Hundreds of thousands of animals are imported into the United States every day, increasing the chance for infectious diseases transmittable to humans to be introduced with them. In fact, the Centers for Disease Control and Prevention (CDC) estimates more than 60% of infectious diseases in humans are spread from animals. The elevated risk of infectious disease resulting from the massive daily influx of imported animals begs the questions: 1) Is anyone monitoring this?, and 2) What steps could be taken to reduce the risk for disease importation?
To answer these questions, the National Association of County and City Health Officials (NACCHO) took an in-depth look into who is involved, to what extent, and where local public health fits into this issue.
Regulating Animal Importation in the United States
The responsibility of regulating animal importation typically sits with federal agencies; however, the focus of those agencies differs. The United States Department of Agriculture (USDA) regulates animals, such as livestock and poultry; the U.S. Fish and Wildlife Service is more concerned with importation of wildlife and protecting endangered species; and the CDC regulates importation of cats and dogs, designating states the authority to mandate whether imported cats and dogs require certificate of veterinary inspection (CVI).
The role of federal and state agencies in regulating animal importation is clear, but it’s unclear how local entities are involved. Considering that infectious disease spread occurs, at least initially, in a local setting, animal importation has critical implications for local public health. Yet, involvement of local health departments (LHDs) in this area varies greatly and information on LHD involvement with importation specifically is limited. But one LHD in California is doing its part to encourage better animal importation practices, including regulation at the federal level.
Animal Importation and Public Health in Los Angeles County
More than a decade ago, local health officials from the Los Angeles County Department of Public Health (LACDPH) noticed Los Angeles (LA) was a major hub for animal importation activity, most notably with regard to dogs for commercial sale. Imported dogs can carry diseases such as rabies, screwworm, and parvovirus. And while rabies vaccination is mandatory for dogs entering the U.S. from countries where rabies is present, vaccination certificates are sometimes falsified, often without legal consequence because resource limitations at U.S. ports make enforcement a challenge.
Concerned with the public health implications of dog importation into the community, the LA County Department of Public Health, Veterinary Public Health Program formed innovative partnerships with the CDC and other local and federal agencies to assess and address the problems around animal importation. In an interview with NACCHO, Dr. Karen Ehnert, Director of Veterinary Public Health at LACDPH, shared how she leveraged unique characteristics of her LHD to get involved and reduce animal importation into LA County.
While LHD involvement in animal importation is often limited, the distinctive nature of LACDPH and a series of specific events led to the agency’s involvement. “We are unique in our whole set up,” notes Dr. Ehnert. “In the 1950s when rabies laws were enacted, rabies control was under the health department rather than animal control, so we were getting confinement agreements from CDC related to animal importations. Initially, we didn’t receive that many, but suddenly in 2003, we saw a big increase. Our staff tried to quarantine [the dogs] and it was frustrating because they were being sold before the end of the confinement agreement. So we got more aggressive with following up and found the agreements would often have false addresses; it would be an empty lot or the address didn’t exist, so we weren’t able to find the animal. At that point, we asked CDC ‘Why are you giving these agreements to follow up on, but the addresses are poor?’”
Dr. Ehnert soon discovered the problem was not limited to LA County, and as a result, 14 animal control agencies and three health agencies created a task force to explore regional animal importation. “In 2005, animal control agencies throughout Southern California received complaints from people who had purchased puppies in places like parking lots from anonymous sellers, only to have the puppy die within a couple of days. Stings conducted by animal control agencies later revealed the puppies were coming from Mexico. The Border Puppy Task Force was created to investigate the problem; for two weeks we looked at every animal that came across the Mexican border and found a lot of dogs being smuggled,” recalled Dr. Ehnert.
“At the same time, I was seeing a flood of sick animals coming in from Korea. These small ‘pocket dogs’ were being sold in our area for two to four thousand dollars each — a huge incentive for importers. We tried to figure out ‘How are we going to deal with this? We’re not a federal agency so how can we control it?’ I was getting frustrated.”
“Then in 2008, we had three dead dogs at the airport in one month when normally, we would see about one dead dog per year. After this, I got CDC to work with the Border Puppy Task Force to do a survey of animals coming into the airport over a three week period.”
Enormous gaps in the regulation of imported animals were brought to light through these surveys. “We saw a massive number of puppies coming in — nearly 40 percent of those we inspected — where the paperwork didn’t match up with the dogs,” said Dr. Ehnert. “The paperwork would say they are four months old and they were really less than eight weeks of age.” Generally dogs 4 months of age or older would not need to be confined after import and could be sold immediately, but older puppies generally sell for much less money. Thus, importers had a strong financial incentive to try to circumvent the dog importation regulations.
These findings led to a new approach that catalyzed meaningful change. “After the results of the survey, CDC agreed to develop a more formalized approach in which the airline gives us advance notification of shipments and our program inspects target shipments. Through this, we have been able to dramatically reduce the amount of fraud going on at Los Angeles International Airport.”
Moving forward, Dr. Ehnert hopes “one day CDC can adopt policies and procedures similar to the USDA and U.S. Fish and Wildlife Service [that] limit importation to airports where there is sufficient staffing and only allow animals in when staff are present.”
Addressing Animal Importation across the Nation
LACDPH’s proactive, hands-on approach was successful in reducing fraudulent regional animal importation. It is important to note, however, the success in LA County may have exacerbated the issue at other international airports, such as in Las Vegas. “This is a national problem,” emphasized Dr. Ehnert. “As long as animal importation is profitable, then importers will just find new ports to utilize.”
NACCHO and LACDPH are interested in the degree to which other LHDs are involved in or aware of this issue. Although the unique circumstances in LA County may not be replicable, Dr. Ehnert is optimistic other LHDs can get involved by tapping into their local animal control agency. Further, LHDs looking to do similar animal importation work may wish to review the “Reducing Zoonoses: Controlling Animal Importation” book chapter in Public Health Practice: What Works, and can reach out to Dr. Ehnert for guidance on the process.
If your LHD is seeing the movement of animals from other countries into your area and is interested in taking action, contact NACCHO’s Infectious Diseases Team. Together, we can move forward to develop policies and procedures at a national level to reduce the risk and protect public health.