Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibriocholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. Researchers have estimated that every year, there are roughly 1.3 to 4.0 million cases, and 21 000 to 143 000 deaths worldwide due to cholera [1].

Past the 19th century, cholera spread across the world from its original reservoir in the Ganges delta in India and then speeded all over the world. Six subsequent pandemics killed millions of people across all continents as it mentioned in the W.H.O website. The current (seventh) pandemic started in South Asia in 1961, and reached Africa in 1971 and the Americas in 1991. Cholera is now endemic in many countries [1].

What countries do when suspect cholera?
Since cholera considered as global threat, therefore international attention should paid to stop the fast transmission though out the health regulation) are a framework that will help countries minimize the impact and spread of public health threats? As an international treaty, the IHR are legally binding; all countries must report events of international public health importance. Countries are using the IHR framework to prevent and control global health threats while keeping international travel and trade as open as possible. The IHR, which are coordinated by the World Health Organization (WHO), aims to keep the world informed about public health risks and events.

The IHR require that all countries have the ability to do the following:
Detect: Make sure surveillance systems and laboratories can detect potential threats
Assess: Work together with other countries to make decisions in public health emergencies
Report: Report specific diseases, plus any potential international public health emergencies
Respond: Respond to public health events in the world health regulations there is an area explaining all the situation when emergency even happened and it divided to thee subject defined as Notification, verification and consultation and each one subject applied for different situation.

Article 6 Notification (Each State Party shall assess events occurring within its territory by using the decision instrument in Annex 2. Each State Party shall notify WHO, by the most efficient means of communication available, by way of the National IHR Focal Point, and within 24 hours of assessment of public health information). This area concern regarding the prompt and immediate notification of all emergency events.

Article 8 Consultation (In the case of events occurring within its territory not requiring notification as provided in Article 6, in particular those events for which there is insufficient information available to complete the decision instrument. The State Party in whose territory the event has occurred may request WHO assistance to assess any epidemiological evidence obtained by that State Party.)this part of IHR reflect the focus of WHO for seeking consultation when it been necessary to avoid event mistaken and to put the control measurement process in place .simply when countries reported any case of watery diarrhea and there were not enough facilities for investigating the causative agent, health authority in this country should contact WHO for further support.

Article 10 Verification (WHO shall request, in accordance with Article 9, verification from a State Party of reports from sources other than notifications or consultations of events which may constitute a public health emergency of international concern allegedly occurring in the State’s territory. In such cases, WHO shall inform the State Party concerned regarding the reports it is seeking to verify) this is shows how flexibility is, when we found any news could threating public health .and WHO will make intervention even without exposing the dignity and respectful of the mentioned country. In conclusion, by notification, consultation and verification no outbreak especially cholera could be out of control and the commandment from the countries only required.