Form VS 4-1D VS 4-1D Application for Validation of a Brucellosis Free Area

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 0579-0047. The time required to complete this information collection is estimated to
average 2 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.

OMB APPROVED
0579-0047
EXP: XX/XXXX

The information in this report is needed for effective monitoring and
management of the Brucellosis Federal-State Cooperative Program
(9 CFR Parts 51 and 78).
GEOGRAPHIC AREA

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

APPLICATION FOR VALIDATION
OF A BRUCELLOSIS-FREE AREA

STATE

APPLICATION FOR BRUCELLOSIS-FREE

The following basic requirements have been met:
(1) In accordance with the provisions of the current Brucellosis Eradication-Uniform Methods and Rules, the required testing has been completed and
the incidence of Brucellosis did not exceed the limits specified.
(2) All swine herds in which brucellosis was disclosed have been slaughtered or released from quarantine. No known foci of swine brucellosis remain in
the area. There are no pending tests of swine herds suspected of being affected with Brucellosis.
(3) Procedures for maintaining continuous surveillance of the swine population as prescribed by the Brucellosis Eradication-Uniform Methods and
Rules, are adequate to locate swine brucellosis if introduced into the area.
If reactors are disclosed in the Area in the future they will be reported promptly to Veterinary Services, Riverdale, Maryland 20737.
We request that this Area be declared a Validated Brucellosis-Free Area.

SIGNATURE OF STATE OFFICIAL

TITLE

SIGNATURE OF FEDERAL VETERINARIAN IN CHARGE

DATE

DATE

CERTIFICATION
Veterinary Services hereby declares the above Area
A VALIDATED BRUCELLOSIS-FREE AREA

beginning_________________________________________________, and ending ____________________________________________________
SIGNATURE OF VS CERTIFYING OFFICER

VS FORM 4-1D
FEB 2009

Previous edition may be used.

DATE

(OVER)

TESTING SUMMARY
2. GEOGRAPHIC AREA

1. REQUEST FOR BRUCELLOSIS-FREE
VALIDATION

REVALIDATION

3. STATE

REINSTATEMENT

4. QUALIFYING METHOD
COMPLETE HERD (Area) TESTING

ALTERNATE METHOD 1

ALTERNATE METHOD 2

5. TOTAL HERDS IN AREA (Item 6a + 7)

6. HERDS IN AREA QUALIFIED BY COMPLETE HERD TESTS
A. Total No. of Herds Tested
B. Total No. of Swine Tested
(6 mos. of age and older)

7. TOTAL NO. OF HERDS IN AREA NOT
TESTED (Specify reasons not testing each
herd in item 18)

8. SWINE HERDS IN AREA SELLING BREEDING STOCK
A. Total No. of Herds
B. No. of Herds Tested

9. ELIGIBLE SWINE SLAUGHTERED
B. No. of Blood Samples Collected

A. No. Slaughtered

C. Total No. of Swine Not
Tested (Under 6 mos. of age)

C. Total No. of Herds Validated
Brucellosis-Free

C. Percent Collected (9B ÷ 9A)
%

10. MST REACTORS TRACED TO HERD OF ORIGIN
B. Percent of Reactors Not Traced
C. Total of Herds Tested
(item 11A ÷ 14E)

A. No. of Reactors Traced
(item 10A + 11A = 14E)

%

11. MST REACTORS NOT TRACED TO HERDS OF ORIGIN
A. No of Reactors Not Traced

OTHER (Specify)

12. TRACEBACK CAPABILITY (item 9C x 10B)

13. TESTING DATES

B. Percent of Reactors Not
Traced (item 11A ÷ 14E)

From

%
NUMBER
SWINE OR HERD CLASSIFICATION

A. HERDS

B. SWINE

To

RESULTS OF BLODD TESTS
INFECTED HERDS
REACTOR SWINE
C. NUMBER

D. PERCENT
(Col. C ÷ A)

E. NUMBER

F. PERCENT
(Col. E ÷ B)

14. Market Swine Tests

15. Test of Herds of origin of MST reactors

16. Other complete herd blood tests

17. Totals
%
%
18. SUMMARY: (Give a brief history of the swine brucellosis status of the area including the date the last infected animal was found. Also, indicate the date of quarantine
release of slaughter for this herd. The method of identification of slaughter animals used and other pertinent information should be briefly described. Attach additional sheet if
necessary.

VS FORM 4-1D (Reverse)