Transcript CDC Presentation - NAS

CDC’s Role in the Importation
and Transportation of Live Animals
Gale Galland, DVM, MS, DACVPM
Senior Veterinary Medical Officer
Importations and Animal Contact Team
Quarantine and Border Health Services Branch
National Center for Emerging and Zoonotic Infectious Diseases
Division of Global Migration and Quarantine
Objectives
• Discuss CDC’s role and authority to regulate the importation
of live animals
• Overview CDC regulations that pertain to live animal
imports
• Describe CDC’s Nonhuman Primate (NHP) Import
Quarantine Program and discuss issues associated
specifically with the importation, transport, and quarantine
of NHPs
Importations and Animal
Contact Team Mission
To prevent and control the transmission of communicable
diseases of public health importance through:
• Administration and enforcement of Foreign and Interstate
Quarantine regulations governing
– live animals and animal products
– human remains, human tissues, and human products
– infectious biological agents, infectious substances, and vectors
of human disease
• Development of effective public- and private-sector partnerships
• Health promotion and risk communication regarding zoonotic
diseases and the public health benefits and risks associated with
human-animal contact
Organizational Structure
CDC
National Center for Emerging and
Zoonotic Infectious Diseases
Division of Global Migration and Quarantine
Quarantine and Border Health Services Branch
Importations and Animal Contact Team
Regulatory Authority
Health and Human Services (HHS)
• The Secretary of HHS has statutory responsibility for
preventing introduction, transmission, and spread of
communicable diseases into and among the United States
• CDC’s Division of Global Migration and Quarantine
administers interstate and foreign quarantine regulations
(42 Code of Federal Regulations (CFR) part 70 and 71)
– To govern the international and interstate movement of persons,
animals, and cargo
• Legal foundation for these activities
– Found in Titles 8 and 42 of the U.S. Code and relevant supporting
regulations
CDC Regulatory Authority for the
Importation of Animals and Animal Products
42 CFR 71 – Foreign Quarantine
Subpart F – Importations
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71.51 – Dogs and cats
71.52 – Turtles, tortoises, and terrapins
71.53 – Requirements for importers of nonhuman primates
71.54 – Import regulations for infectious biological agents,
infectious substances, and vectors
• 71.56 – African rodents
Subpart D – Health Measures at U.S. Ports: Communicable
Diseases
• 71.32-Persons, carriers, things
Dogs and Cats
42 CFR 71.51
photo credit: cartoon drawings.net
photo credit: publicdomainpictures.net
• Dogs and cats must be healthy on arrival at the port of
entry into the United States
• Animals that are ill on arrival may be required to be
taken for an examination by a licensed veterinarian at
importer’s expense
Photo credit: DGMQ staff
Photo credit: DGMQ staff
Dogs and Cats
Rabies Vaccination Requirements
• Cats
– CDC highly recommends rabies vaccination for cats
– Currently no rabies vaccination required
• Dogs: Must have proof of current rabies vaccination
– Puppies must have been at least 3 months of age when vaccinated
– Vaccine must be given at least 30 days before entry
– Certificates should list an expiration date
– Rabies vaccines for dogs have expiration dates that range from
1 to 3 years from date of administration
– Exceptions to this requirement limited
– Rarely granted and only for extenuated circumstances and
importers must agree to confine dog until it can be vaccinated
against rabies when it reaches its final destination in the United
States and for 30 days post vaccination
– Granted in cases where rabies vaccination may interfere with
research projects
Turtles, Tortoises, and Terrapins
42 CFR 71.52
• Restrictions stem from concerns over Salmonella infection
• Turtles with a carapace less than 4 inches and viable turtle
eggs may not be imported for commercial purposes
• Up to a total of six viable turtle eggs or turtles with a
carapace less than 4 inches may be allowed as personal pets
• Greater than 6 small turtles or viable turtle eggs may be
imported for science, education or exhibition with CDC
permission
Photo credit istock
Photo credit: NY of\
Environmental Conservation
Credit: iStockPhoto
Import Regulation for Infectious Biological
Agents, Infectious Substances and Vectors:
42 CFR 71.54
• Persons may not import an animal host or vector of
human disease (or animal capable of being a host or
vector) without a permit
photo credit: echolocalizer.com
Photo credit: scrapetv.com
African Rodents
42 CFR 71.56
• Restrictions followed a 2003 monkeypox outbreak in the
United States
• Linked to African rodents imported for the commercial
pet trade
• First human monkeypox cases reported outside of Africa
• A total of 71 human cases were investigated
• Can only be imported for science, education or exhibition
with CDC permission
•
photo credit: flikr.com
photo credit: Flikr.com
Persons, Carriers, or Things
42 CFR 71.32
(b) When persons, carriers, or things on a carrier are suspected
of being infected or contaminated, CDC may require
detention, disinfection, disinfestation, fumigation, or other
measures necessary to prevent the introduction,
transmission, or spread of communicable diseases
Civets: 42 CFR 71.32(b)
• Civets are linked to transmission of severe acute
respiratory syndrome (SARS)
• Civets can only be imported for science, education or
exhibition with CDC permission
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Photo credit: University of Michigan.edu
Photo credit: Wickispaces.com
Requirements for Importers of Nonhuman
Primates (NHPs): 42 CFR 71.53
• First implemented in 1975
• Revised several times since then
• Importers currently required to:
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Register with CDC
Quarantine imported NHPs for 31 days
Screen for infectious zoonotic diseases
photo credit: fotopedia.com
Ensure imported NHPs have negative TB tests prior to release
Complete filovirus testing for suspected infections
Report any suspected zoonotic illness
Maintain records for distribution
NHP Import Regulations History
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NHP import regulations strengthened in 1990
• Response to 1989 Ebola Reston outbreak
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NHP regulations revised further in 2013
Photo Credit: fotopedia.com
NHP Infectious Disease Risks
• Tuberculosis
• Viral Hemorrhagic Fever
• Ebola, Marburg
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Herpes B virus
Hepatitis A and B viruses
Monkeypox
Simian Immunodeficiency Virus (SIV)
Yellow Fever reservoir
Shigella, Salmonella, Campylobacter
Credit: iStockPhoto
Hemorrhagic Fever Viruses
• 1967 Marburg outbreak
• Occurred in Marburg and Frankfurt, Germany
• Associated with tissues from African green monkeys
• 31 people infected, 7 deaths
photo credit: fotopedia.com
Hemorrhagic Fever Viruses
• 1989 outbreak of Ebola Reston in a group of imported
NHPs
• First thought to be Simian Hemorrhagic Fever
• Illness spread through the facility
• Facility was depopulated
• 500 animals euthanized
• Six individuals associated with this
outbreak were seropositive but did
not develop illness
photo credit: DGMQ staff
Prior to 1990 Regulations:
Baby Carriage on Cargo Belt
Photo credit: DGMQ staff
Prior to 1990 Regulations:
Minimal Personal Protective Equipment
NHP Crates Stacked with Other Cargo
Photo credit: DGMQ staff
Prior to 1990 Regulations:
NHP Crates Stacked with Other Cargo
Photo credit: DGMQ staff
Prior to 1990 Regulations:
Close-up of NHP Crates
Stacked with Other Cargo
Photo credit: DGMQ staff
Current Best Practices for
Meeting NHP Shipments
Photo credit: DGMQ staff
Current Best Practices
for NHP Shipments
Photo credit: DGMQ staff
Most Recent NHP Regulation Update
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April 16, 2013
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Consolidated all the MMWRs, Special Permit
Requirements, Dear Interested Party letters, and best
practices into a single regulation
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Added specific requirements for zoo-to-zoo and lab-tolab transfer
Current Challenges
Importation and Transportation of NHPs
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Currently only a limited number of airlines are routinely
transporting NHPs imported into the United States
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More importers are moving to charter flights
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No domestic airline will carry NHPs
• Shipments must be transported by truck to final quarantine
destination
Potential Consequences
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Charter flights typically have scheduling delays and flight
interruptions
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Leads to more stress on animals
Increased stress means increased potential for animal illness and
death during CDC quarantine
Illnesses and deaths during quarantine may require extension of
quarantine at greater cost to importers
Risk of an outbreak in a cohort is higher
Outbreaks in larger cohorts can cause catastrophic losses
Potential Consequences
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Challenges with larger shipments at port of entry
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Additional staff needed to handle larger shipments
Increased stress on staff (gov’t agencies, ground handlers)
More difficult to find suitable holding facilities during delays
Increased costs for all involved organizations
Large shipments of NHPs on charter flights pose an
increased public health risk
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During transportation
During off-loading
Potential Consequences
• Long truck rides increase transportation time
• More stress on animals
• Increase potential illness
Summary
• CDC’s authority to regulate animals is based on threats
they may pose to human health
• Implementation has been species- and pathogen-specific
• CDC’s role in animal importation is to reduce the risk to
public health
• New regulations are currently being developed
• Goal is to have comprehensive, proactive regulations that help
protect public health
Acknowledgements
Importations and Animal Contact Team
Adam Langer, Team Lead
Julie Sinclair, Deputy Team Lead
Bob Mullan
Heather Bair-Brake
Sheryl Shapiro
Nelva Bryant
Quarantine Station Staff
Disclaimer: The findings and conclusions in this presentation are those of the
author(s) and do not necessarily represent CDC’s official position.