[Federal Register Volume 88, Number 18 (Friday, January 27, 2023)]
[Notices]
[Pages 5348-5357]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-01688]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Notice of Extension of Temporary Suspension of Dogs Entering the
United States From Countries With a High Risk of Rabies
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: The Centers for Disease Control and Prevention (CDC), within
the Department of Health and Human Services (HHS), announces an
extension of the current temporary suspension of the importation into
the United States of dogs from high-risk rabies-enzootic countries
(high-risk countries). This suspension includes dogs that have been in
any high-risk countries during the previous six months.
DATES: The extension of the temporary suspension of the importation of
dogs into the United States from high-risk countries will be
implemented on February 1, 2023, when the current suspension expires,
and will remain in effect through July 31, 2023.
FOR FURTHER INFORMATION CONTACT: Ashley C. Altenburger, J.D., Division
of Global Migration and Quarantine, Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS H16-4, Atlanta, GA 30329.
Telephone: 1-800-232-4636. For information regarding CDC regulations
for the importation of dogs: Dr. Emily Pieracci, D.V.M., Division of
Global Migration and Quarantine, Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS H16-4, Atlanta, GA 30329.
Telephone: 1-800-232-4636.
SUPPLEMENTARY INFORMATION: CDC is extending, but not modifying, the
terms of the current temporary suspension. A suspension remains
necessary to protect the public's health against the reintroduction of
the dog-maintained rabies virus variant (DMRVV) into the United States.
There is a continued threat posed by unvaccinated or inadequately
vaccinated dogs from high-risk countries due to various factors. These
include insufficient veterinary controls in high-risk countries to
prevent the export of inadequately vaccinated dogs, and veterinary
supply chain and workforce capacity shortages that have persisted since
the global COVID-19 pandemic. These factors result in challenges to
efforts to ensure dogs imported into the United States do not pose a
public health threat. CDC
[[Page 5349]]
anticipates that these factors are likely to continue through July 31,
2023.
I. Background and Authority
Rabies, one of the deadliest zoonotic diseases, accounts for an
estimated 59,000 human deaths globally each year.\1\ This equates to
one human death every nine minutes.\2\ DMRVV is responsible for 98
percent of these deaths.\2\ The rabies virus can infect any mammal, and
once clinical signs appear, the disease is almost always fatal.\3\ In
September 2007, at the Inaugural World Rabies Day Symposium, CDC
declared the United States to be free of DMRVV.\4\ However, DMRVV is
still a serious public health threat in the more than 100 countries
where it remains enzootic. Preventing the entry of animals infected
with DMRVV into the United States is a public health priority.
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\1\ World Health Organization (2018). WHO Expert Consultation on
Rabies (WHO Technical Report Series 1012). Retrieved from https://www.who.int/publications/i/item/WHO-TRS-1012.
\2\ Id.
\3\ Fooks, A.R., Banyard, A.C., Horton, D.L., Johnson, N.,
McElhinney, L.M., and Jackson, A.C. (2014) Current status of rabies
and prospects for elimination. Lancet, 384(9951), 1389-1399. doi:
10.1016/S0140-6736(13)62707-5.
\4\ Velasco-Villa, A., Mauldin, M., Shi, M., Escobar, L.,
Gallardo-Romero, N., Damon, I., Emerson, G. (2017) The history of
rabies in the Western Hemisphere. Antiviral Res, 146, 221-232.
doi:10.1016/j.antiviral.2017.03.013.
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Under section 361 of the Public Health Service Act (PHS Act) (42
U.S.C. 264), the Secretary of Health and Human Services may make and
enforce such regulations as in the Secretary's judgment are necessary
to prevent the introduction, transmission, or spread of communicable
diseases from foreign countries into the United States and from one
state or possession into any other state or possession.\5\ Such
regulations may provide for inspection, fumigation, disinfection,
sanitation, pest extermination, destruction of animals or articles
found to be sources of dangerous infection to human beings, and other
measures. Under section 362 of the PHS Act (42 U.S.C. 265), the
Secretary, and by delegation the Director of CDC (CDC Director),\6\ may
prohibit entries and imports from foreign countries into the United
States ``in whole or in part'' if there is a serious risk of
introducing communicable disease and when required in the interest of
public health.
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\5\ Although the statute assigns authority to the Surgeon
General, all statutory powers and functions of the Surgeon General
were transferred to the Secretary of HHS in 1966, 31 FR 8855, 80
Stat. 1610 (June 25, 1966), see also Public Law 96-88, 509(b),
October 17, 1979, 93 Stat. 695 (codified at 20 U.S.C. 3508(b)). The
Secretary has retained these authorities despite the reestablishment
of the Office of the Surgeon General in 1987.
\6\ See 42 CFR 71.51(e), 71.63.
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Under 42 CFR 71.51, all dogs admitted into the United States must
be accompanied by a valid rabies vaccination certificate,\7\ unless the
dogs' owners or importers submit satisfactory evidence that dogs under
six months of age have not been in a high-risk country or dogs older
than six months have not been in a high-risk country for the six months
before arrival.\8\ CDC maintains a publicly available list of high-risk
countries \9\ and provides guidance for dog entry requirements based on
the dog's country of origin.
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\7\ Centers for Disease Control and Prevention (2022). What is a
valid rabies vaccination certificate? Retrieved from https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/vaccine-certificate.html.
\8\ Centers for Disease Control and Prevention (2019). Guidance
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to
the Importation of Dogs Into the United States. Federal Register,
Vol. 84,724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
\9\ Centers for Disease Control and Prevention (2022). What is a
valid rabies vaccination certificate? Retrieved from https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/rabies-vaccine.html.
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CDC subject matter experts review publicly available data and
conduct an annual assessment to determine which countries have high
risk of DMRVV.\10\ This assessment considers the following factors:
presence or prevalence of domestically acquired cases of DMRVV in
humans and animals; efforts towards control of DMRVV in dogs (such as
dog vaccination coverage, dog population management, and existence and
enforcement of legal codes to limit rabies transmission in dogs); and
the quality of rabies surveillance systems, rate of testing, and
laboratory capacity. If data are not available, the most conservative
determination is applied, and the country is not considered to have a
robust rabies control program. If a country has provided additional
substantial data to support a DMRVV-free or low-risk status, CDC can
review that information and re-assess the country's status.
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\10\ Henry RE, Blanton JD, Angelo KM, Pieracci EG, Stauffer K,
Jentes ES, Allen J, Glynn M, Brown CM, Friedman CR, Wallace R. A
country classification system to inform rabies prevention guidelines
and regulations. J Travel Med. 2022 Jul 14;29(4):taac046. doi:
10.1093/jtm/taac046. PMID: 35348741.
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Under 42 CFR 71.51(e), dogs may be subject to ``additional
requirements as may be deemed necessary'' or ``to exclusion if coming
from areas which the [CDC] Director has determined to have high rates
of rabies.'' Based on the previously described criteria, CDC determined
that high-risk countries constitute areas that have high rates of
DMRVV, and dogs imported from these countries are thus subject to
additional requirements and/or exclusion.\11\
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\11\ Henry RE, Blanton JD, Angelo KM, Pieracci EG, Stauffer K,
Jentes ES, Allen J, Glynn M, Brown CM, Friedman CR, Wallace R. A
country classification system to inform rabies prevention guidelines
and regulations. J Travel Med. 2022 Jul 14;29(4):taac046. doi:
10.1093/jtm/taac046. PMID: 35348741.
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Under 42 CFR 71.63, CDC may also temporarily suspend the entry of
animals, articles, or things from designated foreign countries and
places into the United States when it determines there exists in a
foreign country a communicable disease that threatens the public health
of the United States and the entry of imports from that country
increases the risk that the communicable disease may be introduced.
When such a suspension is issued, CDC designates the period of time or
conditions under which imports into the United States are suspended.
CDC likewise determined that DMRVV exists in countries designated as
high-risk countries and that, if reintroduced into the United States,
DMRVV would threaten the public health of the United States.
Based on these legal authorities and determinations, on June 16,
2021,\12\ CDC announced a temporary suspension of the importation of
dogs from high-risk countries into the United States (86 FR 32041) (the
temporary suspension). The temporary suspension went into effect on
July 14, 2021. CDC issued the temporary suspension to protect the
public health against the reintroduction of DMRVV into the United
States at a time when resources were being diverted to the agency-wide
response to the global COVID-19 pandemic.
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\12\ Temporary Suspension of Dogs Entering the United States
from High-Risk Rabies Countries. Federal Register, 86 FR 32041, June
16, 2021.
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At the time the temporary suspension was issued, CDC noted an
increase in importers circumventing dog import regulations. Despite a
decrease in international travel volumes due to the global COVID-19
pandemic, there was a 52 percent increase in dogs ineligible for entry
in 2020 as compared to 2018 and 2019. Additionally, four rabid dogs
were imported into the United States between 2015 and 2021.
The limited availability of public health resources due to the
unprecedented global response to the COVID-19 pandemic resulted in
reduced capacity at the Federal, state, and local levels to address the
increased risk of the reintroduction of DMRVV. For these reasons, CDC
implemented a temporary suspension prohibiting the
[[Page 5350]]
importation of dogs from high-risk countries for rabies in July 2021.
In addition, CDC implemented a CDC Dog Import Permit 13
[(OMB Control Number 0920-0134 Foreign Quarantine Regulations (exp. 12/
31/2022), or as revised] during the temporary suspension to verify the
documentation of imported dogs before they are flown to the United
States.
On June 10, 2022, CDC modified and extended the temporary
suspension through January 31, 2023.\14\ Per the Federal Register
notice announcing the extension and modification of the temporary
suspension, all categories of importers are currently eligible to
import dogs from high-risk countries. Commercially imported dogs are
required to enter the United States at a port of entry with a live
animal care facility \15\ with a Facilities Information and Resource
Management System (FIRMS) code issued by U.S. Customs and Border
Protection (CBP). CDC also expanded the list of the approved ports of
entry to include 18 airports \16\ with a CDC quarantine station for
importers with a valid U.S.-issued rabies vaccination certificate or a
CDC Dog Import Permit.
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\14\ 87 FR 33158 (June 1, 2022).
\15\ https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/approved-care-facilities.html.
\16\ The 18 approved ports of entry are: Anchorage (ANC),
Atlanta (ATL), Boston (BOS), Chicago (ORD), Dallas (DFW), Detroit
(DTW), Honolulu (HNL), Houston (IAH), Los Angeles (LAX), Miami
(MIA), Minneapolis (MSP), New York (JFK), Newark (EWR), Philadelphia
(PHL), San Francisco (SFO), San Juan (SJU), Seattle (SEA), and
Washington DC (IAD).
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Prior to modifying and extending the temporary suspension on June
10, 2022, CDC also evaluated the latest scientific information on
rabies serologic titer test results. Based on this evaluation, CDC
reduced the waiting period requirement, which is the number of days
between when a dog's sample is taken for a serologic titer test and
when the dog can be imported into the United States, from 90 days to 45
days.
Lastly, the June 10, 2022, extension and modification of the
temporary suspension allowed importers whose dogs are at least six
months old, have a microchip, and have a valid U.S.-issued rabies
vaccination certificate to enter the United States without a CDC Dog
Import Permit at one of the 18 airports with a CDC quarantine station
provided the dog appears healthy upon arrival. CDC made this change
because of the reliability of the United States' rabies vaccine supply
and to ease the burden on these importers.
At this time, CDC is extending the temporary suspension through
July 31, 2023, because of the continued risk for the reintroduction of
DMRVV into the United States. This extension is based on the disruption
of rabies vaccination campaigns globally that occurred due to the
COVID-19 pandemic. Since CDC anticipates the timeline needed for global
vaccination campaigns to recover will extend through July 31, 2023, the
risk of a rabid dog being imported into the United States is increased
during that time. Additionally, constraints on the global veterinary
workforce capacity and veterinary supply chain shortages that were
exacerbated by the COVID-19 pandemic have led to delayed or disrupted
care for dogs, which increases the likelihood dogs imported into the
United States may pose a public health threat.17 18 19 20
Federal, state and local public health partners continue to respond to
the global COVID-19 pandemic, which remains a Public Health Emergency
of International Concern according to the World Health Organization
(WHO) \21\ and a U.S. public health emergency per the HHS
declaration.\22\ An imported rabid dog would potentially divert limited
public health resources away from other critical ongoing public health
responses.
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\17\ https://www.theatlantic.com/health/archive/2022/07/not-enough-veterinarians-animals/661497/ 661497/.
\18\ https://www.agcanada.com/2021/07/is-the-veterinarian-
shortage-real-or-
regional#:~:text=A%20perceived%20global%20shortage%20of%20veterinaria
ns%20is%20creating,for%20the%20quality%20of%20care%20they%20can%20off
er.
\19\ https://www.thebusinessresearchcompany.com/report/
companion-animal-veterinary-vaccines-global-market-report.
\20\ https://7news.com.au/lifestyle/pets/aussie-dog-owners-warned-of-national-vaccine-shortage-as-deadly-bacterial-disease-spreads-c-8568550.
\21\ https://www.who.int/europe/news/item/19-10-2022-statement-on-the-thirteenth-meeting-of-the-international-health-regulations-
(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-
19)-pandemic.
\22\ https://aspr.hhs.gov/legal/PHE/Pages/covid19-13Oct2022.aspx.
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CDC will regularly review the terms of this notice to ensure that
the terms remain necessary and that importers are not overly burdened
while the public health of the United States remains protected from the
reintroduction of DMRVV. In conducting this review, CDC will consider
high-risk countries' rabies control programs, the latest scientific
data, and international recommendations for rabies control.
Additionally, CDC previously announced that it is developing a proposed
rule that will outline requirements regarding an importation system to
reduce fraud and improve the U.S. government's ability to verify U.S.
entry requirements and mitigate the introduction of dogs infected with
rabies and other communicable diseases of public health concern.\23\
Development of this proposed rule is ongoing.
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\23\ See https://www.reginfo.gov/public/do/eAgendaViewRule?pubId=202204&RIN=0920-AA82.
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II. Public Health Rationale
A. Dog Importation Into the United States
The United States was declared DMRVV-free in 2007. Importing dogs
from high-risk countries involves a significant public health risk. The
importation of just one dog infected with DMRVV risks re-introduction
of the virus into the United States, resulting in a potential public
health risk with consequent monetary cost and potential loss of human
and animal life.24 25 26 DMRVV has been highly successful at
adapting to new host species, particularly wildlife.\27\ One DMRVV-
infected dog could result in transmission to humans, domestic pets, or
wildlife. In 2019, the importation of a single dog with rabies cost
more than $400,000 for the public health investigations and rabies
post-exposure prophylaxis (PEP) of exposed persons.28 29 To
mitigate the risk of importing dogs with DMRVV, CDC requires compliance
with its public health entry requirements.
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\24\ World Bank (2012). People, Pathogens and Our Planet: The
Economics of One Health. Retrieved from https://openknowledge.worldbank.org/handle/10986/11892.
\25\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore,
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38),
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
\26\ Jeon, S., Cleaton, J., Meltzer, M., Kahn, E., Pieracci, E.,
Blanton, J., Wallace, R. (2019). Determining the post-elimination
level of vaccination needed to prevent re-establishment of dog
rabies. PLoS Neglected Tropical Diseases, 13(12). https://doi.org/10.1371/journal.pntd.0007869.
\27\ Velasco-Villa, A., Mauldin, M., Shi, M., Escobar, L.,
Gallardo-Romero, N., Damon, I., Emerson, G. (2017). The history of
rabies in the Western Hemisphere. Antiviral Research, 146, 221-
232.doi:10.1016/j.antiviral.2017.03.013.
\28\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore,
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38),
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
\29\ Centers for Disease Control and Prevention (2022). Rabies
Postexposure Prophylaxis. Retrieved from https://www.cdc.gov/rabies/medical_care/index.html.
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Although the U.S. Government does not track the total number of
dogs imported each year, it is estimated that approximately 1 million
dogs are imported into the United States annually, of which 100,000
dogs are
[[Page 5351]]
from high-risk countries.\30\ This estimate was based on information
provided by airlines, CBP staff, and a study conducted at a U.S.-Mexico
land border crossing.\31\
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\30\ Centers for Disease Control and Prevention (2019). Guidance
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to
the Importation of Dogs Into the United States. Federal Register,
Vol. 84, 724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
\31\ McQuiston, J.H., Wilson, T., Harris, S., Bacon, R.M.,
Shapiro, S., Trevino, J., Marano, N. (2008.) Importation of dogs
into the United States: risks from rabies and other zoonotic
diseases. Zoonoses Public Health, 55(8-10), 421-6. doi:10.1111/
j.1863-2378.2008.01117.
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CBP does record, by country, the number of dogs imported with
formal entry under Harmonized Tariff Schedule (HTS) code 0106199120 and
HTS description: Other live animals, other, dogs. The total number of
dogs imported into the United States from all countries under this HTS
category varied from 25,232 in 2018 to 58,540 in 2020. The number of
dogs from high-risk countries under this HTS category averaged 16,390
per year and varied from 9,966 to 24,031 over this three-year period.
The number of dogs reported under this HTS category does not include
dogs imported as checked baggage, hand-carried in airplane cabins, or
crossing at land borders without formal entry. Thus, the number
underestimates the true number of dogs imported into the United States.
Since 2015, there have been four known rabid dogs imported into the
United States. All four dogs were imported by rescue organizations for
the purposes of adoption. These four cases, discussed below, highlight
the immense public health resources required to investigate, respond
to, and mitigate the public health threat posed by the importation of a
rabid dog.
In 2015, a rabid dog was part of a group of eight dogs and 27 cats
imported from Egypt by a rescue group. The dog had an unhealed leg
fracture and began showing signs of rabies four days after arrival.
Following the rabies diagnosis, the rescue workers in Egypt admitted
that the dog's rabies vaccination certificate had been intentionally
falsified to evade CDC entry requirements.\32\ Eighteen people were
recommended to receive rabies PEP, seven dogs underwent a six-month
quarantine, and eight additional dogs housed in the same home as the
rabid dog had to receive rabies booster vaccinations and undergo a 45-
day monitoring period.
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\32\ Sinclair J., Wallace, R., Gruszynski K., Bibbs Freeman, M.,
Campbell, C., Semple, S., Murphy, J. (2015). Rabies in a dog
imported from Egypt with a falsified rabies vaccination
certificate--Virginia. Morbidity and Mortality Weekly Report, 64,
1359-62. doi:10.15585/mmwr.mm6449a2.
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In 2017, a ``flight parent'' (a person typically solicited through
social media, often not affiliated with the rescue organization, and
usually compensated with an airline ticket) imported four dogs on
behalf of a rescue organization. One of the dogs appeared agitated at
the airport and bit the flight parent prior to the flight. A U.S.
veterinarian examined the dog one day after its arrival and then
euthanized and tested the dog for rabies. A post-mortem rabies test
showed that the dog was positive for the virus. Public health officials
recommended that at least four people receive rabies PEP, and the
remaining three dogs underwent quarantine periods ranging from 30 days
to six months. An investigation revealed the possibility of falsified
rabies vaccination documentation presented on entry to the United
States.\33\
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\33\ Hercules, Y., Bryant, N., Wallace, R., Nelson, R., Palumbo,
G., Williams, J., Brown, C. (2018). Rabies in a dog imported from
Egypt--Connecticut, 2017. Morbidity and Mortality Weekly Report 67,
1388-91. doi:10.15585/mmwr.mm6750a3.
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In 2019, a rescue group imported 26 dogs, all of which had rabies
vaccination certificates and serologic documentation, indicating the
development of rabies antibodies (in response to immunization), based
on results from an Egyptian Government-affiliated rabies laboratory.
However, one dog developed signs of rabies three weeks after arrival
and had to be euthanized. The dog tested positive for rabies. Forty-
four people received PEP, and the 25 dogs imported on the same flight
underwent re-vaccination and quarantines of four to six months. An
additional 12 dogs had contact with the rabid dog and had to be re-
vaccinated and undergo quarantine periods ranging from 45 days to six
months based on their previous vaccination status.\34\
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\34\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore,
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from
Egypt-Kansas, 2019. Morbidity and Mortality Weekly Report, 69(38),
1374-1377. Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
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On June 10, 2021, shortly before CDC published the temporary
suspension, 33 dogs were imported into the United States from
Azerbaijan by a rescue organization. All dogs had rabies vaccination
certificates that appeared valid upon arrival in the United States. One
dog developed signs of rabies three days after arrival and was
euthanized. CDC confirmed the dog was infected with a variant of DMRVV
known to circulate in the Caucus Mountain region of Azerbaijan. The
remaining rescue animals exposed to the rabid dog during travel were
dispersed across nine states, leading to what is believed to be the
largest, multi-state, imported rabid dog investigation in U.S.
history.\35\
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\35\ Whitehill F, Bonaparte S, Hartloge C, et al. Rabies in a
Dog Imported from Azerbaijan-Pennsylvania, 2021. MMWR Morb Mortal
Wkly Rep 2022; 71: 686-689.
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Eighteen people received PEP to prevent rabies as a result of
exposure to this one rabid dog. Post-vaccination serologic monitoring
of the remaining dogs and the public health investigation revealed that
improper vaccination practices by the veterinarian in Azerbaijan likely
contributed to the inadequate vaccination response documented in 48
percent of the imported animals, including the rabid dog.\36\ The 33
exposed animals were placed in quarantine periods ranging from 45 days
to six months based on individual serologic titer test results and
local jurisdictional requirements.\37\
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\36\ Centers for Disease Control and Prevention (2021). CDC
responds to a case of rabies in an imported dog. Retrieved from
https://www.cdc.gov/worldrabiesday/disease-detectives/rabies-imported-dog.html.
\37\ Whitehill F, Bonaparte S, Hartloge C, et al. Rabies in a
Dog Imported from Azerbaijan-Pennsylvania, 2021. MMWR Morb Mortal
Wkly Rep 2022; 71: 686-689.
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CDC estimates that costs for public health investigations and
subsequent cost of care for people exposed to rabid dogs range from
$220,897 to $521,828 per importation event, as summarized in an
economic analysis found on CDC's website.38 39 40 This cost
estimate does not account for the worst-case outcomes, which include:
(1) transmission of rabies to a person who dies from the disease; and
(2) ongoing transmission to other domestic animals and wildlife species
in the United States. A previous campaign to eliminate domestic dog-
coyote rabies virus variant jointly with gray fox (Texas fox) rabies
virus variant in Texas over the period from 1995 through 2003 cost $34
million,41 42 or $48 million in
[[Page 5352]]
2020 U.S. dollars. Re-establishment of DMRVV into the United States
could result in costly efforts over several years to eliminate the
virus again.
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\38\ Raybern, C., Zaldivar, A., Tubach, S., Ahmed, F., Moore,
S., Kintner, C., Garrison, I. (2020) Rabies in a dog imported from
Egypt-Kansas, 2019. MMWR Morb Mort Wkly Rep, 69(38), 1374-1377.
Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6938a5-H.pdf.
\39\ Centers for Disease Control and Prevention (2019). Guidance
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to
the Importation of Dogs Into the United States. Federal Register,
Vol. 84, 724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
\40\ https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/vaccine-certificate.html.
\41\ Thomas, S., Wilson, P., Moore, G., Oertli, E., Hicks, B.,
Rohde, R., Johnston, D. (2005). Evaluation of oral rabies
vaccination programs for control of rabies epizootics in coyotes and
gray foxes: 1995-2003. Journal of the American Veterinary Medicine
Association, 227(5), 785-92. doi: 10.2460/javma.2005.227.785.
\42\ Sterner, R., Meltzer, M., Shwiff, S., Slate, D. (2009).
Tactics and Economics of Wildlife Oral Rabies Vaccination, Canada
and the United States. Emerging Infectious Diseases, 15(8), 1176-
1184. doi: 10.3201/eid1508.081061.
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B. Ongoing COVID-19 Response Activities
Since January 2020, public health resources globally have been
dedicated to responding to the COVID-19 pandemic, which remains a
public health emergency as declared by the HHS Secretary and a Public
Health Emergency of International Concern as declared by WHO. This
context caused a lapse in canine rabies vaccination efforts in high-
risk countries.43 44 In the United States, the public health
response to combatting the emergence of SARS-CoV-2 variants has
required sustained Federal, state, and local public health resources.
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\43\ Kunkel, A., Jeon, S., Joseph, H., Dilius, P., Crowdis, K.,
Meltzer, M., Wallace, R. (2021). The urgency of resuming disrupted
dog rabies vaccination campaigns: a modeling and cost-effectiveness
analysis. Scientific Reports, 11, 12476. doi:10.1038/s41598-021-
92067-5.
\44\ Raynor, B., D[iacute]az, E., Shinnick, J., Zegarra, E.,
Monroy, Y., Mena. C., . . . Castillo-Neyra, R.(2021). The impact of
the COVID-19 pandemic on rabies reemergence in Latin America: The
case of Arequipa, Peru. PLoS Neglected Tropical Diseases, 15(5),
e0009414. doi:10.1371/journal.pntd.0009414.
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The importation of a rabid dog on June 10, 2021, diverted public
health resources from CDC, the U.S. Department of Agriculture (USDA),
and nine states away from critical COVID-19 response activities. Any
increase in the number of dogs with inadequate or falsified rabies
vaccination certificates arriving in the United States increases the
likelihood of a DMRVV-importation event and threatens the diversion of
critical public health resources.\45\
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\45\ Pieracci, E., Williams, C., Wallace, R., Kalapura, C.,
Brown, C. U.S. dog importations during the COVID-19 pandemic: Do we
have an erupting problem? PLoS ONE, 16(9), e0254287. doi: 10.1371/
journal.pone.0254287.
---------------------------------------------------------------------------
C. Insufficient Canine Vaccination Rates and Veterinary Controls in
High-Risk Countries To Prevent the Export of Inadequately Vaccinated
Dogs
Historically, approximately 60 to 70 percent of CDC's dog entry
denials (or about 200 cases annually) have been based on fraudulent,
incomplete, or inaccurate paperwork.\46\ This number is less than one
percent of dog importations. However, between January and December 2020
(i.e., during the global COVID-19 pandemic), CDC documented more than
450 instances of incomplete, inadequate, or fraudulent rabies
vaccination certificates for dogs arriving from high-risk countries.
This number increased for the first six months of 2021, during which
time CDC documented more than 560 instances of incomplete, inadequate,
or fraudulent rabies vaccination certificates for dogs arriving from
high-risk countries.\47\ These cases resulted in dogs being denied
entry into the United States and ultimately returned to their country
of origin.
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\46\ Centers for Disease Control and Prevention (2021).
Quarantine Activity Reporting System (version 4.9.8.8.2.2A). Dog
Importation data, 2010-2019. Accessed 1 October 2022.
\47\ Pieracci, E., Williams, C., Wallace, R., Kalapura, C.,
Brown, C. U.S. dog importations during the COVID-19 pandemic: Do we
have an erupting problem? PLoS ONE, 16(9), e0254287. doi: 10.1371/
journal.pone.0254287.
---------------------------------------------------------------------------
During the global COVID-19 pandemic, canine rabies vaccination
campaigns were suspended in many high-risk countries, which resulted in
an increase in canine and human rabies cases.48 49 The pause
in canine vaccination campaigns and the delay in re-establishing pre-
COVID rabies vaccination rates in dogs in many high-risk countries,
combined with insufficient veterinary controls in place to prevent the
exportation of inadequately vaccinated dogs with fraudulent rabies
vaccination certificates, presents a significant public health risk.
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\48\ Kunkel, A., Jeon, S., Joseph, H., Dilius, P., Crowdis, K.,
Meltzer, M., Wallace, R. (2021). The urgency of resuming disrupted
dog rabies vaccination campaigns: a modeling and cost-effectiveness
analysis. Scientific Reports, 11, 12476. doi:10.1038/s41598-021-
92067-5.
\49\ Raynor, B., D[iacute]az, E., Shinnick, J., Zegarra, E.,
Monroy, Y., Mena. C., . . . Castillo-Neyra, R.(2021). The impact of
the COVID-19 pandemic on rabies reemergence in Latin America: The
case of Arequipa, Peru. PLoS Neglected Tropical Diseases, 15(5),
e0009414. doi:10.1371/journal.pntd.0009414.
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A survey of global, regional, national, and local rabies working
partners from the network of the United Against Rabies Forum \50\ and
rabies practitioners found that the global COVID-19 pandemic impacted
rabies control efforts in many high-risk countries during 2020. The
study authors reported that dog vaccinations were administered as
planned in just four percent of the countries for which data were
available. Around half of respondents reported that funds for rabies
control were diverted to global COVID-19 activities. However, even in
countries where funds were not diverted, it was reported that funding
for rabies control was insufficient and unpredictable even before the
global COVID-19 pandemic. Among respondents who reported diversion of
rabies control funds to global COVID-19 responses, they reported that
animal rabies vaccines and dog vaccination campaigns were often the
first rabies control activities to be cut.\51\
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\50\ A forum supported by the Food and Agriculture Organization
of the United Nations, the World Organisation for Animal Health, and
the World Health Organization (the Tripartite), which takes a multi-
sectoral, One Health approach bringing together governments, vaccine
producers, researchers, non-governmental organizations and
development partners to end human deaths from dog-mediated rabies.
\51\ Nadal D, Abela-Ridder B, Beeching S, Cleaveland S, Cronin
K, Steenson R and Hampson K (2022). The Impact of the First Year of
the COVID-19 Pandemic on Canine Rabies Control Efforts: A Mixed-
Methods Study of Observations About the Present and Lessons for the
Future. Front Trop Dis 3:866811.doi: 10.3389/fitd.2022.866811.
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Additionally, there are global veterinary workforce capacity and
veterinary supply chain shortages, exacerbated by the COVID-19
pandemic, that have led to delayed or disrupted care for dogs (and
other pets) globally. The lack of veterinarians, veterinary
technicians, and other animal care staff who are available to provide
care for dogs prior to travel, combined with a lack of veterinary
supplies such as drugs and vaccines, increase the likelihood dogs
imported into the United States may pose a public health
threat.52 53 54 55
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\52\ https://www.theatlantic.com/health/archive/2022/07/not-enough-veterinarians-animals/661497/ 661497/.
\53\ https://www.agcanada.com/2021/07/is-the-veterinarian-
shortage-real-or-
regional#:~:text=A%20perceived%20global%20shortage%20of%20veterinaria
ns%20is%20creating,for%20the%20quality%20of%20care%20they%20can%20off
er.
\54\ https://www.thebusinessresearchcompany. com/report/
companion-animal-veterinary-vaccines-global-market-report.
\55\ https://7news.com.au/lifestyle/pets/aussie-dog-owners-warned-of-national-vaccine-shortage-as-deadly-bacterial-disease-spreads-c-8568550.
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D. Potentially Unsafe Conditions for Dogs Arriving From High-Risk
Countries Without Appropriate Rabies Vaccination Certificates
Prior to the implementation of the suspension, dogs arriving from
high-risk countries without appropriate rabies vaccination certificates
were denied entry and returned to the country of origin on the next
available flight.\56\ Airlines were required to house dogs awaiting
return to their country of origin
[[Page 5353]]
at a facility that meets the USDA's Animal Welfare Act standards,
preferably a live animal care facility with an active custodial bond
and a FIRMS code issued by CBP. If a live animal care facility with a
CBP-issued FIRMS code was not available, the airline was required, at a
minimum, to provide accommodation meeting the USDA's Animal Welfare Act
standards.\57\
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\56\ Centers for Disease Control and Prevention (2019). Guidance
Regarding Agency Interpretation of ``Rabies-Free'' as It Relates to
the Importation of Dogs Into the United States. Federal Register,
Vol. 84 724-730. Retrieved from https://www.federalregister.gov/documents/2019/01/31/2019-00506/guidance-regarding-agency-interpretation-of-rabies-free-as-it-relates-to-the-importation-of-dogs.
\57\ U.S. Department of Agriculture (2020). Animal Welfare
Regulations; Part 3, Subpart A: Transportation Standards. Sections
3.14-3.20. Retrieved from https://www.aphis.usda.gov/animal_welfare/downloads/AC_BlueBook_AWA_508_comp_version.pdf.
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Some airlines housed dogs in cargo warehouses that created an
unsafe environment for dogs due to the prolonged periods of time
between flights, inadequate cooling and heating, poor cleaning and
sanitization of crates, and inability to physically separate the
animals from areas of the warehouse where other equipment, machinery,
and goods are used and stored. Cargo warehouse staff who are not
trained to house, clean, and care for live animals with appropriate
personal protective equipment were at risk of bites, scratches, and
exposures to potentially infectious bodily fluids from dogs left in
cargo warehouses.
During 2020, due to the global COVID-19 pandemic, there were fewer
international flights worldwide,58 59 resulting in delayed
returns for dogs denied entry. While international flights in 2022
increased compared to 2020-2021, the number of flights remained
somewhat below pre-pandemic levels with uncertainty regarding how
quickly international passenger traffic will fully recover to pre-
pandemic levels.\60\ In August 2020, a dog denied entry based on
falsified rabies vaccination certificates later died while in the
custody of an airline at Chicago O'Hare International Airport. Despite
CDC's request to find appropriate housing at a local kennel or
veterinary clinic, the airline left the dog, along with 17 other dogs,
in a cargo warehouse without food and water for more than 48 hours.\61\
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\58\ Josephs, L. (2020). American Airlines cutting international
summer schedule by 60% as coronavirus drives down demand. CNBC.
Retrieved from https://www.cnbc.com/2020/04/02/coronavirus-update-american-airlines-cuts-summer-international-flights-by-60percent-as-demand-suffers.html.
\59\ American Airlines (2020). American Airlines announces
additional schedule changes in response to customer demand related
to COVID-19. American Airlines Newsroom. Retrieved from https://news.aa.com/news/news-details/2020/American-Airlines-Announces-Additional-Schedule-Changes-in-Response-to-Customer-Demand-Related-to-COVID-19-031420-OPS-DIS-03/default.aspx.
\60\ International Civil Aviation Organization (2022). Effects
of novel coronavirus (COVID-19) on civil aviation: economic impact
analysis. Retrieved from https://www.icao.int/sustainability/Documents/Covid-19/ICAO_coronavirus_Econ_Impact.pdf.
\61\ CBS Broadcasting (2020). Dog dies at O'Hare Airport
warehouse, 17 others saved after being left without food or water
for 3 days. CBS Chicago. Retrieved from https://www.cbsnews.com/chicago/news/dog-dies-at-ohare-airport-warehouse-17-others-saved-after-being-left-without-food-or-water-for-3-days.
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While costs associated with housing, caring for, and returning dogs
are the responsibility of the importer (or airline if the importer
abandons the dog), some importers and airlines are reluctant to pay
these costs, requiring the U.S. Government to find appropriate interim
housing facilities and veterinary care. The cost for housing, care, and
returning improperly vaccinated dogs ranges between $1,000 and $4,000
per dog, depending on the location and time required until the next
available return flight. Because there is no reimbursement system in
place, and seeking reimbursement is administratively challenging, the
U.S. Government is left to bear these costs when airlines and importers
do not. From May through December 2020, CDC spent more than 3,000
personnel-hours at an estimated cost of $270,000 to respond to the
attempted importation of unvaccinated or inadequately vaccinated dogs
from high-risk countries. The time spent represented a substantial
increase from previous years due to (1) the increase in dogs with
inadequate documentation; and (2) the additional time spent identifying
interim accommodations for the dogs because of the reduced outbound
international flight schedules due to the pandemic.
During 2020, CDC observed a 52 percent increase (from an average of
300 to 450) in the number of dogs ineligible for entry compared to 2018
and 2019.\62\ The trend continued in the first half of 2021 when there
was a 24 percent increase (from 450 to 560) in the number of dogs
ineligible for entry compared to the whole of 2020.\63\ From January 1,
2021, to July 13, 2021, prior to CDC's suspension taking effect, there
were 16 sick dogs and 18 dead dogs reported to CDC upon arrival in the
United States. From July 14, 2021, when the suspension was implemented,
to September 30, 2022, CDC has denied entry to 145 dogs, and eight sick
dogs and 26 deaths have been reported to CDC. This substantial decrease
in the number of dogs denied entry since the implementation of the
suspension and limited number of sick and dead dogs arriving in the
United States has resulted in an estimated $55,000 to $190,000 in cost
savings to importers and $3,400 to $170,000 in cost savings to Federal
and state public health and animal health agencies when comparing the
two periods.
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\62\ Pieracci, E., Williams, C., Wallace, R., Kalapura, C.,
Brown, C. U.S. dog importations during the COVID-19 pandemic: Do we
have an erupting problem? PLoS ONE, 16(9), e0254287. doi: 10.1371/
journal.pone.0254287.
\63\ Centers for Disease Control and Prevention. Quarantine
Activity Reporting System (version 4.9.8.8.2.2A). Dog Importation
data, January 1, 2021-July 14, 2021. Accessed: 04 January 2022.
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During the timeframe of the current suspension, the number of dogs
denied entry and the number of sick and dead dogs has substantially
decreased despite the increased communicable disease risk due to
disruptions to vaccination programs in high-risk countries and
veterinary supply chain and staffing shortages worldwide. This
constitutes strong evidence that the suspension has been effective at
preventing the importation of dogs that present a communicable disease
risk that would otherwise require significant U.S. resources to
address. There was an increasing number of dogs denied entry in 2020
and 2021, prior to the suspension, and there were fewer international
flights in 2020 and 2021 compared to 2022.\64\ If the increase in
number of flights in 2022 corresponded with numbers of dogs denied
entry per flight in 2021 and 2022, lifting the suspension at this time
could result in a return to pre-suspension or greater numbers of dogs
denied entry along with an associated large increase of sick, dead, or
inadequately vaccinated dogs arriving in the United States that could
quickly overwhelm already strained public health and veterinary
healthcare systems.
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\64\ U.S. Bureau of Transportation Statistics. (2022) August
2022 U.S. Airline Traffic Data. https://www.bts.gov/newsroom/august-2022-us-airline-traffic-data.
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Since there remains an elevated level of risk of a rabid dog being
imported into the United States compared to before the global COVID-19
pandemic and because responding to imports of potentially rabid dogs or
dogs with other communicable illnesses of public health concern
requires significant veterinary and public health resources, lifting
the suspension would be unwarranted at this time.
Instead, CDC is extending the temporary suspension for dogs
arriving into the United States from high-risk countries. Given that
the conditions for dog importations under the suspension have prevented
the reintroduction of DMRVV into the United States and have decreased
the number of issues with imported dogs (suspected fraudulent
[[Page 5354]]
documentation, dogs abandoned by importers, sick and dead dogs arriving
in the United States) compared to the period prior to the suspension,
maintaining the current requirements for dog importation should not
result in an increased need for veterinary and public health resources
to address dog importation issues.
III. Conditions for Dog Importation Under the July 10, 2021, Temporary
Suspension
During the temporary suspension of dogs arriving from countries at
high risk for dog rabies, eligible importers, including owners of
service dogs, U.S. and foreign-government personnel, and persons
permanently relocating to the United States, could apply to import
their personally owned pet dogs. People were also permitted to import
dogs for science, education, exhibition, or bona fide law enforcement
purposes. To receive a CDC Dog Import Permit, eligible importers had to
provide a rabies vaccination certificate prior to the dog arriving in
the United States that met the criteria outlined below, as well as
rabies serologic titers from a CDC-approved laboratory if the dog was
vaccinated outside the United States. Dogs were also required to be at
least six months of age and have a microchip implanted prior to arrival
in the United States.
For dogs arriving from high-risk countries, the rabies vaccination
certificates had to include the following information to be considered
complete and accurate:
Name and address of owner;
Breed, sex, date of birth (approximate age if date of
birth unknown), color, markings, and other identifying information for
the dog;
Microchip number;
Date of rabies vaccination and vaccine product
information;
Date the vaccination expires; and
Name, license number, address, and signature of
veterinarian who administered the vaccination.
For a rabies vaccine to be effective, a dog must be at least 12
weeks (84 days) of age at the time of administration. A dog's initial
vaccine must also be administered at least four weeks (28 days) before
arrival in the United States for the dog to be considered adequately
vaccinated against rabies.
A. Extension of the Temporary Suspension Enacted June 10, 2022
On June 10, 2022, CDC extended and modified the temporary
suspension to allow a pathway for all importers to import dogs into the
United States utilizing one of the three options listed in sections IV-
VII below. CDC is now extending the suspension through July 31, 2023.
Although CDC is providing clarifying language to the entry requirements
in section IV-VI below, it is not modifying the terms of the current
suspension itself. CDC will be implementing the use of a standardized
rabies vaccination form to reduce errors and omissions frequently
documented on rabies vaccination certificates. This form will not
require any new information to be submitted to CDC but will assist
importers in ensuring the rabies vaccination form they submit includes
all required information. This will help to reduce wait times for
importers applying for CDC dog import permits.
IV. Conditions for Entry of U.S.-Vaccinated Dogs During the Extension
Through this notice, CDC is continuing the current requirements for
entry of U.S.-vaccinated dogs. Dogs returning to the United States from
high-risk countries with a valid U.S.-issued rabies vaccination
certificate will be allowed to enter the United States without a CDC
Dog Import Permit, if the dog:
Is six-months of age or older;
Has an ISO-compatible microchip; \65\
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\65\ ISO means international standards organization.
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Arrives at one of 18 CDC-approved ports of entry with CDC-
staffed quarantine stations; and
Has a valid U.S. rabies vaccination certificate
documenting that the dog was vaccinated against rabies by a U.S.-
licensed veterinarian in the United States on or after the date the dog
was 12 weeks (84 days) of age and at least four weeks (28 days) before
the date of arrival in the United States if it was the dog's first
rabies vaccine. The rabies vaccination certificate must include:
[cir] Name and address of owner;
[cir] Breed, sex, date of birth (approximate age if date of birth
unknown), color, markings, and other identifying information for the
dog;
[cir] Microchip number;
[cir] Date of rabies vaccination and date next vaccine is due
(i.e., date the vaccination expires);
[cir] Vaccine manufacturer, product name, lot number and product
expiration date; and
[cir] Name, license number, address, and signature of veterinarian
who administered the vaccination.
U.S. veterinarians, at their option, may choose to include the
above information on the CDC Rabies Vaccination and Microchip Record
(OMB No. 0920-1383) for U.S.-vaccinated dogs prior to traveling outside
the United States, but completion of the form is not required for a
U.S.-vaccinated dog's re-entry into the United States if all other
necessary information has been provided. The form is available for
download online at: www.cdc.gov/dogpermit.
U.S.-vaccinated dogs with expired U.S. rabies vaccination
certificates must meet the requirements for foreign-vaccinated dogs
after being revaccinated prior to U.S. entry.
There is no limit on the number of U.S.-vaccinated dogs with valid
U.S.-issued rabies vaccination certificates that an importer can
import.
These requirements are consistent with CDC's practices as of
December 1, 2021, and are a continuation of the terms of the modified
temporary suspension announced in the June 2022 Federal Register notice
(87 FR 33158, June 1, 2022).
V. Conditions for Entry of Foreign-Vaccinated Dogs With a CDC Dog
Import Permit During the Extension
CDC is continuing to require foreign-vaccinated dogs to meet the
terms of the modified temporary suspension published in the June 2022
Federal Register notice (87 FR 33158, June 1, 2022). Importers of
personal pet dogs may receive up to two CDC Dog Import Permits (i.e.,
permits for two dogs) during the suspension period. Commercial
importers and personal pet owners who do not have serologic titer
results for their dogs will also continue to have an alternate pathway
for importation.
All importers of personal pet dogs (defined for the purpose of this
notice as owners or importers attempting to import fewer than three
dogs total during the suspension and not intended for resale, rescue,
or adoption) from high-risk countries are eligible to apply for a CDC
Dog Import Permit. Commercial dog importers (defined for the purpose of
this notice as importing three or more dogs during the suspension or
those being imported for resale, rescue, or adoption) are not eligible
to apply for a CDC Dog Import Permit and their dogs must meet the
requirements for entry outlined in Section VI below.
Foreign-vaccinated dogs arriving from high-risk countries with a
valid CDC Dog Import Permit will be allowed to enter the United States
if the dogs:
Are six-months of age or older (photographs of the dog's
teeth are required for age verification);
Have an ISO-compatible microchip;
[[Page 5355]]
Have a CDC Rabies Vaccination and Microchip Record
([approved under OMB Control Number 0920-1383 Importation Regulations
(42 CFR 71 Subpart F) (exp. 1/31/2026, or as revised)]) completed by
the veterinarian who administered the rabies vaccine. The record must
state that the vaccine was administered on or after the date the dog
was 12 weeks (84 days) of age. The record must be in English;
Have serologic evidence of rabies vaccination (titer) from
an approved rabies serology laboratory \66\ (serologic titer results
>=0.5 IU/mL are required) with the sample collected at least 45 days
prior to entry and no greater than 365 days before entry; and
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\66\ Centers for Disease Control and Prevention (2022). Approved
Rabies Serology Laboratories for Testing Dogs. Retrieved from
https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/approved-labs.html.
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Arrive at one of the 18 CDC-approved ports of entry with
CDC-staffed quarantine stations.
In order to reduce the time to review applications and issue CDC
Dog Import Permits, CDC is requiring that importers of foreign-
vaccinated dogs submit the rabies vaccination and microchip information
via the form CDC Rabies Vaccination and Microchip Record (OMB No. 0920-
1383). As of October 31, 2022, almost half of CDC Dog Import Permit
applicants submitted an incomplete application with information
pertaining to the rabies vaccination certificate constituting the
majority of the missing information. Requiring importers to submit the
CDC Rabies Vaccination and Microchip Record form will help ensure they
submit all required information and will reduce the burden on importers
by reducing the time it takes for them to receive a permit.
Additionally, CDC has included a description on the form to clarify for
veterinarians the information to which they are attesting when they
sign the form on behalf of an importer. The form is available for
download online at: www.cdc.gov/dogpermit.
To apply for a CDC Dog Import Permit, importers whose dogs meet the
entry requirements listed above must submit the Application for Special
Exemption for a Permitted Dog Import, [approved under OMB Control
Number 0920-1383 Importation Regulations (42 CFR 71 Subpart F) (exp. 1/
31/2026), or as revised]. The permit application is available online at
www.cdc.gov/dogpermit.
The importer's application, with all supporting documentation, must
be submitted at least 30 business days (i.e., excluding weekends and
U.S. federal holidays) before the date on which the dog will enter the
United States. Importers may submit an application electronically at
www.cdc.gov/dogpermit. An application cannot be made at the port of
entry upon the dogs' arrival in the United States; dogs that arrive
without a CDC Dog Import Permit will be returned to their country of
departure on the next available flight or quarantined at the importer's
expense at a CDC-approved animal care facility (if one is available at
the port of entry where the dog arrived) pending availability and
payment of all associated examination, vaccination, and quarantine fees
upfront (see Section VI).
Within 10 days of arrival, foreign-vaccinated dogs with a CDC Dog
Import Permit must receive a USDA-licensed rabies booster vaccination
administered by a U.S. veterinarian.
VI. Conditions for Entry of Foreign-Vaccinated Dogs Without a CDC Dog
Import Permit During the Extension
CDC is continuing the requirements of the temporary suspension
published in the June 2022 Federal Register notice (87 FR 33158, June
1, 2022) that provide a pathway for commercial dog importers to import
dogs. While importers of commercial shipments of dogs cannot apply for
a CDC Dog Import Permit, a separate entry process, as outlined below,
has been established. All commercial dog importers from high-risk
countries may import dogs provided that the dogs, upon entering the
United States, are examined, revaccinated, and have proof of an
adequate titer from a CDC-approved laboratory upon arrival or are held
in quarantine at a CDC-approved animal facility until they meet CDC
entry requirements. Importers of personally owned pets may also choose
to use this pathway in lieu of obtaining a CDC Dog Import Permit.
Foreign-vaccinated dogs without a valid CDC Dog Import Permit must
meet all other entry requirements (sections VI-VII) prior to arrival
and must also meet the following requirements:
Dogs must enter at a port of entry with a CDC-approved
animal facility; \67\
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\67\ Centers for Disease Control and Prevention (2022). Bringing
a dog into the United States. Retrieved from www.cdc.gov/dogtravel.
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Dogs must be six months of age or older at the time of
entry;
Dogs must have an ISO-compatible microchip; and
Dogs must have a CDC Rabies Vaccination and Microchip
Record [approved under OMB Control Number 0920-1383 Importation
Regulations (42 CFR 71 Subpart F) (exp. 1/31/2026, or as revised)])
completed by the veterinarian who administered the rabies vaccine. The
record must state that the vaccine was administered on or after the
date the dog was 12 weeks (84 days) of age. The record must be in
English;
Importers must provide all required entry documents (CDC
Rabies Vaccination and Microchip Record, serologic titer results if
available, photos of dogs' teeth) to the CDC-approved animal care
facility at least 10 days before the dogs' arrival;
Importers must arrange for an examination date and time
and reserve space with a CDC-approved animal facility;
Importers must arrange for transportation by a CBP-bonded
transporter (i.e., provided by the airline carrier or a CDC-approved
animal facility) to a CDC-approved animal facility immediately upon the
dogs' arrival to the United States; and
Dogs must undergo veterinary examination and revaccination
against rabies at a CDC-approved animal facility upon arrival at the
importer's expense.
In order to reduce the time for facility operators to review the
documents required to request a reservation at a CDC-approved animal
care facility, CDC is requiring that importers of foreign-vaccinated
dogs submit the rabies vaccination and microchip information via the
form CDC Rabies Vaccination and Microchip Record. Requiring importers
to submit the CDC Rabies Vaccination and Microchip Record (OMB NO.
0920-1383) form will help ensure they submit all required information
and will reduce the burden on importers and the CDC-approved animal
care facilities by reducing the time it takes for facility operators to
review all required documents. Additionally, CDC has included a
description on the form to clarify for veterinarians that to which they
are attesting when they sign the form for an importer.
Dogs must also be held at the CDC-approved animal facility until
the following entry requirements are completed:
Veterinary health examination by a USDA-accredited
veterinarian for signs of illness, including zoonotic or foreign animal
diseases. Suspected or confirmed zoonotic or foreign animal diseases
must be reported to CDC, USDA, the state or territorial public health
veterinarian, and the state or territorial veterinarian. The CDC-
approved animal care facility must not release the dog without the
written approval of CDC;
[[Page 5356]]
Vaccination against rabies with a USDA-licensed rabies
vaccine and administered by a USDA-accredited veterinarian;
Confirmation of microchip number;
Confirmation of age through dental examination by a USDA-
accredited veterinarian; and
Verification of adequate rabies titer from a CDC-approved
laboratory.\68\ Serologic titer results of >=0.5IU/mL are required from
a CDC-approved laboratory, with the sample collected at least 45 days
prior to entry and no greater than 365 days before entry. Dogs that
arrive without documentation of an adequate rabies titer from an
approved laboratory must be housed at the CDC-approved animal facility
for a 28-day quarantine at the expense of the importer following
administration of the U.S. rabies vaccine in addition to meeting the
criteria listed above. Dogs cannot be released from quarantine unless
all requirements have been met.
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\68\ Approved laboratories can be found at: www.cdc.gov/importation/bringing-an-animal-into-the-united-states/approved-labs.html.
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Importers are responsible for all fees associated with the
importation of dogs into the United States, including transportation,
examination, vaccination, and quarantine fees.
Foreign-vaccinated dogs arriving without a CDC Dog Import Permit
must enter the United States through a CDC-approved port of entry with
a CDC-approved animal care facility. As of December 2022, these
facilities are located at: Atlanta Hartsfield-Jackson International
Airport, John F. Kennedy International Airport (New York), Los Angeles
International Airport, Miami International Airport, and Washington
Dulles International Airport (outside Washington, DC). Importers are
responsible for reserving examination times and space at the CDC-
approved animal care facility prior to arrival in the United States.
Dogs that arrive at unapproved ports of entry or without reservations
at a CDC-approved animal care facility will be denied entry and
returned to the country of departure.
VII. Continued Conditions for All Dogs From High-Risk Countries During
the Extension
Consistent with the terms of the original temporary suspension
published in the June 2021 Federal Register notice (86 FR 32041, June
16, 2021), all dogs arriving from high-risk countries must be
microchipped prior to arrival in the United States. The microchip can
be administered in any country and does not need to be a U.S.-issued
microchip. The microchip number must be listed on the rabies
vaccination certificate. The microchip must be ISO-compatible.
Any dog from a high-risk country will be excluded from entering the
United States and returned to its country of departure on the next
available flight, regardless of carrier or route, if the dog arrives
under any of the following circumstances:
A dog arrives in the United States and does not meet the
minimum pre-arrival requirements (i.e., age greater than six months,
microchip, and either valid U.S.-issued rabies vaccination certificate
or complete and accurate CDC Rabies Vaccination and Microchip Record);
A dog presented does not match the description of the
animal listed on the permit (if required), U.S. rabies vaccination
certificate, or CDC Rabies Vaccination and Microchip Record;
A dog arrives at an unapproved port of entry;
A dog arrives at an airport with a CDC-approved animal
care facility without a reservation and no space at the facility is
available; or
Importer refuses transportation to, or receipt of or
payment for services at, a CDC-approved animal care facility (if
required). CDC may consider the dog abandoned and transfer custody of
the dog to the airline carrier for final disposition.
The importer shall be financially responsible for all housing,
care, and return costs. If an importer abandons a dog while it is at a
CDC-approved animal care facility, the carrier shall become responsible
for all costs associated with the care, housing, and return of the dog
to the country of departure. In keeping with current practice,
importers should continue to check with Federal, state, and local
government officials regarding additional requirements of the final
destination prior to entry or re-entry into the United States.
VIII. Additional Determinations Relating to This Notice
Pursuant to the terms of this notice, CDC is extending the
temporary suspension for the importation of dogs from high-risk
countries. This suspension includes dogs originating in DMRVV low-risk
or DMRVV-free countries that have been in a high-risk country in the
previous six months (not including animals transiting through high-risk
countries).
To enter the United States, dogs imported from a high-risk country
must meet certain entry requirements as described in Sections IV
through VII of this notice.
Table 1--Entry Conditions for Dogs Under Extended Suspension
----------------------------------------------------------------------------------------------------------------
Dogs with valid CDC
Dog Import Permit Dogs with valid CDC Dogs with valid CDC
Dogs with valid U.S. Rabies (fewer than three dogs Rabies Vaccination and Rabies Vaccination and
Vaccination certificate (RVC) being imported with Microchip Record Microchip Record with
titer) without titer titer
----------------------------------------------------------------------------------------------------------------
At least six months of age........... At least six months of At least six months of At least six months of
age. age. age.
Microchip............................ Microchip.............. Microchip.............. Microchip.
Entry allowed at 18 ports of entry Entry allowed at 18 Entry allowed at five Entry allowed at five
with CDC quarantine station. ports of entry with ports of entry with ports of entry with
CDC quarantine station CDC-approved animal CDC-approved animal
with valid CDC Dog care facility. care facility.
Import Permit issued
prior to arrival.
Titer not needed..................... Serologic titer (>=0.5 Not applicable*........ Serologic titer (>=0.5
IU/mL) from a CDC- IU/mL) from a CDC-
approved laboratory. approved laboratory.
Titer drawn at least 45 Titer drawn at least 45
days before entry and days before entry and
not more than 365 days not more than 365 days
before entry. before entry.
No quarantine........................ No quarantine.......... 28-day quarantine at No quarantine.
CDC-approved animal
care facility.
[[Page 5357]]
Veterinary exam, booster vaccination Veterinary exam or Veterinary examination, Veterinary examination,
or quarantine not required unless quarantine not booster vaccination, booster vaccination,
the animal appears ill upon arrival. required with valid and paperwork and paperwork
CDC Dog Import Permit verification at CDC- verification at CDC-
unless the animal approved animal care approved animal care
appears ill upon facility required upon facility required upon
arrival. arrival. arrival.
Booster vaccination is
required within 10
days of arrival by
U.S. veterinarian.
----------------------------------------------------------------------------------------------------------------
* This is an alternate pathway for importation in the event documentation of an adequate titer is not available
upon arrival.
The suspension will continue to reduce the risk of importation of
DMRVV, ensure public health safeguards are in place for the importation
of dogs from high-risk countries, and preserve public health resources.
The terms of the suspension allow for sufficient safeguards to mitigate
the public health risk. The suspension will also allow CDC to continue
to work with Federal, state, territorial and local partners, airlines,
and other affected parties to consider options for a more streamlined
and efficient dog importation process that will be safer for pets. Most
importantly, it will ensure that U.S. public health remains protected.
Therefore, pursuant to 42 CFR 71.51(e) and 42 CFR 71.63, CDC hereby
excludes the entry and suspends (subject to the terms and conditions
outlined in this notice) the importation of dogs from high-risk
countries, including dogs from DMRVV low-risk and DMRVV-free countries
if the dogs have been present in a high-risk country in the previous
six months.
Additionally, under 42 CFR 71.63, CDC continues to find that DMRVV
exists in countries designated as high-risk countries and that, if
reintroduced into the United States, DMRVV would threaten the public
health of the United States. The continued entry of dogs from high-risk
countries in the context of rabies vaccination campaign disruptions and
veterinary supply and veterinary workforce shortages as a result of the
global COVID-19 pandemic as well as the insufficient safeguards in
place to prevent the exportation of inadequately vaccinated dogs from
high-risk countries further increases the risk that DMRVV may be
introduced, transmitted, or spread into the United States. CDC has
coordinated in advance with other Federal agencies as necessary to
implement and enforce this notice.
CDC further clarifies through this notice that there is no agency
policy of using the ``least restrictive means'' (as that concept is
typically understood and applied in cases involving interests protected
by the U.S. Constitution) in regard to animal importations under 42 CFR
part 71. ``The Due Process Clause of the Fourteenth Amendment imposes
procedural constraints on governmental decisions that deprive
individuals of liberty or property interests.'' Nozzi v. Hous. Auth. of
City of Los Angeles, 806 F.3d 1178, 1190 (9th Cir. 2015). However,
``[d]ue process protections extend only to deprivations of protected
interests.'' Shinault v. Hawks, 782 F.3d 1053, 1057 (9th Cir. 2015).
Because individuals have no protected property or liberty interest in
importing dogs into the United States, it is CDC's policy to not employ
a constitutional analysis of ``least restrictive means'' in regard to
animal imports under 42 CFR part 71. See Ganadera Ind. v. Block, 727
F.2d 1156, 1160 (D.C. Cir. 1984) (``no constitutionally-protected right
to import into the United States''); see also Arjay Assoc. v. Bush, 891
F.2d. 894, 896 (Fed. Cir. 1989) (``It is beyond cavil that no one has a
constitutional right to conduct foreign commerce in products excluded
by Congress.'').
Notwithstanding, to the extent that any court determines that an
analysis of ``least restrictive means'' is necessary, CDC finds and
asserts that the measures contained in this notice constitute the least
restrictive means of protecting the public's health from the
reintroduction of DMRVV. Although a complete ban on all dog imports
would arguably provide a greater level of public health protection, it
would deprive individuals of the many benefits arising from dog imports
including the companionship offered by pet dogs. Similarly, removing
all restrictions at this time (as has been explained in this notice)
would endanger the public's health and risk the reintroduction of DMRVV
based on, among other things, the lack of veterinary controls in
foreign countries. Accordingly, in establishing the terms and
conditions of this notice, CDC has carefully balanced the need to
protect the public's health against the potential burden on importers
and determined that the measures in this notice constitute the least
restrictive means.
This notice is not a legislative rule within the meaning of the
Administrative Procedure Act (APA), but rather a notice of an exclusion
and temporary suspension taken under the existing authority of 42 CFR
71.51(e) and 42 CFR 71.63, which were previously promulgated with full
notice and comment. If this notice qualifies as a legislative rule
under the APA, notice and comment and a delay in effective date are not
required because there is good cause to dispense with prior public
notice and the opportunity to comment on this notice. Considering the
insufficient safeguards in place to prevent the exportation of
inadequately vaccinated dogs from high-risk countries, and the risk of
reintroduction of DMRVV from dogs being imported from high-risk
countries, it would be impractical and contrary to the public's health,
and by extension the public's interest, to delay the issuance and
effective date of this notice. Notwithstanding, CDC is publishing this
notice in advance of its effective date, to allow potential dog
importers and other interested parties sufficient time to adjust their
practices in accordance with the terms of this temporary suspension.
This temporary suspension will enter into effect on February 1,
2023, and remain in effect through July 31, 2023, unless modified or
rescinded by the CDC Director based on public health or other
considerations.
Dated: January 24, 2023.
Sherri Berger,
Chief of Staff, Centers for Disease Control and Prevention.
[FR Doc. 2023-01688 Filed 1-24-23; 4:15 pm]
BILLING CODE 4163-18-P