(2013)
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OMB Number 0579-0299 Exp. Date:X/XX/2016 USDA:APHIS:VS:CEAH Fort Collins, CO 80526-8117 |
Instructions
These instructions refer to completion of the National Animal Health Reporting System (NAHRS) form by the State Veterinarian’s office or representative.
For each month, please report disease presence or absence for the entire month. Monthly reports are due by the 20th of the following month. If you receive reports on out-of-state submissions, REPORT ONLY CASES THAT OCCURRED IN YOUR OWN STATE. Be sure to indicate the State and month for which you are reporting. If there are questions on reporting, consult the NAHRS disease reporting criteria. The NAHRS Operational Manual and Uniform Methods and Rules can be located on the NAHRS Homepage, http://www.aphis.usda.gov/vs/ceah/ncahs/nahrs.
If you received a report of a case which fits the NAHRS criteria, check ‘YES’ under PRESENT. If you received a report of a case which does not fit the NAHRS criteria, but you have additional evidence to support the presence of confirmed disease, check ‘YES’ under PRESENT. If you received no reports in the investigation of a suspected confirmed disease which fit the NAHRS criteria and you have no further supporting evidence of the presence of confirmed disease, check ‘NO’ under PRESENT (e.g., all investigations for a given disease were negative.) A ‘NO’ report, in relation to an endemic disease, indicates that from information available there were no reports of confirmed disease occurrence, and does not infer the endemic disease does not occur in the State.
Most endemic diseases include both a presumptive and definitive level of confirmation. If a case meets the NAHRS definitive criteria for presence of disease, record it as present. If a case does not meet the NAHRS definitive criteria, but meets presumptive criteria—report the case if it is considered a probable case and ‘presumptive’ can be indicated in the comment section. The disease reporting criteria are minimum standards and additional information can be utilized to report i.e. epidemiological link, or other non-listed laboratory tests.
Add any additional information which you feel may be of value or pertinent in the COMMENTS column e.g. level of lab diagnosis; presumptive vs. definitive; environment disease occurrence located in – backyard, feral, etc; and any other clarifying information needed.
If a report of a case is received after the report has been sent or edits to the report are required, notify the NAHRS administrator to update the information.
NOTE: Diseases below that are indicated as FAD (foreign animal disease) are those diseases that are considered foreign to the United States or are managed as FADs. To report the presence of an FAD or occurrence, mark ‘yes’ for the disease after State-Federal coordination.
NAHRS Report for:
STATE: |
MONTH: |
YEAR: |
Person Completing the Report:
NAME: |
TELEPHONE: |
ADDRESS: |
E-MAIL ADDRESS: |
CITY, STATE, ZIP: |
Disease Occurrence Information:
OIE NUMBER - DISEASE NAME |
PRESENT |
COMMENTS |
|
BOVINE |
YES |
NO |
|
A010-A018 Foot and mouth disease (all FMD, Viruses O, A, C, SAT 1, SAT 2, SAT 3, Asia 1) |
|
FAD |
|
A020-A023 Vesicular stomatitis (VS, Viruses Indiana, New Jersey, or not typed) |
|
FAD |
|
A040 Rinderpest |
|
FAD |
|
A060 Contagious bovine pleuropneumonia (Mycoplasma mycoides mycoides) |
|
FAD |
|
A070 Lumpy skin disease |
|
FAD |
|
A080 Rift valley fever |
|
FAD |
|
N001 Crimean Congo hemorrhagic fever |
|
FAD |
|
A090 Bluetongue |
|
|
|
B051 Anthrax (Bacillus anthracis) |
|
|
|
B052 Aujesky’s disease (Pseudorabies) |
|
|
|
B053 Echinococcosis / Hydatidosis |
|
|
|
B055 Heartwater (Cowdria ruminantium) |
|
FAD |
|
B056 Leptospirosis |
|
|
|
B057 Q fever (Coxiella burnetti) |
|
|
|
B058 Rabies |
|
|
|
B059 Paratuberculosis (Johne’s Disease, Mycobacterium avium paratuberculosis) |
|
|
|
B060-B061 New and Old World screwworm (Cochliomyia (Callitroga) hominivorax, Chrysomya bezziana) |
|
FAD |
|
B101 Anaplasmosis (Anaplasma marginale, A. centrale) |
|
|
|
B102 Babesiosis (Babesia bovis, B. bigemina) |
|
FAD |
|
N103 Bovine brucellosis (Brucella abortus) |
|
|
|
N152 Brucellosis (Brucella melitensis) |
|
FAD |
|
N253 Brucellosis (Brucella suis) |
|
|
|
B104 Bovine genital campylobacteriosis (Campylobacter fetus venerealis) |
|
|
|
B105 Bovine tuberculosis (Mycobacterium bovis) |
|
|
|
N117 Bovine viral diarrhea (BVD) |
|
|
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B108 Enzootic bovine leukosis (BLV) |
|
|
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B109 Hemorrhagic septicemia (Pasteurella multocida, B/Asian or E/African serotypes) |
|
|
|
B110 Infectious bovine rhinotracheitis/ infectious pustular vulvovaginitis (IBR/IPV) |
|
|
|
B111 Theileriasis (Theileria annulata, T. parva) |
|
FAD |
|
B112 Trichomoniasis (Tritrichomonas (Trichomonas) foetus) |
|
|
|
B113 Trypanosomiasis (Trypanosoma congolense, T. vivax, T. brucei brucei, T. evansi) |
|
FAD |
|
B114 Malignant catarrhal fever |
|
|
Indicate if Sheep or Wildebeest related form/ or other (Wildebeest-FAD) |
B115 Bovine spongiform encephalopathy |
|
FAD |
|
N158 Epizootic hemorrhagic disease (EHD) |
|
|
|
CAPRINE AND OVINE |
YES |
NO |
|
A010-A018 Foot and mouth disease (FMD, Viruses O, A, C, SAT 1, SAT 2, SAT 3, Asia 1, or not typed) |
|
FAD |
|
A020-A023 Vesicular stomatitis (VS, Viruses Indiana, New Jersey, or not typed) |
|
FAD |
|
A040 Rinderpest |
|
FAD |
|
A050 Peste des petits ruminants |
|
FAD |
|
A080 Rift Valley fever |
|
FAD |
|
A090 Bluetongue |
|
|
|
N001 Crimean Congo hemorrhagic fever |
|
FAD |
|
A100 Sheep pox and goat pox |
|
FAD |
|
B051 Anthrax (Bacillus anthracis) |
|
|
|
B052 Aujesky’s disease (Pseudorabies) |
|
|
|
B053 Echinococcosis / Hydatidosis |
|
|
|
B055 Heartwater (Cowdira ruminantium) |
|
FAD |
|
B056 Leptospirosis |
|
|
|
B057 Q fever (Coxiella burnetti) |
|
|
|
B058 Rabies |
|
|
|
B059 Paratuberculosis (Johne’s Disease, Mycobacterium paratuberculosis) |
|
|
|
B060-B061 New and Old World screwworm (Cochliomyia (Callitroga) hominivorax, Chrysomya bezziana) |
|
FAD |
|
B151 Ovine epididymitis (Brucella ovis infection) |
|
|
|
N152 Caprine and ovine brucellosis- (B. melitensis) (all others except B. ovis) |
|
|
|
B153 Caprine arthritis / encephalitis (CAE) |
|
|
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B154 Contagious agalactia (Mycoplasma agalactiae, M. capricolum capricolum, M. putrefaciens, M. mycoides mycoides, M. mycoides mycoides LC) |
|
|
|
B155 Contagious caprine pleuropneumonia (Mycoplasma capricolum capripneumoniae) |
|
FAD |
|
B156 Enzootic abortion of ewes (Ovine Psittacosis, Chlamydia psittaci) |
|
|
|
B158 Nairobi sheep disease |
|
FAD |
|
B159 Salmonellosis (Salmonella abortus ovis) |
|
|
|
B160 Scrapie |
|
|
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B161 Maedi-visna / ovine progressive pneumonia |
|
|
|
B352 Tularemia (Francisella tularensis) |
|
|
|
N002 West Nile fever / encephalitis |
|
|
|
EQUINE |
YES |
NO |
|
A020-A023 Vesicular stomatitis (VS, viruses Indiana, New Jersey, or not typed) |
|
FAD |
|
A110 African horse sickness |
|
FAD |
|
B051 Anthrax (Bacillus anthracis) |
|
|
|
B056 Leptospirosis |
|
|
|
B058 Rabies |
|
|
|
B060-B061 New and Old World screwworm (Cochliomyia (Callitroga) hominivorax, Chrysomya bezziana) |
|
FAD |
|
B062 Trichinellosis (Trichinela spiralis) |
|
|
|
B201 Contagious equine metritis (Taylorella equigenitalis) |
|
FAD |
|
B202 Dourine (Trypanosoma equiperadum) |
|
FAD |
|
N220 Eastern equine encephalomyelitis (EEE) |
|
|
|
N221 Western equine encephalomyelitis (WEE) |
|
|
|
B205 Equine infectious anemia (EIA) |
|
|
Report additional EIA testing information below |
B206 Equine influenza (virus type A) |
|
|
|
B207 Equine piroplasmosis (Babesiosis, Babesia (Piroplasma) equi, B. caballi) |
|
FAD |
|
B208 Equine rhinopneumonitis (EHV 1 and 4) |
|
|
|
B208a Equine herpesvirus myeloencephalopathy (EHV1 – EHM) |
|
|
|
B209 Glanders (Pseudomonas mallei) |
|
FAD |
|
B211 Equine viral arteritis (EVA) |
|
|
|
B212 Japanese encephalitis |
|
FAD |
|
B215 Surra (Trypanosoma evansi) |
|
FAD |
|
B216 Venezuelan equine encephalomyelitis |
|
FAD |
|
N352 Tularemia (Francisella tularensis) |
|
|
|
N002 West Nile Fever / encephalitis |
|
|
|
PORCINE |
YES |
NO |
|
A010-A018 Foot and mouth disease (FMD-O, A, C, SAT 1, SAT 2, SAT 3, Asia 1, or not typed) |
|
FAD |
|
A020-A023 Vesicular stomatitis (VS, Viruses Indiana, New Jersey, or not typed) |
|
FAD |
|
A030 Swine vesicular disease |
|
FAD |
|
A040 Rinderpest |
|
FAD |
|
A120 African swine fever |
|
FAD |
|
A130 Classical swine fever (hog cholera) |
|
FAD |
|
N258 Nipah virus encephalitis |
|
FAD |
|
B051 Anthrax (Bacillus anthracis) |
|
|
|
B052 Aujesky’s disease (Pseudorabies) |
|
|
|
B053 Echinococcosis / Hydatidosis |
|
|
|
B056 Leptospirosis |
|
|
|
B058 Rabies |
|
|
|
B060-B061 New and Old World screwworm (Cochliomyia (Callitroga) hominivorax, Chrysomya bezziana) |
|
FAD |
|
B062 Trichinellosis (Trichinela spiralis) |
|
|
|
B252 Cysticercosis (Cysticercus cellulosae metacestode stage of Taenia solium) |
|
|
|
N253 Porcine brucellosis (Brucella suis) |
|
|
|
B254 Transmissible gastroenteritis (TGE) |
|
|
|
B257 Porcine reproductive and respiratory syndrome (PRRS) |
|
|
|
B212 Japanese encephalitis |
|
FAD |
|
B352 Tularemia (Francisella tularensis) |
|
|
|
POULTRY |
YES |
NO |
|
A150 Highly pathogenic avian influenza (fowl plague) |
|
FAD |
|
A160 Newcastle disease (exotic) |
|
FAD |
|
N150i Low pathogenic avian influenza (H5 or H7 subtypes) poultry |
|
|
|
1008 Turkey rhinotracheitis |
|
|
|
B301 Avian infectious bronchitis |
|
|
|
B302 Avian infectious laryngotracheitis |
|
|
|
B304 Duck viral hepatitis |
|
FAD |
|
B306 Fowl cholera (Pasteurella multocida) |
|
|
|
B308 Fowl typhoid (Salmonella gallinarum) |
|
FAD |
|
B309 Infectious Bursal Disease (Gumboro Disease) |
|
|
|
B310 Marek’s Disease |
|
|
|
B311 Mycoplasmosis (Mycoplasma gallisepticum) |
|
|
|
1009 Mycoplasmosis (Mycoplasma synoviae) |
|
|
|
B312 Avian Chlamydiosis (Psittacosis and Ornithosis, Chlamydia psittaci) |
|
|
|
B313 Pullorum Disease (Salmonella pullorum) |
|
|
|
AQUACULTURE |
YES |
NO |
|
FISH |
|
|
|
B401 Viral hemorrhagic septicemia (VHS) |
|
|
|
B404 Spring viremia of carp (SVC) |
|
|
|
B405 Infectious hematopoietic necrosis (IHN) |
|
|
|
B413 Epizootic hematopoietic necrosis |
|
FAD |
|
N416 Infectious salmon anemia (ISA) |
|
FAD |
|
N417 Epizootic ulcerative syndrome |
|
|
|
N418 Gyrodactylosis (Gyrodactylus salaries) |
|
FAD |
|
N419 Red sea brea iridoviral disease |
|
FAD |
|
N420 Koi herpesvirus disease |
|
|
|
MOLLUSC |
|
|
|
Infection with Bonamia ostreae |
|
FAD |
|
Infection with Bonamia exitiosa |
|
FAD |
|
Infection with Marteilia refringens |
|
FAD |
|
Infection with Perkinsus marinus |
|
|
|
Infection with Perkinsus olseni |
|
FAD |
|
Infection with Xenohaliotis californiensis |
|
FAD |
|
Abalone viral mortality |
|
FAD |
|
CRUSTACEAN |
|
|
|
Taura syndrome |
|
FAD |
|
White spot disease |
|
FAD |
|
Yellowhead disease |
|
FAD |
|
Tetrahedral baculovirosis (Baculovirus penaei) |
|
FAD |
|
Spherical baculovirosis (Penaeus monodon-type baculovirus) |
|
FAD |
|
Infectious hypodermal and haematopoietic necrosis |
|
FAD |
|
Crayfish plague (Aphanomyces astaci) |
|
FAD |
|
Infectious myonecrosis |
|
FAD |
|
White tail disease |
|
FAD |
|
Additional Equine Infectious Anemia Testing Information:
1. Number of EIA tests performed in reporting month: |
|
2. Number of horses tested in reporting month (leave blank if unavailable): |
|
3. Number of horses tested positive in reporting month: |
|
4. Number of premises (epidemiological units) with positive(s) in reporting month (If premises previously reported in calendar year do not report, and if no other positive premises indicate -- 0): |
|
5. Number of total horses quarantined in State for positive EIA test: |
|
Instructions for Additional Equine Infectious Anemia Questions:
Number
of EIA tests
performed
in reporting month:
Report the total number of EIA tests performed the reporting month
for horses that reside
in
your State. This includes all tests on resident horses conducted
both at in-state and out-of-state labs.
Number
of horses
tested in reporting month (if
unavailable leave blank):
Report the number of horses
tested for EIA for the reporting month. Do not include repeat EIA
tests on the same horse in the calendar year.
If
this information is unavailable, leave this blank.
Number
of horses
tested positive in reporting month:
Report the total number of newly identified horses
tested positive for EIA in the reporting month. Do not include
repeat testing of an already identified positive horse.
Number
of premises
(epidemiological units) with positive(s) in reporting month (If
premise previously reported in calendar year do not report, and if
no other positive premises indicate -- 0):
Identify the number of premises (epidemiological units) with
positive EIA horses for the calendar year. If a premise has been
reported as positive in a previous monthly report, do not include in
number of premises positive in reporting month. If the only
positive premises is a premises identified on a previous monthly
report for the calendar year, report ‘0’. Example: if a
premise has one positive horse in June and additional testing in
July identifies 3 additional positive horses on the same premises –
for July indicate 3 positive horses and ‘0’ for number
of premises.
Number of total horses quarantined in State for positive EIA test: This is the total number of EIA quarantined horses at the end of the previous month with the addition of newly identified EIA positive horses and minus any EIA quarantined animals that were destroyed or died in the reporting month.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0299. The time required to complete this information collection is estimated to average 8 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
This form (2/13) replaces all previous forms
File Type | application/msword |
File Title | Form Approved |
Author | James T. Case DVM, PhD |
Last Modified By | cbsickles |
File Modified | 2013-01-11 |
File Created | 2013-01-10 |