VS Form 9-7 Flock Inspection And Check-Testing Report

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OMB APPROVED
0579-0007
EXP: 02/2022

This report is required by Regulations 9 CFR 145. Failure to report will hinder nationwide review and analysis of disease investigations.

1. ISOLATION REPORTED

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANTHEALTH INSPECTION SERVICE
THE NATIONAL POULTRY IMPROVEMENT PLAN

INVESTIGATION OF SALMONELLA
ISOLATIONS IN POULTRY

2. VS FORM 9-6 SERIAL NO.

a.

PULLORUM

b.

TYPHOID

c.

TYPHIMURIUM

d.

ARIZONA

e.

OTHER (specify)

3. SPECIMEN SUBMITTED
a.

CHICKEN

c.

OTHER (specify)

4. DATE SPECIMEN SUBMITTED
b.

TURKEY

SECTION A - FLOCK FROM WHICH INFECTED SPECIMENS WERE SUBMITTED
5. NAME & ADDRESS OF OWNER (include zip code)

7. BREED, STRAIN, OR TRADE NAME

11 ESTIMATED EFFECTS OF THIS
INSPECTION

6. LOCATION OF FLOCK

8. NO. BIRDS

a. MORTALITY

12. SUSPECTED SOURCE OF THIS INFECTION
b.

9. AGE

10. PURPOSE OF FLOCK (check appropriate blocks)

b. MORIDITY

13. KIND OF SPECIMENS
COLLECTED FOR LAB EXAM

NEARBY FLOCK

a.

PRODUCTION

b.

REPRODUCTION

c.

EGGS

e.

PRIMARY

f.

MULTIPLIER

g.

OTHER (specify)

PREMISES

a.

QUARANTINE

c.

CONTAMINATED SUPPLIES

c.

CLEAN AND DISINFECT PREMISES

d.

d.

OTHER (specify)

e.

CLEANUP BY RETESTING

FUMIGATE EGGS

g.

MEDICATION

YES

MEAT

14. CORRECTIVE MEASURES APPLIED

a.

15. MEASURES CHECKED IN ITEM 14
ADEQUATE TO PREVENT SPREAD

d.

b.

h.

DISCONTINUE AS HATCHERY FLOCK

f.

SLAUGHTER

OTHER (specify)

NO

SECTION B • HATCHERY SOURCE OF FLOCK REPORTED IN SECTION A
16. NAME & LOCATION OF HATCHERY (include ZIP code)

17. APPROVAL
NUMBER

18. PREVIOUS ISOLATIONS OF SAME SEROTYPE
IMPLICATING THIS HATCHERY
NO. OF REPORTS

19. INVESTIGATIVE PROCEDURES (indicate positive (+} or negative (-) results of each procedure used)
A. SURVEY OF FLOCKS FROM

B. LABORATORY EXAMINATION OF SPECIMENS COLLECTED AT HATCHERY

a.

SAME OR PROXIMATE HATCHES

a.

EGGS (incubator rejects) b.

INCUBATOR SWABS

c.

AIR SAMPLE

b.

SAME PARENT FLOCK(s)

d.

FLUFF

BABY POULTRY

f.

OTHER (specify)

e.

20. ADEQUATE MEASURES APPLIED TO ELIMINATE PREMISES (hatchery) INFECTION?

YES

NO

SECTION C - PARENT FLOCK OF FLOCK REPORTED IN SECTION A
21. NAME & ADDRESS OF OWNER OF PARENT FLOCK (include ZIP code)

24. SOURCE OF PARENT
FLOCK BY SEX

A. MALES (name and address of breeder)

25 CLASSIFICATION AND
BASIS OF QUALIFICATION

A. U.S. PULLORUM-TYPHOID CLEAN

26. EXAMINATIONS FOR
SUSPECTED SEROTYPE

23. NO. BIRDS IN
PARENT FLOCK

B. FEMALES (name and address of breeder)

B. U.S. TYPHIMURIUM CONTROLLED

a.

100% TEST

c.

MONITORING PROGRAM (date of last exam)

A. SEROLOGICAL

b.

22. LOCATION OF PARENT FLOCK

SAMPLE TEST _____________% TESTED

a.

PREMISES HISTORY

b.

100% TEST

B. BACTERIOLOGICAL (indicate positive (+) or negative (-) results)

a. NO. BIRDS TESTED

a.

REACTORS

b.

CLOACAL SWABS

c.

CULL BIRDS

b. NO. REACTORS

d.

FECES

e.

LITTER

f.

DUST

27. SERIAL NUMBERS OF VS FORM 9-6 REPORTS OF POSITIVES SHOWN IN ITEM 26B AND ISOLATIONS OF OTHER SEROTYPE

28. REMARKS

29. INSPECTOR

VS FORM 9-7
AUG 2005

30. STATE

31. DATE