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“These changes have been coming for a long time,” says Krebs. “It’s important, from a public health standpoint, that these changes are being made, especially because it’s such a huge human risk to have a dog come into a country that potentially has rabies that we don’t know about.”
Rabies is a zoonotic infectious disease, transmitted from animals to humans. In the United States, about 4,000 cases of animal rabies are reported each year, more than 90 percent of which come from wild animals such as bats, raccoons, foxes, and skunks.SN: 6/12/19). This represents a significant change from the mid-1900s, when domestic animals such as dogs contributed to most cases of rabies. According to the CDC, fewer than 10 human deaths from rabies are now reported in the United States each year, down from several hundred in the 1960s.
As of 2021, only five rabid dogs had been imported from high-risk countries since dog rabies was eliminated from the United States in 2007. All but one of these cases were due to fraudulent documentation, which new CDC regulations could address them. The other was due to vaccination failure.
“The United States has a very low rate of rabies, and because of US-mandated rabies vaccinations for dogs, we don’t often see our pets suffer from rabies,” Krebs says. “So you also don’t want to bring a dog in from a high-risk country if it doesn’t have adequate rabies vaccination.”
Before the Aug. 1 regulations, dogs arriving in the United States that had not been to high-risk countries were only required to have a travel history and a healthy appearance. All dogs that had been in a high-risk area and were under six months old, without a microchip or without a history of rabies vaccination were denied entry.
Now, dogs arriving in the United States from countries the CDC has classified as having a lower rabies risk require an entry form that can be completed by the importer and does not require confirmation of rabies vaccination. Dogs imported from high-risk countries are divided into those vaccinated in the United States and those vaccinated abroad. For the former, a USDA-certified veterinarian must complete forms confirming rabies vaccination. Foreign vaccinated dogs require forms approved by a government veterinarian; as previously required, dogs must also have a microchip, appear healthy and be at least six months old at the time of entry.
Rabies, which belongs to a group of viruses called lyssaviruses, targets the body’s nervous system. Once the rabies virus is transmitted — often through saliva in a bite from an animal — “it can replicate a little bit in the muscle, but then it’s looking for nerve cells,” says Susan Moore, an infectious disease researcher at the University of Missouri in Columbia. The virus then “enters your central nervous system … and then through the spine and up into the brain.”
Once the rabies virus has entered the brain, it is hidden from the body’s immune system by the blood-brain barrier. With no way to fight back, this brain infection can lead to neurological problems, coma and death.
The only way to treat rabies is post-exposure treatment immediately after contact with a rabid animal. Treatment involves giving the infected person antibodies to “help bridge the point between the bite and where you start vaccinating” the patient to stimulate the body’s ability to make its own antibodies, Moore says. All of this must happen before the rabies virus reaches the brain – which can take weeks to months – when antibodies can still be effective in fighting the virus in the extremities of the body.
“Rabies is not a candidate for eradication,” says Charles Rupprecht, a rabies expert based in Lawrenceville, Ga. “We can prevent it; we can control it.” But there are still high levels of rabies in countries around the world, and the risk remains that it could be brought into the United States through infected dogs. “So these recommendations were put in place because that’s the state of our world right now.”
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