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pdfAccording 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 0579-0146. The time required to complete this information collection is
estimated to average .16 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.
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
NATIONAL VETERINARY SERVICES LABORATORIES
P.O. BOX 844, 1920 DAYTON AVENUE, AMES, IA 50010
515-337-7514
SPECIMEN COLLECTION
Bovine Tuberculosis
Reactors, Suspects, and Trace-Exposed
1. SUBMITTER NAME (INCLUDING BUSINESS NAME)
2. NVSL SUBMITTER ID
3. OWNER NAME
4. IDENTIFICATION
OFFICIAL ANIMAL ID
HERD/MANAGEMENT TAG
TRACE-EXPOSED ANIMAL?
FROM WHICH AFFECTED HERD (NAME OR STATE)
Use this form only as a
supplement to
VS Form 10-4. See
reverse for instructions.
CHECK IF WILDLIFE (NO OWNER)
BREED/SPECIES
AGE
YES
NO
5. PRIOR TEST RESULTS (CHECK APPROPRIATE BOX)
CAUDAL FOLD (CFT) TEST OR
SINGLE CERVICAL TEST (SCT)
POSITIVE
NEGATIVE
NOT DONE
COMPARATIVE CERVICAL (CCT)
REACTOR
SUSPECT
INTERFERON GAMMA ELISA RESULT
DPP TEST RESULTS
NOT DONE
NOT DONE
OTHER ANTEMORTEM TEST RESULTS
6. EXAMINE AND SUBMIT THE FOLLOWING LYMPH NODES (LN):
SAMPLE ID
CHECK BOX IF
NO GROSS
LESIONS (NGL)
LN
DESCRIBE LESIONS, IF PRESENT
HEAD LN POOL
MEDIAL RETROPHARYNGEAL
NGL
LATERAL RETROPHARYNGEAL
NGL
MANDIBULAR
NGL
PAROTID
NGL
THORACIC LN POOL
TRACHEOBRONCHIAL
NGL
CRANIAL, MIDDLE, CAUDAL MEDIASTINAL
NGL
ABDOMINAL LN POOL
MESENTERIC
NGL
HEPATIC
NGL
7. EXAMINE THE FOLLOWING TISSUES BUT SUBMIT ONLY IF LESIONED:
LUNG, PLEURA, LIVER, SPLEEN, OVARIES, UTERUS, PRESCAPULAR LN, CERVICAL LN, POPLITEAL LN, MAMMARY LN, AND/OR ILIAC LN
SAMPLE ID
VS FORM 10-7
MAY 2014
BRIEF DESCRIPTION OF LESIONED TISSUE
OMB Approved
0579-0146
Exp.: 11/30/2016
SEX
VS FORM 10-7 INSTRUCTIONS
THIS FORM IS INTENDED AS A SUPPLEMENT TO VS FORM 10-4
AND MUST BE ACCOMPANIED BY VS FORM 10-4. ALL information
must be printed legibly or typed. USE A SEPARATE FORM FOR
EACH ANIMAL.
The FSIS Guidebook may be helpful for identifying tuberculosis
lesions:
See www.aphis.usda.gov/animal_health/animal_diseases/tuberculosis/
downloads/tb_guidebook.pdf for instructions on submitting tuberculosis
lesions and/or thoracic granulomas.
I. TISSUE SELECTION AND PRESERVATION
1 and 2. SUBMITTER CONTACT INFORMATION
Enter the submitter’s business name/affiliation and NVSL Submitter ID
(if available) exactly as entered on VS Form 10-4.
A.
B.
3. OWNER INFORMATION
Enter the name of the animal owner as entered on VS Form 10-4.
C.
4. IDENTIFICATION
Sample ID – Ensure the sample identification number on this form
matches the sample identification number placed on the
specimen container.
Official Animal ID – Record the animal’s national identification tag
number. NOTE: Laboratory results will be reported by animal
identification number.
Herd/Management Tag – Record the identification used within the herd
or management system.
Breed – Enter the animal breed or species (e.g., Holstein, Angus,
Fallow Deer).
Age – Indicate the approximate age in years (y) or months (m).
Sex – Indicate the sex, male (M), or female (F).
D.
E.
AVOID CONTAMINATION: Remove excess fat.
Divide lesions in half. Place one portion in formalin for
histopathology and place the remaining portion in borate or
whirl-pack for culture.
HISTOLOGY PORTION: Cut specimen, including normal
tissue surrounding lesion, into slices approximately 1 cm
(½ inch) thick. Prior to placing in formalin.
CULTURE PORTION: Place the intact portion of the sample
into borate or whirl-pack. Do NOT cut the sample into slices.
Maximum tissue to preservative ration: Formalin – 1:10
Borate – 1:1
II. IDENTIFYING DEVICES
If the identifying devices will not be held locally, place the identifying
devices from each animal in a plastic bag, and send to the NVSL in the
box with the specimens.
III. SHIPPING SAMPLES
5. PRIOR TEST RESULTS
Enter the results of prior tests and examinations performed on the
animal.
6. EXAMINE AND SUBMIT LYMPH NODES
Examine and submit the indicated lymph nodes. Check whether
lesions were noted on each tissue and add any pertinent comments.
Unless otherwise directed by a USDA tuberculosis epidemiologist, use
separate containers for head, thoracic, and abdominal lymph nodes
from the animal, including those with no gross lesions.
A.
B.
C.
D.
E.
Ensure the sample identification number on this form matches
the sample identification number placed on the specimen
container.
F.
7. EXAMINE OTHER TISSUES. SUBMIT ONLY IF LESIONS ARE
FOUND. Examine each tissue listed in this section but submit samples
only if lesions are found. Submit lesioned tissues in separate
containers from lymph nodes listed in Block 6. Provide a brief
description of the lesions found on each submitted tissue.
H.
G.
I.
Shipping containers are available from the NVSL. Contact
the shipping department at 515-337-7530 or
NCAH.Shipping@aphis.usda.gov.
No refrigeration is required for borate or formalin. Ice packs
are required for fresh tissue. DO NOT FREEZE; freezing
ruins specimens.
PREVENT LEAKAGE: Tighten and tape caps.
SECONDARY CONTAINER: Place samples in a leak-proof
bag.
ABSORBENT PAD: Place absorbent material in bag with
samples to absorb any leakage.
IDENTIFYING DEVICES: Place in separate plastic bag with
samples.
SHIPPING CONTAINER- Insert sealed secondary container
into an approved diagnostic shipping container and seal.
SUBMISSION FORMS: Place between sealed secondary
container and outside mailer.
RETURN ADDRESS: Provide complete return address on
mailing label.
Ship submissions to:
USDA, APHIS
NATIONAL VETERINARY SERVICES LABORATORIES
1920 DAYTON AVE
AMES, IOWA 50010
TELEPHONE NUMBER: 515-337-7212
IV. ADDITIONAL GUIDANCE
For questions regarding histology, contact the NVSL Pathobiology
Laboratory at 515-337-7912.
For questions regarding bacteriology, contact the NVSL Diagnostic
Bacteriology Laboratory at 515-337-7388.
VS Form 10-7 (Reverse)
File Type | application/pdf |
File Title | According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond |
Author | Khbrown |
File Modified | 2014-05-27 |
File Created | 2014-05-20 |