessment guidance documents and tools published by the World Health Organization to be used by Member States 47

The MS-RRA tool and QIRA algorithm 47

Comparing internal WHO processes and Member States' processes 48

References 55

Tables 17

Table 1. Definitions and criteria for assessing the confidence level 17

Table 2. How to answer the main question for each domain of the QIRA algorithm by using the guiding questions 21

Figures 13

Fig. 1. Immediate and formal rapid risk assessments in the public health intelligence workflow 13

Fig. 2. Quick and Immediate Risk Assessment (QIRA) algorithm for potential adaptation for use in Member States or other areas 20

Annex Tables 51

Table A3.1. List of key WHO risk assessment tools and guidance for public health events and emergencies, and for preparedness and... 51

Annex Figures 36

Fig. A2.1/Fig. A2.2. QIRA algorithm pathway for assessment of the dengue outbreak in Tripura, August 2023 36

Fig. A3.1. Flowchart to support choosing among key WHO risk assessment tools and guidance for responding to public health events and... 50

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