Rabies, and the Rabies Antibody Titer Testing process

Cat adoptions - Cat travel - Travelling out of Maldives - Export out of Maldives

Many countries in the world rely on a proof that the cat to be imported is free of rabies. Rabies is a viral zoonotic disease (which means it can get transmitted from animal to human) that causes progressive and fatal inflammation of the brain and spinal cord. Rabies still kills tens of thousands of people each year. Of these cases, approximately 99% are acquired from the bite of an infected dog.

Even though Maldives never had a case of a rabid animal, Maldives is also not officially considered "rabies-controlled” – at least not by the EU and the UK (note: the UAE considers Maldives “rabies-free”!). 

Some of the countries that require the test for importing a cat from the Maldives are: The entire European Union, the United Kingdom, Hawaii, Guam, Japan, Australia, New Zealand, Korea, the Seychelles, Singapore, South Africa and others.

This means that cats that are transported from the Maldives to a country that requires a serological Rabies Antibody Titer Test (RNATT), needs to be

• microchipped
  
• vaccinated against rabies and
  
• needs proof of a minimum amount of rabies antibodies in the blood of 0.5IU/mL (International Units per milliliter), which demonstrates an adequate response to the vaccination. 
  

There are approximately 40 approved laboratories around the world that are authorized to conduct the test.

Important info, if your cat requires Rabies Titer Testing:

• First of all, animals less than 12 weeks are not allowed to travel by plane, further would 12 weeks be the minimum age that a cat can be vaccinated against rabies.

• For most rabies vaccines, a single dose at 12 weeks of age or older in healthy cats is administered, repeated 1 year later. However, some veterinarians recommend a booster shot 4 weeks after the first dose, before continuing on an annual basis. There are rabies vaccines that are recommended to booster every three years after the first year’s booster. Always check with your veterinarian about the vaccination schedule depending on the product they use.
  
• Before or during the rabies vaccination you must make sure that your cat is implanted with an approved ISO 15 digit non-encrypted microchip identification. Vaccines that are not tied to a microchip do not count.
  
• Earliest thirty days after the successful rabies immunization date can blood be drawn to be tested for rabies antibodies.

• You must use blood test tubes without anti-coagulants (no LI-Heparin, no EDTA tubes!) unless your laboratory requests something different. You can submit either 5ml blood, or 500µl-1ml serum after spinning in a centrifuge.
  
• The serum can be stored in the fridge (4°C, one week) or in the freezer (-20 °C, one moth) until transport. The quality of the sample may decrease slightly during this time. Transport always has to be done cooled (4°C or cooler).

Packing and labelling
The sample needs to be labelled “Exempt Animal Specimen - Serum from a cat” and "For laboratory use only". Specimens collected from animals that have a minimal likelihood of containing pathogens may be transported as Exempt Animal Specimens if they are transported in packaging that prevents any release of the specimen. Exempt Animal specimens are not subject to IATA Dangerous Goods Regulations or ADR regulations. Specimens for rabies antibody determination do NOT have to be reported to the BRO (Bio Risk Officer)!

The packaging must not break under normal transport conditions! The sender is responsible for packing according to the regulations. The packaging (e.g. of serum or blood samples) must consist of three components:

1) A vessel as primary packaging: leak-proof, watertight container with a tight seal. When placing multiple primary tubes in a single secondary package, the primary tubes must be separated by an absorbent material. Sufficient padding and absorbent material must surround each primary receptacle containing liquid. Primary containers must be carefully labeled with a waterproof pen, e.g., for rabies antibody testing with the pet's microchip number and possibly the pet's name.

1b) Absorbent material
• Place absorbent material (cellulose, kitchen roll material, or paper towels) between the primary and secondary containers, and use enough material to absorb the entire contents of all primary containers.
2) A secondary container (secondary packaging)
• The secondary container cannot serve as an outer shipping container! It must be impervious to liquids such as serum or blood.
• Place an enclosed document, e.g., rabies form - preferably in a plastic bag - between the secondary container and the outer packaging
• When sending serum, place a cooling cartridge in the secondary container next to the samples - do not use dry ice! Transport always has to be done cooled (4°C or cooler)

3) Outer packaging: The primary container (1) and secondary packaging (2) must be enclosed in an outer packaging (3).

• The outer packaging must be rigid. Foam boxes, plastic bags, and paper envelopes are not suitable outer packaging!

• The outer shipping package (3) must be labeled on the address side with the words "Exempt Animal Specimen(s)" or "Exempt Veterinary Specimen" and "UN3373 BIOLOGICAL SUBSTANCE CATEGORY B". Some shipping companies also require the biohazard label.

Each laboratory will have their own forms to fill that need to be submitted with the sample. Once the specimen reaches the lab and is analyzed, it will take at least three days for each test to run. Depending on the laboratory, the report will also be issued by email. However, only the original hard-copy document is valid by law and you should try to get it sent to your address before flying with your cat!

With a few exceptions (e.g. Japan, Australia or New Zealand), the rabies antibody titer testing is valid for life of the animal, as long as you keep boostering the vaccine in the given intervals by the manufacturer of the vaccine.

The 3-months waiting time

Drawing blood for the rabies titer testing must be at least 30 days after the vaccination, and at least 3 months before the arrival of the cat in your home country!
Therefore, animals that travel from the Maldives into the EU, the UK or any other country where rabies titer testing is compulsory, would be at least 7 months old:

• Min. age for rabies vaccine: 12 weeks (3 months) of age
  
• Min age to draw blood for testing: 4 months of age
  
• Waiting time: 3 months
  
• = Min age to travel: 7 months of age

Before we get started, you should know that the whole process of importing a cat to Europe and the UK without quarantining, takes a minimum of 4-5 months. You will therefore need to work out where the cat will live in the Maldives throughout this time as, unless you are very lucky, I imagine you won’t be holidaying for the full duration.

The first step is getting your cat microchipped and vaccinated against rabies. (The microchip must be implanted BEFORE the vaccination is given. They can both be done at the same vet appointment). Although Maldives is rabies free, it is still classed as an ‘unlisted’ or ‘high-risk’ country by most European governments. Therefore, it is essential that your cat is vaccinated against rabies. You will, of course, need a vet to do this for you.

Oases Vet Hospital in Male lists their microchipping service for 450 Rufiyaa (approximately $30) and their rabies vaccination service tends to be around the same price (note that this information from 2021/22 may be outdated - please check current prices!). Oases or Erika Veterinary Clinic is likely the easiest place for most people to travel to as it is situated in the capital. Of course, if you are holidaying on a different island, you will need to acquire a pet carrier to transport your cat to Male, and then back to wherever your cat will  be living for the next 4 months. Unfortunately, vets are very rare throughout the Maldives so finding one will likely be your biggest challenge. It is also very important to get your cat spayed or neutered if they will be living around other cats for the next four months. 

Once your cat is microchipped and vaccinated, you must then wait a minimum of 30 days before you need to return to the vets to take a blood sample. This blood sample (the serum) then needs to be sent to a laboratory that is approved by the country you wish to import the cat to. Unfortunately, there are no approved laboratories in the Maldives so you must send the sample abroad. You can find a list of the approved labs for inside the EU and outside the EU by following the links provided here. Once received by the lab, the blood sample will undergo something called a Titer Test.

A Titer Test is required to prove that there is an acceptable level of the rabies antibodies (at least 0.5 IU/ml) in the cat’s blood stream. Each lab will have different specifications on how the blood sample should be provided. Some may require the sample to be a serum or clotted. Speak to your vet and laboratory to determine what is necessary. I have used the following labs so far:

• The first lab that I have used is the Animal and Plant Health Agency (APHA) in the UK. The lab charged £52.10 per sample in 2021 and the results took a couple of weeks to be emailed back. Each lab will have specific requirements for how the sample should be provided and packaged. You can read about the APHA’s requirements here and find the necessary form to complete here. Luckily, I had a friend travelling to the UK at the time, so they took the iced and correctly packaged samples in their suitcase and posted them on to the APHA once they had landed. If you choose to do something like this, you must provide the traveller with a ‘Freedom from Disease Declaration’ letter signed by your vet. This will explain everything should the traveller be stopped by airport security/customs.

• Alternatively, we have also used the Central Veterinary Research Laboratory in Dubai, who charged around $250 in 2022. However, this time we needed to FedEx the package from Male. It cost around $150 to FedEx the sample and took approximately three days to arrive in Dubai. This meant that there were very specific requirements to correctly package the samples. You can read more about the specifics here. Again, the results took a couple of weeks to be emailed back.

Once the blood sample has been taken and the Titer Test results are acceptable, you are nearly ready. However, your cat cannot enter the EU or UK till after a minimum of 3 calendar months after the date the blood sample was taken. Now we play the waiting game and sort out the paperwork.
You will need multiple printed copies of the following paperwork: 

• Titer Test results
• an export permit
• your cat’s pet health certificate
• details of your customs clearing agent.
  

Titer Test: You should already have a copy of the results from the lab. Print out copies to take to the airport.

Export Permit: You must fill out an export permit for your cat to leave the Maldives. You can acquire this here. 

You will need details of the person sending and receiving the cat, as well as the cat’s microchip number, and breed. The permit will need to be submitted, along with any relevant additional documents listed on the permit, to be approved by the Maldives Ministry of Agriculture and Animal Welfare. Please keep in mind that the Maldives works at a somewhat relaxed pace and often has religious holidays causing offices to close. You should apply for the permit well in advance to allow for any delays.

Pet Health Certificate: Different countries will ask for different versions of a pet passport. The UK, and most European countries, require a Pet Health Certificate to import a non-commercial pet. You can download the Great Britain Pet Health Certificate from the UK government’s website. You will need a vet in the Maldives to fill this out and your cat must travel within 10 days of the form being signed. Some vets may charge a fee to fill out this type of documentation.

Custom’s Clearing Agents: This will likely be the most expensive part of the process. For your cat to pass through airport customs in your home country you must hire a clearing agent. Some airlines will provide this service but, in my experience, most do not. You can Google the various companies that will do this for you depending on the airport your cat is flying to. 

I have used the following services in the UK, and I have listed a breakdown of their costs from 2021/2022.

• Pets on Jets (Manchester Airport):
£145 per pet check
£70 customs clearance fee
£42.90 handling fee
£24.75 service charge

• AirPets (London Heathrow Airport):
It depends on the airline you use but budget between £450 and £600.

Next, you will need to contact an airline and book your cat a ticket home. Some airlines will allow your cat to travel in the passenger cabin (such as Lufthansa), though only if travelling with a human and each human may only take one cat. Please note that your cat carrier will need to be IATA approved, so please check the rules with your airline before purchasing a ticket. You can contact Zoophilist Maldives to purchase an IATA approved cat carrier.

If you can’t find an airline that allows pets to travel in the cabin, most airlines will allow animals to travel in the pressurised cargo hold. It is important to note that currently there is an embargo preventing some airlines from importing live animals into the UK. You will therefore need to do your homework and find an airline that works for you. I mainly use Qatar Airways (approved to import live cargo to the UK) as they have a very good reputation when it comes to caring for animals. You can read more about their pet polices here. 

Unfortunately, Qatar Airways have had some issued with their cargo ventilation systems lately so have been refusing live cargo on occasion. Please check with them in advance to ensure your pet will be safe and able to fly. Please get in touch with Cat Rescue Maldives for contact details of the Qatar Airways cargo team based in Male'.

On the day of travel, you, or a nominated person, will need to drop off your cat at Male airport’s cargo depot (past the domestic terminal, on the right-hand side). The cargo team will weigh the carrier with your cat inside and this will determine the overall cost. You should budget for at least $800 to $1000 (prices from 2021). Please note that the cargo team will likely only accept cash. There are ATMs in the airport but there may be a limit on how much you can withdraw. Please note, you, or your nominated person, must travel home from the Maldives within 5 days of your cat. If your cat is travelling with a nominated person and not yourself, it is a good idea to write a letter confirming you have given permission for them to export your cat.

The cargo team in Male will then personally check the cat carrier to ensure you aren’t smuggling anything out illegally. Your cat CANNOT go through the security scanner. Please make sure they don’t do this as it has been known to happen in Male' airport. Then you will go and board your flight and your cat will be transferred via the quickest route to your final destination. Then you will need to pick up your cat from your destination airport cargo depot and sign a couple of forms, maybe pay some extra taxes and hey presto! You just rescued a stray cat from the Maldives!

Quarantine Option

If you don’t want to wait 4 months or can’t find anywhere for your cat to live whilst you wait, you can put your cat in quarantine for 3 months in the UK. I am sure there are similar options available in Europe too. However, it is important to consider the pros and cons of putting a stray cat in an unfamiliar environment following a very stressful flight.

The company that we have used before is called Ryslip Boarding Kennels and Cattery near London Heathrow and they charge the following in 2022:
£900 +VAT for 3 months board
£95 +VAT for a health check
£90 +VAT for collection from Heathrow airport
£154.13 +VAT for the blood sample and Titer Test
£14 +VAT for a Broadline treatment

You should still get your cat microchipped and vaccinated against rabies (and ideally spayed or neutered too) in the Maldives and then Ryslip will arrange a Titer Test upon arrival in to quarantine.

You can read more about our experience with Ryslip and quarantining here.

Here's little "Milo's" experience, skipping the rabies titer testing and moving straight into UK quarantine.