Live exotic animals legally and illegally imported via the main Dutch airport and considerations for public health.

The trade in live animals and animal products is considered one of the major drivers of zoonotic disease emergence. Schiphol airport in the Netherlands is one of the largest European airports and is considered a main hub for legal and illegal import of exotic animals. However, so far there is little information about what pathogens these imported animals might carry with them. Therefore, this study aimed to assess the zoonotic risks of exotic animals imported into the Netherlands through Schiphol airport in 2013 and 2014. Based on a previous list of highly prioritised emerging zoonoses for the Netherlands (EmZoo list), WAHID and Promed databases, literature and expert opinions, a list of 143 potentially relevant zoonotic pathogens was compiled. In a step-wise selection process eighteen pathogen-host combinations that may pose a public health risk by the import of exotic animals via Schiphol airport were identified and these were assessed by expert elicitation. The five pathogens with the highest combined scores were Salmonella spp., Crimean-Congo haemorrhagic fever virus, West Nile virus, Yersinia pestis and arenaviruses, but overall, the public health risk of the introduction of these exotic pathogens into the Netherlands via the legal import of exotic animals was considered low. However, the vast majority of imported exotic animals were imported by trade companies, increasing the risk for specific groups such as retail and hobbyists/pet owners. It is expected that the risk of introduction of exotic zoonotic pathogens via illegal import is substantial due to the unknown health status. Due to changing trade patterns combined with changing epidemiological situation in the world and changing epidemiological features of pathogens, this risk assessment needs regular updating. The results could give directions for further adjusting of health requirements and risk based additional testing of imported exotic animals.