In June 2021, the CDC published a notice to temporarily suspend the importation of dogs from countries categorized as “high risk” for canine rabies. The importation suspension also applied to dogs that had been in any of the high-risk countries in the six months preceding importation. The CDC issued the suspension notice 30 days prior to the suspension going into effect. The reason for such action is: “In 2020, CDC identified a significant increase compared with the previous 2 years in the number of imported dogs that were denied entry into the United States from high-risk countries. Due to reduced flight schedules, dogs denied entry are facing longer wait times to be returned to their country of departure, leading to illness and even death in some cases.”1
Wait, what?! No mention of rabies prevention?!
Justification would seem obvious as rabies is a significant human health concern and canine rabies has been eradicated in the US for decades following effective policies legally compelling vaccination and eliminating stray populations. However, digging just a bit deeper into the issue provides some startling and disturbing facts surrounding rabies, animal movement and resulting animal welfare. Let’s start with canine rabies…
In 2007, the CDC officially declared the US free of canine rabies.2 The announcement represents the culmination of years of hard work and is the result of a multifactorial approach to a serious public health threat. Rabies remains nearly 100% fatal in most, if not all, species susceptible to infection. In fact, at least 60,000 people die from rabies annually and most are children infected with canine rabies from a dog bite.3
A key characteristic of rabies is that the virus exists as different strains or types that are named according to their maintenance host in which the virus is adapted to survive and as an indicator of transmission. For example, raccoon rabies is specifically used to refer to a strain that is maintained in raccoon populations, thus, raccoons may survive for extended periods following infection and successfully transmit the virus to others to maintain the virus in their population.
Rabies is most frequently transmitted via a bite as the virus is shed efficiently in saliva of infected hosts. The virus then remains in the local bite site for several days before traveling through the nervous system to the brain and then into the salivary glands. Rabies has two distinct clinical syndromes: paralytic (or dumb) and furious. However, both are nearly 100% fatal once symptoms appear.
The most effective “treatment” for rabies in any species is prophylaxis prior to the onset of clinical symptoms. If vaccinated prior to exposure, patients require less post-exposure prophylaxis and externally administered immunoglobulin is not indicated.
Each year, ~55,000 people are treated for rabies exposure in the US with cost ranging from $10,000 to $100 million per person, depending on exposure, wound care, intervention timing, etc.4 Total public health expenditures on rabies prevention and control in the US tops out at an eye-popping $245-510 million annually. A recently imported rabid rescue dog cost the federal government a whopping $215,000-$509,000 to investigate.5 Currently, the companion animal vaccine is perhaps the cheapest vaccine available and, once again, confirms that prevention is much, much cheaper than a cure.
Rabies is surely a concerning disease, but how often are companion animals or other species actually traveling internationally and being imported into the US?
According to a recent report by the USDA, more than one million dogs are imported into the US each year.6 This includes those declared as personal pets by the owners and those imported for distribution and resale through all outlets (shelters, rescues, breeders, etc.). The majority of these are assumed to be personal pets; however, assumptions are less than ideal when discussing disease vectors.
Importation permits for dogs are fairly simple and variables are based on country of origin. Generally, a simple health certificate is all that is required. In fact, with changes in the last few years to the CDC requirements, 75% of all imported dogs are exempt from any rabies certificate requirements. Contrast these facts with the significantly more complex process of importing almost any other species into the US, as most require multiple serological tests, immunizations and permanent ID placement, and are visually inspected by officials upon entry into the US, with some species further requiring significant quarantine at great expense (and risk) to the importer.
Beyond these minimal requirements for dogs to move around internationally, what about the welfare implications—not only for the dogs in transit but for the dogs already in the US?
Roughly 1.5 million animals are killed at US shelters every year which is more than the estimated total dog imports from the USDA’s 2018 report.7 It is simplistic to believe all dog imports are by traditional pet stores or even breeders. Importing dogs to “rescue” them is a rapidly growing industry with apparently mortal consequences for local resident pups. For example, one such organization states that they have imported 600 dogs from China over the last two years for the purpose of rehoming them in the US.8 The organization states that the cost to bring each dog to the US is $2,500-$3,500. That’s per dog! While all personnel involved are said to be volunteers so that all funding is consumed by operations, that’s a lot of money for each dog. This organization is based in a county with a population of ~100,000 and the county animal shelter has dogs available for purchase (adoption) for a mere $85 and estimates $460 spent per animal.9-11 If the rescue organization shifted focus to animals within their home community, an additional 3,300 American dogs could be saved. Additionally, China is currently categorized as a “high risk” country for rabies by the CDC12 and considered an incubator for influenza. Surely avoiding euthanasia is the pinnacle of improved animal welfare?!
While the CDC claims the temporary change in importation policy is a response to the number of dogs denied entry that have poor outcomes awaiting shipment home, one may wonder if the dramatic increase in the number of imported dogs testing positive for rabies after arriving in the US and the number of people involved in likely exposures to the nearly 100% fatal virus is also a contributing factor?
As a veterinarian routinely administering rabies vaccinations in practice, this approach would make perfect sense. For a pathogen with a near 100% mortality rate in dogs and humans (and many other species), caution seems minimally prudent. This policy might also inspire all shelter pets in the US to rejoice!
A commonsense presumption would be that if rescue organizations and shelters are actively seeking to import stray dogs for resale (adoption), then all shelters in the US must be empty or, at the very least, have euthanasia rates nearing zero? Must we look abroad for homeless pets? What a champagne problem!
Importing cattle from foot and mouth disease (FMD)-endemic countries is far more difficult than importing dogs from canine rabies-endemic countries—and FMD is not lethal to humans. FMD is considered a foreign animal disease not currently present in the US. Canine rabies is considered not currently present in the US. Should importation policies not be applied equally across species in order to maintain these hard-fought (and expensive), disease-free designations?
The change in policy is not only perplexing in and of itself, but the early warning of the implementation is equally disconcerting as it allowed for circumvention of the targeted outcome. Following the CDC’s announcement of the future effective date of the ban, overseas rescues use the announced implementation date to ramp up efforts to ship as many “rescue dogs” into the US as possible ahead of the ban, thereby circumventing the effort to prevent rabies control efforts.13
Overall, this recent temporary CDC policy shift has illuminated the large number of organizations expending incredible resources to import stray dogs from abroad while American strays are euthanized daily. Shouldn’t available resources be focused on avoiding euthanasia of as many dogs as possible in the US before looking for additional dogs abroad? Especially if those imported dogs are potential disease vectors for diseases currently absent from the US?
In other words, if the US is battling overpopulation, why are additional dogs being imported by the millions each year? I encourage all veterinarians to make an effort to remain aware of these activities in the pet industry as well as encourage clients to purchase dogs that have empty passports. +
References
- Notice of Temporary Suspension of Dogs Entering the United States. (2021, June, 14). CDC. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/high-risk-dog-ban-frn.html
- US Declared Canine-Rabies Free. (2007, Sept, 7). CDC. https://www.cdc.gov/media/pressrel/2007/r070907.htm
- Rabies. OIE. https://www.oie.int/en/disease/rabies/
- Cost of Rabies Prevention. (2019, June, 11). CDC. https://www.cdc.gov/rabies/location/usa/cost.html
- Dog Adopted By Chesco Family Had Dangerous Variant Of Rabies. (2021, June, 21). Patch. https://patch.com/pennsylvania/philadelphia/rabid-dog-azerbaijan-adopted-chester-county-family-cdc
- Report on the Importation of Live Dogs into the United States. (2019, June, 25). AKC GR. https://cqrcengage.com/akc/file/ZSOYKBw3C5F/USDA_DogImportReport6_25_2019.pdf
- Pet Statistics. (2015-2018). ASPCA. https://www.aspca.org/helping-people-pets/shelter-intake-and-surrender/pet-statistics
- China Rescue Dogs. https://chinarescuedogs.org/about/#
- Moore County, NC Sheriff’s Office. https://www.moorecountync.gov/sheriff/animal-services
- Public Animal Shelter Report. (2017). North Carolina Department of Agriculture & Consumer Services. http://www.ncagr.gov/vet/aws/Fix/documents/2017PublicShelterReport.pdf
- Moore County, North Carolina Census. (2019, July, 1). United States Census Bureau. https://www.census.gov/quickfacts/fact/table/moorecountynorthcarolina/PST045219
- High-Risk Countries for Dog Rabies. (2021, July, 14). CDC. https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/high-risk.html
- US Suspends Dog Importation From 100-Plus Countries. (2021, July, 28). AMVA. https://www.avma.org/javma-news/2021-08-15/us-suspends-dog-importation-100-plus-countries
