National Center for Emerging and Zoonotic Infectious DiseasesDivision of Global Migration and Quarantine

“Tails” from Quarantine:Animal Importation

Stories from the On-Call Veterinarian

LCDR Heather Bair Brake

Zoonoses TeamQuarantine Border and Health Services

BranchCenters for Disease Control and

Prevention

Overview Animal Importation

Volume & purpose Regulatory authority

CDC Zoonoses Team Tails from Quarantine

“Bat on a Plane” “Rabid Rescue” “Cargo Ship Monkey”

Live Animal Importation - 2006

135,731 mammals 243,004 birds 1.5 million reptiles 4.8 million amphibians 228 million fish

CDC Animal Data 287,000 dogs* 26,000 nonhuman primates***McQuiston JH et al. Importation of Dogs into the United States: Risks from Rabies and Other Zoonotic Diseases. Zoonoses and Public Health, 2008: 55;421–426**Bob Mullan, CDC Zoonoses Team, Personal Communication

U.S. Fish & Wildlife Service LEMIS Data

Reasons for Animal Importation Exhibition at zoos Education and research Scientific conservation

programs Use as food and other

products Tourism and immigration Commercial pet trade Personal pets Accidental

Regulating Animals and Animal Products

U.S. Department of Agriculture, Animal Plant Health Inspection Service (USDA/APHIS)

Veterinary Services Animal Care

Department of Interior U.S. Fish and Wildlife Service (USFWS)

Department of Health and Human Services (DHHS)

Centers for Disease Control and Prevention (CDC)

Department of Homeland Security (DHS) Customs and Border Protection (CBP)

DHHS, CDC, Division of Global Migration and

Quarantine Primary focus is human health

Authority to restrict importation of animals is related to potential health risks to humans

20 CDC Quarantine Stations at major ports

Enforce DHHS statutory authority at ports of entry

Depends heavily on federal partners at ports of entry

CDC Regulatory AuthorityImportation of Animals and Animal

Products42 Code of Federal Regulations 71 – Foreign Quarantine

Subpart F – Importations71.51 – Dogs and cats71.52 – Turtles, tortoises and terrapins71.53 – Nonhuman primates71.54 – Etiologic agents, hosts and

vectors71.56 – African rodents

Subpart D – Health Measures at U.S. Ports:

Communicable Diseases71.32(b) – Persons, carriers, things

Responding to a Public Health Threat

42 CFR 71.32(b) : Persons, Carriers, or Things When persons, carriers, or things on a carrier are suspected of being infected or contaminated, CDCmay require detention , disinfection, disinfestation, fumigation, or other measures necessary to prevent the introduction,

transmission, or spread of communicable

diseases.

Zoonoses Team MissionPrevent the introduction and spread of diseases of public health significance to humans from imported live animals or cargo containing infectious animal products

IT’S A BIRD… IT’S A PLANE… NO. IT’S A BAT ON A PLANE!

August 5, 2011

http://img.metro.co.uk/i/pix/2011/08/10/article-1312981208026-0D6121D500000578-530287_304x456.jpg

6:45 am flight from Madison, WI, to Atlanta, GA

Risk Assessment Agent of concern: Rabies Evaluation of passenger exposure status

Contact with bat Sleeping during the flight Mental impairment Wounds of unknown origin

Evaluation of crew/ground staff exposure Contact with bat History of bat infestation at airport

Categorized into no, low, medium or high risk

Passenger and Crew Risk Assessment Results

Passengers Residents of 11 states Mean age: 41.2 years (range: 2 – 63 years) 47% female

Crew 2 pilots 1 flight attendant 16 ground crew members

Ground crew reported prior bat sightings No crew or pasengers reported contact with

bat No postexposure prophylaxis (PEP)

recommended

Environmental Assessment No evidence of bats or bat droppings Airport animal incident record review

5 bats identified during 2011 Airplane doors kept open overnight Holes in the ceiling where jetway meets

terminal Jetway canopy folds likely hiding place

Recommendations Close holes in jetway ceilings Clean jetways during bat season Require mandatory employee training

Custodial staff Baggage handlers

THE CASE OF THE RABID RESCUE

Operation Baghdad Pups Society for the Prevention of Cruelty

to Animals International organizes rescues

Rescue of soldiers’ pets from Iraq and Afghanistan

Rescue initiated by one soldier’s plea to save his regiment’s mascot, Charlie

Coming to America 2008, a shipment of 24 dogs and 2 cats

arrived in United States from Iraq Housed in empty

cargo warehouse at at Newark Liberty Airport Groomed Evaluated by veterinarian

Two animals showed neurologic signs Cat – had small bite wound on its tail Dog – no obvious signs of bite wounds, no

history of exposure to rabid animals

http://blog.syracuse.com/pets/2008/06/post_13.html

Crusade for Crusader June 8: Crusader became

wobbly and “snappy,” and developed diarrhea

June 11: Euthanized following progressive weakness

June 18: Tissue tested positive for rabies

“Crusader” http://gothamist.com/2008/10/03/rescued_dogs_from_iraq_prompt_rabie.php

Follow-Up Investigation June 10: Remaining 23 dogs and one

cat shipped to destinations in 16 states

All animals were located within 2 weeks

Because of exposure to rabid dog: Pets:

Receive rabies booster 6 months of quarantine as determined by

their state People:

13 received PEP

International Pet Rescue Thousands of dogs

and cats are rescued and brought into the United States yearly

Many are rescued off the streets

Creates health risks for both humans and animals Animal Rescue Team Taiwan

Regulations for Importation CDC requirements:

Dogs:– Must be healthy upon arrival AND– Must be accompanied by proof of

valid rabies vaccination* OR be placed in confinement

– Must meet state and local government requirements

Cats:– Must be healthy upon arrival

*Rabies vaccination is waived for dogs arriving from rabies-free countries.

National Center for Emerging and Zoonotic Infectious DiseasesDivision of Global Migration and Quarantine

OPERATION SEA MONKEY

Event Time Line

3/24/2011 3/29/2011 4/13/2011

Ship departed CBP reported Ship due to Angola monkey loose arrive in on cargo ship Houston, TX

Pre-Event Planning Houston Quarantine Station

Confirmed report and notified branch leadership and Z-team

Joint agency planning began

Initial Picture from Vessel

Pre-Event Planning Two conditions for ship to dock

1) NHP is captured and secured in a crate or other container by crew before ship arrives

2) NHP is dead, double bagged and stored, preferably cold, before arrival

Guidance developed for each scenario Minimize exposure to NHP Disinfect soiled areas on vessel

The Response April 9, 2011: Captain reports

NHP capture

Boarding Plan and Responsibilities

US Coast Guard and CBP Security and entry screenings

Houston Quarantine Staff Crew health assessments

Zoonoses Team Assess NHP health and crate integrity Inspect areas where NHP had access

Response at Port of Houston Response at dock

US Fish and Wildlife Vessel agent and

legal representative CBP CDC Transport company

NHP removed from vessel in crate and

transported to registered importer facility

NHP Assessment

No fear of humans Possible pet Hybrid of species

Physical Exam Performed under anesthesia Good body condition No significant findings

Testing of NHP First tuberculin skin test placed

one day after arrival Positive test NHP was euthanized

Necropsy No significant findings on gross pathology Filovirus test was negative TB cultures, no growth

Conclusions

Risk to crew from NHP was minimal No evidence of active tuberculosis in

NHP Reports indicated that NHP was outside

most of the voyage Crew reported no close contact with NHP

PNAS, 2004

There is nowhere in the world from which we are remote and no one from whom we are

disconnected

Preventing Disease Importation Partnership with state and local

health departments

Partnership with other federal agencies at U.S. ports of entry

Open communication between CDC and importing organizations: International pet rescue groups Zoos Research institutions

Acknowledgments

CDC Quarantine BranchEmily Lankau – DGMQ EIS OfficerTeal Bell – CSTE fellowThomas George – Officer in Charge, Houston QS Zoonoses TeamAdam LangerGale GallandBob MullanJulie SinclairSheryl Shapiro