Monday, June 30, 2003, 21:45 EDT (9:45 PM EDT)
CDCHAN-00148-03-06-30-ADV-N
Interim Guidance for the Removal of Quarantine Orders and the Euthanasia of Animals Affected by the Monkeypox Outbreak
The Centers for Disease Control and Prevention (CDC) has been working closely with
several state and local health departments and other partners to investigate
cases of monkeypox virus infections among persons who had direct or close
contact with ill prairie dogs. Exposures of interest to these ill animals
occurred after April 15, 2003
Monkeypox is a rare viral disease that typically occurs among animals and humans in central
and west Africa. In humans, the illness produces a blister-like rash similar to
that of smallpox. Time from contact with a sick animal to the beginning of
fever in a person is usually about 12 days. During the current outbreak of monkeypox
in the United States, most infected persons have had illness that was relatively mild to moderate in
severity, and there have been no deaths. However, the disease can be severe,
and in Africa about 1% to 10% of human cases are fatal. (For additional information
about monkeypox,
see
www.cdc.gov/ncidod/eid/vol7no3/hutinG1.htm.)
This document provides interim guidance for state and federal officials who have
issued quarantine orders restricting the movement of animals that may have been
exposed to monkeypox virus.
Background and Rationale for Recommendations
During the emergency response to monkeypox, CDC and the Food and Drug Administration
issued a joint order banning the importation of African rodents and the sale
and movement of involved animals (see:
http://www.cdc.gov/ncidod/monkeypox/pdf/embargo.pdf
). The joint order remains in effect regardless of the actions taken pursuant
to this guidance. In addition, CDC recommended that states place
quarantines or hold orders on 1) premises with infected animals (Infected
Premises); 2) premises that received African rodents from a particular shipment
(from Ghana to Texas on April 9, 2003) of imported animals that was identified
during the traceback investigation (Premises Receiving Imported African
Rodents); and 3) premises that received prairie dogs from a holding facility
where wild or exotic mammalian pets with suspect, probable, or confirmed monkeypox
have been reported.
Minimal data are available about the natural history of monkeypox in animals, and
certain aspects of infection, such as the types of susceptible animal species,
incubation period, and duration of infectiousness, are not known. Various
rodent species are known to be susceptible, but all mammals are considered
potentially susceptible. Currently, capacity for laboratory testing of animals
is limited, and available assays are not able to prove that animals are not infectious.
These guidelines attempt to balance the prudent use of quarantine and euthanasia of
exposed animals with the goal of preventing additional infections among humans
and other animals, as well as preventing monkeypox from being maintained in a
new wild animal reservoir.
Recommendations for Prairie Dogs Acquired from Affected Facilities
Commercial and residential premises that have prairie dogs acquired from affected
facilities should be placed under quarantine until the following conditions are
met:
- All prairie dogs on the premises have been euthanized.
- All other mammals remaining on the premises have completed a six-week quarantine following the last date of occupation by the aforementioned prairie dogs.
Premises Receiving Imported African Rodents are defined as commercial facilities or domiciles that housed a rodent originating from the shipment of animals imported from Ghana to Texas on 4/9/03, which included Tree squirrels (Heliosciurus sp.), Rope squirrels (Funisciurus sp.), Dormice (Graphiurus sp.), Gambian Giant Pouched Rats (Cricetomys sp.), Brush-tailed porcupines (Atherurus sp.), and Striped mice (Hybomys sp.). These premises should be placed under quarantine until the following conditions are met:
- All African rodents from the 4/9/03 shipment from Ghana on the premises have been euthanized.
- All prairie dogs on the premises that may have been exposed to African rodents have been euthanized.
- All other mammals remaining on the premises have completed a 6-week quarantine following the last date of occupation by the aforementioned African rodents and prairie dogs.
Infected premises are defined as a commercial facility or domicile that housed animals meeting the suspect, probable, or confirmed case definition for monkeypox. (www.cdc.gov/ncidod/monkeypox/animalcasedefinition.htm) Infected premises should be placed under quarantine until the following conditions are met:
- All animals meeting the suspect, probable, or confirmed case definition for monkeypox have been euthanized.
- Allprairie dogs have been euthanized.
- Other mammals remaining on the premises have completed a 6-week quarantine following the last date of occupation by the aforementioned infected animals and prairie dogs.
Owners of commercial establishments may choose the following alternative to the 6-week
quarantine period: quarantines may be lifted immediately if all mammals on an
infected premise are euthanized and the premise is thoroughly cleaned and
disinfected prior to restocking. Trade in animals not covered by the CDC/FDA
joint order of June 11, 2003, may resume immediately following cleaning and disinfection.
Euthanasia and Disposal of Animals
Animals should be humanely euthanized. (See the AVMA guidelines on humane
euthanasia for more information:
www.avma.org/resources/euthanasia.pdf.)
Carcasses should not be disposed of by burial in a landfill or
backyard setting. CDC recommends incineration of carcasses. Animals associated
with a human case should be tested for monkeypox. Necropsies should not be
performed on animals with suspected monkeypox. Rather, whole carcasses should
be double bagged and frozen. To obtain submission
instructions before sending specimens to CDC, consult with the state
epidemiologist
(www.cste.org/members/state_and_territorial_epi.asp)
and state health laboratory
(www.aphl.org/public_health_labs/index.cfm).
Cleaning of Premises after Removal of an Animal with Monkeypox
Contaminated surfaces should be cleaned and disinfected. Standard household cleaners or
disinfectants may be used in accordance with the manufacturer's instructions.
Do not dispose of the animal's bedding, cage, toys, or food and water bowls
with the household trash or at a dump or landfill because this material may be
potentially infectious; contact the state or local health department for
instructions. Follow the laundry steps provided above
(www.cdc.gov/ncidod/monkeypox/animalhandlers.htm)
when caring for a quarantined animal.
Recommendations for Follow-Up of Previously Quarantined Facilities
Close public health surveillance of morbidity and mortality of animals on the
premises is required during the 6-week quarantine. Evidence of monkeypox based
on clinical or laboratory findings results in automatic extension of
quarantine. Following the end of the 6-week quarantine or depopulation,
cleaning, and disinfection of the premises, trade in animals not covered by the
CDC/FDA joint order of June 11, 2003, may resume at commercial facilities; the
owners will be required to keep
records on all sales and transactions. Close state and federal surveillance of
morbidity and mortality of animals on the premise is encouraged for at least
6-weeks after the quarantine is lifted and trade has resumed.
Additional Information
For more information, contact the state or local health department or the CDC
Emergency Operations Center at 770-488-7100.
Additional information and recommendations will be released as they become
available. Updated information will be available at CDC's monkeypox Web site
(www.cdc.gov/ncidod/monkeypox).
For more information, visit
www.cdc.gov/ncidod/monkeypox
or call the CDC public response hotline at (888) 246-2675 (English), (888) 246-2857 (Español), or (866) 874-2646 (TTY)
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