[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