[Federal Register Volume 69, Number 15 (Friday, January 23, 2004)]
[Notices]
[Pages 3364-3365]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 04-1401]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Foreign Quarantine
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice of embargo of civets (Family: Viverridae).
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SUMMARY: According to published scientific articles, Severe Acute
Respiratory Syndrome (SARS)-like virus has been isolated from civets
(Family: Viverridae) captured in areas of China where the 2002-2003
SARS outbreak originated. Shipments of civets are being imported into
the United States and further distributed. CDC is banning the
importation of all civets immediately and until further notice. CDC is
taking this action to prevent the importation and spread of SARS, a
communicable disease.
DATES: This embargo is effective on January 13, 2004, and will remain
in effect until further notice.
FOR FURTHER INFORMATION CONTACT: Paul Arguin, National Center for
Infectious Diseases, Centers for Disease Control and Prevention,
Mailstop C-14, 1600 Clifton Rd., Atlanta, GA 30030, telephone 404-498-
1600.
SUPPLEMENTARY INFORMATION:
Background
Severe Acute Respiratory Syndrome (SARS) is a viral respiratory
illness caused by a coronavirus, called SARS-associated coronavirus
(SARS-CoV). In general, SARS begins with a high fever (temperature
greater than 100.4F (38.0[deg]C)). Other symptoms may
include headache, an overall feeling of discomfort, and body aches.
Some people also have mild respiratory symptoms at the outset. About 10
percent to 20 percent of patients have diarrhea. After 2 to 7 days,
SARS patients may develop a dry cough. Most patients develop pneumonia.
The case-fatality rate among persons with illness is approximately 10%.
The main way that SARS seems to spread is by close person-to-person
contact. The virus that causes SARS is thought to be transmitted most
readily by respiratory droplets (droplet spread) produced when an
infected person coughs or sneezes. Droplet spread can happen when
droplets from the cough or sneeze of an infected person are propelled a
short distance (generally up to 3 feet) through the air and deposited
on the mucous membranes of the mouth, nose, or eyes of persons who are
nearby. The virus also can spread when a person touches a surface or
object contaminated with infectious droplets and then touches his or
her mouth, nose, or eye(s). In addition, it is possible that the SARS
virus might spread more broadly through the air (airborne spread) or by
other ways that are not now known.
At this time, there is no known effective treatment for SARS.
Public Health Risks
SARS was first reported in Asia in February 2003. Over the next few
months, the illness spread to more than two dozen countries in North
America, South America, Europe, and Asia. According to the World Health
Organization (WHO), during the SARS outbreak of 2003, a total of 8,098
people worldwide became sick with SARS; of these, 774 died. In the
United States, there were a total of 192 cases of SARS among people,
using the 2003 WHO case definitions of ``probable'' and ``suspect,''
all of whom recovered. Eight of these cases were subsequently
laboratory confirmed as SARS-CoV.
Public health officials worldwide commonly used isolation and
quarantine measures to control the outbreak. In the United States, some
states exercised their legal authorities to compel isolation of suspect
cases. On April 4, 2003, the President added SARS to the list of
diseases for which the federal government could isolate or quarantine
individuals, though use of this federal authority never became
necessary.
The SARS global outbreak of 2003 was contained after extraordinary
global effort that focused on reducing contact with infected
individuals. Subsequently, there have been 2 laboratory acquired cases
of SARS, one in Taiwan and one in Singapore; however, on January 5,
2004 the government of China and the World Health Organization
confirmed the first non-laboratory-acquired case of SARS infection in a
human since the initial
[[Page 3365]]
outbreak subsided in the spring of 2003. Measures being taken by
Chinese health authorities since the 2004 non-laboratory-acquired case
was reported include interventions on civets in the animal market based
upon an accumulating but as yet unpublished body of evidence linking
them with SARS-CoV infection.
To date, scientists have not been able to confirm the origin of
SARS in humans. Some public health officials hypothesize that SARS-CoV
was transmitted from an animal to human thereby sparking the 2003
outbreak. There is growing indirect evidence suggesting that exposure
to certain wild animals, may be associated with infection, although
there is no evidence that humans have become infected with the SARS
coronavirus from direct contact with certain wild animals. During the
initial investigations of cases of SARS coronavirus infection, it was
reported that cases occurred among restaurant workers that handled wild
animals and among workers in animal associated professions (1,2). Two
subsequent investigations demonstrated higher rates of seropositivity
against the SARS coronavirus among wild animal traders compared to
controls (1,3). An analysis of the epidemiology of the SARS outbreak in
Guangdong indicated that the outbreak appeared to have originated in
many different municipalities without identified person to person
linkages (4). Assuming humans acquire infection directly from animals,
this suggests that there may have been multiple introductions from
animals to humans and that the transmission was not a one-time unusual
occurrence.
To date a SARS-like coronavirus has been isolated from many palm
civets (Paguma larvata) (1). A comparison of isolates from civets and
humans demonstrated 99.8% homology (1). In addition, there have been
reports of small numbers of other animals that have demonstrated
evidence of infection with SARS-like coronaviruses (1,5,6). Although it
is possible that other animals may have a role in the lifecycle of the
SARS coronavirus, to date the best available evidence points towards
involvement of civets.
Civets, being wild terrestrial carnivores, also can be infected
with and transmit rabies (7).
In 2001-2002, 98 civets were imported into the United States (44%
from Asia); most, if not all, were imported for private ownership.
Introduction of non-native species, such as civets, into the United
States can lead to outbreaks of disease in the human population. CDC is
therefore taking this action to reduce the chance of the introduction
or spread of SARS into the United States. Importation of civets
infected with SARS would present a public health threat, and, based
upon currently available evidence, banning the importation of civets is
an effective way of limiting this threat.
Because there is no current evidence suggesting that SARS-infected
civets have been imported and are causing disease in the United States,
this order does not include restrictions upon the domestic movement of
civets already in the United States.
Immediate Action
Therefore, pursuant to 42 CFR 71.32(b) and in accordance with this
order, no person may import or attempt to import any civets (Family:
Viverridae), whether dead or alive, or any products derived from
civets. This prohibition does not apply to any person who imports or
attempts to import products derived from civets if such products have
been properly processed to render them noninfectious so that they pose
no risk of transmitting or carrying the SARS virus. Such products
include, but are not limited to, fully taxidermied animals and
completely finished trophies. This prohibition also does not apply to
any person who receives permission from the CDC to import civets or
unprocessed products from civets for educational, exhibition, or
scientific purposes as those terms are defined in 42 CFR 71.1.
Dated: January 15, 2004.
Julie Louise Gerberding,
Director, Centers for Disease Control and Prevention.
References Cited
1. Guan Y, Zheng BJ, He YQ, et al. Isolation and characterization of
viruses related to the SARS coronavirus from animals in southern China.
Science 2003;302(5643):276-8.
2. He SF et at. Severe acute respiratory syndrome in Guangdong province
of China: Epidemiology and control measures. Chin J Prev Med
2003;37(4):227.
3. CDC. Prevalence of IgG Antibody to SARS-associated coronavirus in
animal traders--Guangdong Province, China, 2003. MMWR 2003;52(41):986-
7.
4. He SF et al. An epidemiological study on the index cases of severe
acute respiratory syndrome occurred in different cities in Guangdong
Province. Chin J Epidemiol 2003;24(5):347.
5. Normille D and Enserink M. Tracking the roots of a killer. Science
2003;301:297-9.
6. Ng SKC. Possible role of an animal vector in the SARS outbreak at
Amoy Gardens. Lancet 2003;362:570-2.
7. CDC. Human rabies prevention--United States, 1999. Recommendations
of the Advisory Committee on Immunization Practices (ACIP). MMWR
1999;48(No. RR-1):1-21.
[FR Doc. 04-1401 Filed 1-22-04; 8:45 am]
BILLING CODE 4163-18-P