VS 4-59 Monthly Report of Swine Brucellosis Eradication Activiti

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.

QUARTERLY REPORT OF SWINE
BRUCELLOSIS ERADICATION ACTIVITIES
(VS Memorandum 551.7)

SAMPLES COLLECTED AT

1. STATE

OMB APPROVED
0579-0047
EXP: XX/XXXX

2. PROGRAM STAGE

3. MONTH/YEAR

SECTION A – MARKET SWINE TESTING (MST) SUMMARY

FARM OF ORIGIN IDENTIFIED SAMPLES COLLECTED IN THIS STATE FROM THIS
FARM OF ORIGIN IDENTIFIED SAMPLES COLLECTED IN
STATE’S SOWS AND BOARS
OTHER STATES FROM THIS STATE’S SOWS AND BOARS
A. NO. TESTED
B. NO. REACTORS
C. NO. SUSPECTS
D. NO. TESTED
E. NO. REACTORS
F. NO. SUSPECTS

4. MARKETS
Total
5. SLAUGHTER ESTABLISHMENTS

No. Collected by FSIS

6. TOTALS

SECTION B – TRACEBACK OF MST REACTORS AND SUSPECTS
A. TRACED
TO KNOWN
INFECTED HERD

B. TRACED
AND CHT
REQUIRED

C. TRACED AND
CHT NOT
REQUIRED

D. TRACED TO
DEALER
ONLY

E. TRACED TO
ANOTHER STATE
(Explain)

F. UNABLE TO
TRACE
(Explain)

G. TEST
RESULTS
PENDING

7. MST REACTORS

8. MST SUSPECTS

SECTION C – SUMMARY OF ON FARM TESTING RESULTS
NO. INFECTION FOUND
A.
B.
HERD
SWINE
TESTED
TESTED

REASON FOR TEST

C.
HERD
TESTED

INFECTION FOUND
D.
SWINE
TESTED

E.
SWINE
POSITIVE

TOTALS

F.
HERD
TESTED

G.
SWINE
TESTED

9. MST REACTOR TRACEBACK
10. MST SUSPECT TRACEBACK
11. PRV PROGRAM ASSOCIATED
12. DIAGNOSTIC
13. CHANGE OF OWNERSHIP
14. VALIDATED HERD TESTING
15. EPIDEMIOLOGY
16. DOWN-THE-ROAD SURVEILLANCE
17. OTHER

SECTION D – SOURCE OF NEW HERD INFECTIONS
PURCHASED
SWINE
18. NUMBER OF HERDS

19. NUMBER OF VALIDATED SB FREE
HERDS

21. NUMBER OF HERDS DEPOPULATED

VS 4-59
MAR 2009

EXPOSURE TO
FERAL SWINE

A.

COMMUNITY
SPREAD

B.

C.

OTHER
(Explain)
D.

UNKNOWN
E.

SECTION E – GENERAL
20. SB INFECTED HERDS IN STATE
# OF INFECTED
HERDS UNDER
QUARANTINE AT
BEGINNING OF QTR.
A.

# OF NEW INFECTED
HERDS ADDED OR
RECOGNIZED DURING
QTR.
B.

# OF HERDS
RELEASED FROM
QUARANTINE
DURING QTR.
C.

22. NUMBER OF SWINE DEPOPULATED

(OVER)

# OF INFECTED HERDS
UNDER QUARANTINE
AT END OF QTR.
D.

CUMULATIVE # OF
INFECTED HERDS THIS
FISCAL YEAR
E.

23. TOTAL INDEMNITY PAID

24. EXPLANATIONS/COMMENTS

SECTION F – SWINE BRUCELLOSIS INFECTED HERDS (S) (To be completed for each infected herd)

25. NAME AND ADDRESS OF HERD OWNER

26. DESCRIBE HOW THIS INFECTED HERD WAS DISCLOSED

27. DATE HERD DETERMINED TO BE INFECTED

28. ORIGIN OF INFECTION

29. RESULTS OF ALL TESTING IN HERD SINCE LAST REPORT
TYPE OF TEST

TEST DATE

NUMBER SOWS NEGATIVE

30. NUMBER OF SWINE CULTURES
32. SWINE INVENTORY

NUMBER SOWS POSITIVE

NUMBER BOARS
NEGATIVE

31. CULTURE RESULTS
NUMBER

33. DESCRIBE PLANS FOR ELIMINATION OF SWINE BRUCELLOSIS FROM THE HERD:

SOWS
BOARS
GILTS
PIGS ON FEED
SUCKLINGS
34. SIGNATURE OF AREA VETERINARIAN IN CHARGE

VS4-59 (Reverse)

NUMBER BOARS POSITIVE

35. SIGNATURE OF STATE ANIMAL HEALTH OFFICIAL

Privacy Act Notice
Veterinary Services – Brucellosis Information System and Brucellosis Recording and Reporting System
Authority: 21 U.S.C. 111, 112, 114, 114a-1, 115, 120, 121, 125, 134a-134f and title 9, Code of Federal Regulations, part 51 and
part 78.
Purpose and Routine Uses:
Routine uses of records maintained in the system, including categories of users and the purposes of such uses:
1)
2)
3)
4)
5)
6)
7)

Detecting the foci of infection to reduce the rate of spread of infection to new herds;
Evaluating brucellosis program activities of State, Federal, and contractual personnel;
Preparing mailing labels and preaddressed forms to enhance field activities;
Evaluating program effectiveness;
Detecting factors of epidemiologic importance in containing or eliminating foci of infected herds;
Assuring that brucellosis indemnities are promptly and properly paid;
Notification of livestock owners with the animals at high risk of exposure to brucellosis because of livestock movements or
an outbreak of disease or presence of quarantined premises in a community;
8) Referral to the appropriate agency, whether Federal, State, local, or foreign, charged with responsibility of investigating or
prosecuting a violation of law concerning animal disease control and eradication, or of enforcing or implementing a
statute, rule, regulation, or order issued pursuant thereto, of any record within this system when information available
indicates a violation or potential violation of law concerning animal disease control and eradication, whether civil, criminal,
or regulatory in nature, and either arising by general statute or particular program statute, or by rule, regulation, or court
order issued pursuant thereto;
9) Litigation by the Department of Justice when the agency, or any component thereof, or any employee of the agency in his
or her official capacity, or any employee of the agency in his or her individual capacity where the Department of Justice
has agreed to represent the employee, or the United States, where the agency determines that litigation is likely to affect
the agency or any of its components, is a party to litigation or has an interest in such litigation, and the use of such
records by the Department of Justice is deemed by the agency to be relevant and necessary to the litigation; provided,
however, that in each case, the agency determines that disclosure of the records to the Department of Justice is a use of
the information contained in the records that is compatible with the purpose for which the records were collected;
10) Use in a proceeding before a court or adjudicative body before which the agency is authorized to appear, when the
agency, or any component thereof, or any employee of the agency in his or her official capacity, or any employee of the
agency in his or her individual capacity where the agency has agreed to represent the employee, or the United States,
where the agency determines that litigation is likely to affect the agency or any of its components, is a party to litigation
or has an interest in such litigation, and the agency determines that use of such records is relevant and necessary to the
litigation; provided, however, that in each case, the agency determines that disclosure of the records to the court is a use
of the information contained in the records that is compatible with the purpose for which the records were collected; and
11) Response to a request from a congressional office from the record of an individual made at the request of that individual.
To certain Federal and State animal health officials to conduct, analyze, and report on the progress of animal disease
control or surveillance programs.

Disclosure: Furnishing this information is voluntary; however, failure to furnish this information may impede brucellosis
eradication activities.