Control of Communicable Diseases; Foreign Quarantine: Importation of Dogs and Cats

<RULE> DEPARTMENT OF HEALTH AND HUMAN SERVICES <CFR>42 CFR Part 71</CFR> <DEPDOC>[CDC Docket No. CDC-2023-0051]</DEPDOC> <RIN>RIN 0920-AA82</RIN> <SUBJECT>Control of Communicable Diseases; Foreign Quarantine: Importation of Dogs and Cats</SUBJECT> <HD SOURCE="HED">AGENCY:</HD> Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). <HD SOURCE="HED">ACTION:</HD> Final rule. <SUM> <HD SOURCE="HED">SUMMARY:</HD> The Centers for Disease Control and Prevention (CDC), in the Department of Health and Human Services (HHS), issues this final rule to provide clarity and safeguards that address the public health risk of dog-maintained rabies virus variant (DMRVV) associated with the importation of dogs into the United States. This final rule addresses the importation of cats as part of overall changes to the regulations affecting both dogs and cats, but the final rule does not require that imported cats be accompanied by proof of rabies vaccination and does not substantively change how cats are imported into the United States. </SUM> <EFFDATE> <HD SOURCE="HED">DATES:</HD> This final rule is effective August 1, 2024. </EFFDATE> <FURINF> <HD SOURCE="HED">FOR FURTHER INFORMATION CONTACT:</HD> Ashley C. Altenburger, J.D., Division of Global Migration Health, 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 operations and importations: Dr. Emily Pieracci, D.V.M., Division of Global Migration Health, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS H16-4, Atlanta, GA 30329; Telephone: 1-800-232-4636. </FURINF> <SUPLINF> <HD SOURCE="HED">SUPPLEMENTARY INFORMATION:</HD> This rule is organized as follows: <EXTRACT> <FP SOURCE="FP-2">I. Executive Summary</FP> <FP SOURCE="FP1-2">a. Purpose of This Regulatory Action</FP> <FP SOURCE="FP1-2">b. Summary of Major Provisions</FP> <FP SOURCE="FP1-2">c. Costs and Benefits</FP> <FP SOURCE="FP-2">II. Public Participation</FP> <FP SOURCE="FP-2">III. Background</FP> <FP SOURCE="FP1-2">a. Legal Authority</FP> <FP SOURCE="FP1-2">b. Regulatory History</FP> <FP SOURCE="FP-2">IV. Summary of the Final Rule</FP> <FP SOURCE="FP-2">V. Alternatives Considered</FP> <FP SOURCE="FP-2">VI. Summary of Public Comment and Responses</FP> <FP SOURCE="FP-2">VII. Required Regulatory Analyses</FP> <FP SOURCE="FP1-2">a. Executive Orders 12866, 13563, and 14094</FP> <FP SOURCE="FP1-2">b. The Regulatory Flexibility Act</FP> <FP SOURCE="FP1-2">c. The Paperwork Reduction Act</FP> <FP SOURCE="FP1-2">d. National Environmental Policy Act (NEPA)</FP> <FP SOURCE="FP1-2">e. Executive Order 12988: Civil Justice Reform</FP> <FP SOURCE="FP1-2">f. Executive Order 13132: Federalism</FP> <FP SOURCE="FP1-2">g. The Plain Language Act of 2010</FP> </EXTRACT> <HD SOURCE="HD1">I. Executive Summary</HD> <HD SOURCE="HD2">A. Purpose of This Regulatory Action</HD> Through this final rule, HHS/CDC is revising its regulation at 42 CFR 71.51 to prevent the reintroduction and spread of dog-maintained rabies virus variant (DMRVV) in the United States. HHS/CDC is also revising 42 CFR 71.50, which contains definitions applicable to animal importations under 42 CFR part 71, subpart F. The United States was declared DMRVV-free in 2007. <SU>1</SU> <FTREF/> The importation of just one dog infected with DMRVV risks re-introduction of the virus into the United States; such a public health threat could result in the loss of human and animal life and consequential economic impact. <E T="51">2 3 4</E> <FTREF/> The rabies virus can infect any mammal, and, once clinical signs appear, the disease is almost always fatal. <SU>5</SU> <FTREF/> A DMRVV-infected dog can transmit the virus to humans, domestic pets, livestock, or wildlife. Importing inadequately vaccinated dogs from countries at high risk of DMRVV (high-risk countries)  <SU>6</SU> <FTREF/> involves a significant public health risk to people who directly interact with those dogs. This rule also includes requirements for dogs from DMRVV-free and low-risk countries to confirm that the dog has not been in a high-risk country during the six months before arriving in the United States. In 2019, the importation of a DMRVV-infected dog cost the affected State governments more than $400,000 U.S. dollars (USD) for the ensuing public health investigations and rabies post-exposure prophylaxis (PEP) treatments administered to exposed persons. <E T="51">7 8</E> <FTREF/> <FTNT> <SU>1</SU>  Centers for Disease Control and Prevention. US Declared Canine-Rabies Free. <E T="03">https://www.cdc.gov/media/pressrel/2007/r070907.htm.</E> Accessed June 1, 2023. </FTNT> <FTNT> <SU>2</SU>  World Bank (2012). People, Pathogens and Our Planet: The Economics of One Health. Retrieved from <E T="03">https://openknowledge.worldbank.org/handle/10986/11892.</E> Accessed December 19, 2023. <SU>3</SU>  Raybern, C et al. Rabies in a dog imported from Egypt-Kansas, 2019. <E T="03">MMWR Morb Mort Wkly Rep</E> 2020; 69 (38): 1374-1377. <SU>4</SU>  Jeon S, Cleaton J, Meltzer M, et al. Determining the post-elimination level of vaccination needed to prevent re-establishment of dog rabies. <E T="03">PLoS Neg Trop Dis 2019; 13 (12): e0007869.</E> </FTNT> <FTNT> <SU>5</SU>  Fooks AR, Banyard AC, Horton DL, Johnson N, McElhinney LM, Jackson AC. Current status of rabies and prospects for elimination. Lancet 2014;384:1389-99. </FTNT> <FTNT> <SU>6</SU>  A complete list of countries with high risk of DMRVV is available at “High-Risk Countries for Dog Rabies.” <E T="03">https://www.cdc.gov/importation/bringing-an-animal-into-the-united-states/high-risk.html.</E> Accessed June 8, 2023. </FTNT> <FTNT> <SU>7</SU>  Raybern, C et al. Rabies in a dog imported from Egypt-Kansas, 2019. <E T="03">MMWR Morb Mort Wkly Rep</E> 2020; 69 (38): 1374-1377. <SU>8</SU>  Centers for Disease Control and Prevention (2022). Rabies Postexposure Prophylaxis. Retrieved from <E T="03">https://www.cdc.gov/rabies/medical_care/index.html.</E> </FTNT> Through this final rule, HHS/CDC also seeks to prevent and deter the importation of dogs with falsified or fraudulent rabies vaccine documentation. In 2020, CDC observed a 52 percent increase in the number of dogs that were ineligible for admission due to falsified or fraudulent documentation, as compared to 2018 and 2019 (450 dogs compared to the previous baseline of 300 dogs per year out of an estimated 32,530 foreign-vaccinated dogs arriving annually from DMRVV high-risk countries as reported in Section VIIA). <E T="51">9 10</E> <FTREF/> This troubling trend continued from January through June 2021, prior to the implementation of the temporary suspension in July 2021, <SU>11</SU> <FTREF/> with an additional 24 percent increase of dogs ineligible for admission in just the first half of the year, compared to the full 2020 calendar year (January-December) (approximately 560 dogs with falsified or fraudulent documentation). <SU>12</SU> <FTREF/> This final rule will also support CDC's efforts to improve data collection related to dog importation, including tracking the total number of dog importations which CDC has been unable to do previously across all ports and for all importations. <FTNT> <SU>9</SU>  Centers for Disease Control and Prevention. Quarantine Activity Reporting System (version 4.9.8.8.2.2A). Dog importation data, 2018-2020. Accessed: 15 February 2021. <SU>10</SU>  Pieracci EG, Wallace R, Maskery B, Brouillette C, Brown C, Joo H. Dogs on the move: Estimating the risk of rabies in imported dogs in the United States, 2015-2022. <E T="03">Zoonoses and Public Health</E> 2024; 00:1-9 DOI: 10.1111/zph.13122. </FTNT> <FTNT> <SU>11</SU>  Temporary Suspension of Dogs Entering the United States from High-Risk Rabies Countries. <E T="04">Federal Register</E> , 86 FR 32041 (June 16, 2021). </FTNT> <FTNT> <SU>12</SU>  Centers for Disease Control and Prevention. Port Health Activity Reporting System (version 4.9.8.8.2.2A). Dog importation data, January 1, 2021-July 14, 2021. Accessed: 01 October 2021. </FTNT> The use of a single false rabies vaccination certificate (RVC)  <SU>13</SU> <FTREF/> or other rabies vaccination document as part of a larger shipment of multiple dogs raises suspicion that the rabies vaccination documents for the remaining dogs may also be false. This is not an uncommon occurrence  <SU>14</SU> <FTREF/> and creates an additional burden on CDC and State health departments to track, test, and evaluate the remaining dogs in the shipment. <FTNT> <SU>13</SU>  Centers for Disease Control and Prevention. What is a valid rabies vaccination certificate? Available at: <E T="03">www.cdc.gov/importation/bringing-an-animal-into-the-united-states/vaccine-certificate.html.</E> </FTNT> <FTNT> <SU>14</SU>  Centers for Disease Control and Prevention. Port Health Activity Reporting System (version 4.9.8.8.2.2A). Dog importation data, 2018-2021. Accessed: 26 March 2024. </FTNT> CDC has documented numerous importations every year in which flight parents  <E T="51">15 16</E> <FTREF/> transport dogs for the purpose of resale, adoption, or transfer of ownership that do not meet CDC's entry requirements. These flight parents often claim the dogs are their personal pets to avoid U.S. Department of Agriculture (USDA) Animal Care  <SU>17</SU> <FTREF/> entry requirements and potential tariffs or fees under CBP regulations. Even when well-meaning, these importers jeopardize public health, as many of them do not know the history of the animals they are transporting. Deterring individuals who serve as flight parents from supporting fraudulent dog importations has proven difficult despite the existence of CBP penalties relating to a ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Preview showing 10k of 638k characters. 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