LCDR Heather Bair Brake
description
Transcript of LCDR Heather Bair Brake
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