Severe Acute
Respiratory Syndrome (SARS) |
ORDER
OF THE CENTERS FOR DISEASE CONTROL AND PREVENTION, DEPARTMENT OF HEALTH
AND HUMAN SERVICES
Notice of Embargo of Civets
May 3, 2005
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ACTION:
Notice of embargo of civets (Family: Viverridae).
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.
DATE:
This embargo is effective on January 13, 2004, and will remain in effect
until further notice.
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 [>38.0EC]).
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 US, 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 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 U.S. 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 U.S., this order does not
include restrictions upon the domestic movement of civets already in the
U.S.
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.
Julie Louise
Gerberding
Director, Centers for Disease Control
and Prevention.4
References:
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 al. Severe acure 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.
See
Also
News
Release: HHS Bans Civet Imports, U.S. Department of Health & Human
Services
(January 13, 2004)
Questions
and Answers on the Embargo of Civets
|