Is there a significant risk of international spread	III. Is there a significant risk of international spread?	
	6. Is there evidence of an epidemiological link to similar events in other States?	
	7. Is there any factor that should alert us to the potential for cross border movement of the agent,  vehicle or host?	
	 THE FOLLOWING ARE EXAMPLES OF CIRCUMSTANCES THAT MAY PREDISPOSE TO INTERNATIONAL  SPREAD:	
	– Where there is evidence of local spread, an index case (or other linked cases) with a history within the  previous month of:	
	= international travel (or time equivalent to the incubation period if the pathogen is known)	
	= participation in an international gathering (pilgrimage, sports event, conference, etc.)	
	= close contact with an international traveller or a highly mobile population.	
	– Event caused by an environmental contamination that has the potential to spread across  international borders.	
	– Event in an area of intense international traffic with limited capacity for sanitary control or  environmental detection or decontamination.	
	IS THERE A SIGNIFICANT RISK OF INTERNATIONAL SPREAD?	
	Answer “yes” if you have answered “yes” to questions 6 or 7 above.