CDC’s Role in the Importation and Transportation of Live

Animals

Gale Galland, DVM, MS, DACVPMSenior Veterinary Medical Officer

Importations and Animal Contact TeamQuarantine and Border Health Services Branch

National Center for Emerging and Zoonotic Infectious DiseasesDivision 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

Products42 CFR 71 – Foreign Quarantine Subpart F – Importations

• 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 CatsRabies 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 Terrapins42 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

• 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

African Rodents42 CFR 71.56

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

• • • Photo credit:

Wickispaces.com

Photo credit: University of Michigan.edu

Requirements for Importers of Nonhuman Primates (NHPs): 42 CFR

71.53• First implemented in 1975• Revised several times since then• Importers currently required to:

• 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

• NHP import regulations strengthened in 1990• Response to 1989 Ebola Reston outbreak

• NHP regulations revised further in 2013

Photo Credit: fotopedia.com

NHP Infectious Disease Risks

• Tuberculosis• Viral Hemorrhagic Fever

• Ebola, Marburg

• 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

• April 16, 2013

• Consolidated all the MMWRs, Special Permit Requirements, Dear Interested Party letters, and best practices into a single regulation

• Added specific requirements for zoo-to-zoo and lab-to-lab transfer

Current Challenges Importation and Transportation

of NHPs

• Currently only a limited number of airlines are routinely transporting NHPs imported into the United States

• More importers are moving to charter flights

• No domestic airline will carry NHPs • Shipments must be transported by truck to final

quarantine destination

Potential Consequences

• Charter flights typically have scheduling delays and flight interruptions • 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

• Challenges with larger shipments at port of entry• 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• 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 TeamAdam Langer, Team Lead

Julie Sinclair, Deputy Team LeadBob Mullan

Heather Bair-BrakeSheryl ShapiroNelva 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.