One Health - RCA Current Version - Test Version (DO NOT USE)

• Version # 9: March 6, 2020

• Doc ID: 4.a.ii.2.a

• Notify Veterinarian of an initiated OHC

  NOTIFY

• Date of RCA Submission

  Date

• Farm Name

  Select

• House Number

• Date Placed

  Date

• Number of Birds Placed

• Requirements Statement:
  -For week 1 (0-7 days of age) action threshold is >5/1000/day for more than 2 consecutive days.
  -For week 2-harvest (8 days-harvest) action threshold is >3/1000/day for more than 2 consecutive days, or > 5/1000 for 1 day.

Requirements Statement: -For week 1 (0-7 days of age) action threshold is >5/1000/day for more than 2 consecutive days. -For week 2-harvest (8 days-harvest) action threshold is >3/1000/day for more than 2 consecutive days, or > 5/1000 for 1 day.

Chick Health

• Increments of "0.1" - round to the tenth decimal place, are only accepted. (As Needed)

• EX: 2.3 is okay, but 2.28 is NOT accepted.

• Is This First Week Mortality?

  Yes

  No

• Is this delayed reporting?

  Yes

  No

Reason for Delay:

• Grower

• Reporting not immediate as required by contract

• Retrained for conformance

• Other:

• Describe

• Flock Supervisor

• Other:

• Describe

• Age of birds at time of mortality increase:

• Mortality Day 1 (x /1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

Chick Quality, Select Following:

• Chick Quality (0-7 Days)
  Select One Of The Following:

• Infectious Disease (Omphalitis, Asper, etc...)

  Yes

  No

• Non-Infectious Disease (Dehydration, Red Hocks, Navel)

  Yes

  No

• Mixed

  Yes

  No

• Other

• Describe:

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

Chick Quality, Select Following:

• Chick Quality (0-7 Days)
  Select One Of The Following:

• Infectious Disease (Omphalitis, Asper, etc...)

  Yes

  No

• Non-Infectious Disease (Dehydration, Red Hocks, Navel)

  Yes

  No

• Mixed

  Yes

  No

• Other

• Describe:

Correction

• Describe The Correction:

On Farm Necropsy

• Yes

  No

Submitted to Laboratory?

• Yes

  No

AI Swabs Submitted

• Yes

  No

Was a Feed Sample Submitted

• Yes

  No

Script Request

• Script Request Submitted?

  Yes

  No

• Tack A Picture Of Your Script Request Form

  Media

• Has a written and/or verbal instruction on administering medication occurred?

  Yes

  No

• Date communicated

  Date

• Was This house Treated last flock?

  Yes

  No

• Is This The Second Flock In This House Being Treated?

  Yes

  No

• Is This The Third Flock In This House Being Treated?

  Yes

  No

• Is This The Fourth Flock In This House Being Treated?

  Yes

  No

• Is This The Fifth Flock In This House Being Treated?

  Yes

  No

• Is This More Than The Fifth Flock Being Treated In This House?

  Yes

  No

Flock Supervisor Sign-off and Date

• Please sign when complete

  Sign

• Is this delayed reporting?

  Yes

  No

Reason for Delay:

• Grower

• Reporting not immediate as required by contract

• Retrained for conformance

• Other:

• Describe

• Flock Supervisor

• Other:

• Describe

• Age of birds at time of mortality increase:

• Mortality Day 1 (x /1000)

• Mortality Day 2 (x /1000)

• Mortality Day 3 (x /1000)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

Swab Clarification

• Are birds greater than 21 days of age?

  Yes

  No

• Is the mortality (deads, NOT culls) greater than 3/1000 for 2 consecutive days or 5/1000 for 1 day?

  Yes

  No

• Will or have birds or AI swabs been submitted to the lab in response?

  Yes

  No

On-Farm Issues

• Water

• Describe Issue:

• Temperature Extremes

• Describe The Issue:

• Air Quality

• Describe The Issue:

• Feed

• Describe The Issue:

• Lights

• Describe The Issue:

• Catch Mortality

• Suffocation

• Culling

• Other

• Other

• Describe The Issue:

Infectious Disease

• Respiratory

• Select One Of The Following:

• Airsac

• Vaccine Reaction

• ILT

• Polyserositis

• Other

• Describe The Issue:

Guts

• Select One Of The Following:

• Necrotic Enteritis

• Cocci

• RSS

• Other

• Describe The Issue:

Lameness

• Select One Of The Following:

• Bacteria (FHN) (Synovitis)

• Reovirus (Ruptured Tendons)

• Kinky Back

• Kick Stand

• Other

• Describe The Issue:

Other

• Dermatitis

• Mixed

• Uneven

• Spike

• Feed Knockdown

• Unknown

• Describe:

• Comments (If Applicable)

• Age of birds (in days) at time of submission:

• Mortality Today (x /1000)

• Mortality Yesterday (x /1000)

• Mortality 2 Days Ago (x /1000)

Swab Clarification

• Are birds greater than 21 days of age?

  Yes

  No

• Is the mortality (deads, NOT culls) greater than 3/1000 for 2 consecutive days or 5/1000 for 1 day?

  Yes

  No

• Will or have birds or AI swabs been submitted to the lab in response?

  Yes

  No

On-Farm Issues

• Water

• Describe Issue:

• Temperature Extremes

• Describe The Issue:

• Air Quality

• Describe The Issue:

• Feed

• Describe The Issue:

• Lights

• Describe The Issue:

• Catch Mortality

• Suffocation

• Culling

• Other

• Other

• Describe The Issue:

Infectious Disease

• Respiratory

• Select One Of The Following:

• Airsac

• Vaccine Reaction

• ILT

• Polyserositis

• Other

• Describe The Issue:

Guts

• Select One Of The Following:

• Necrotic Enteritis

• Cocci

• RSS

• Other

• Describe The Issue:

Lameness

• Select One Of The Following:

• Bacteria (FHN) (Synovitis)

• Reovirus (Ruptured Tendons)

• Kinky Back

• Kick Stand

• Other

• Describe The Issue:

Other

• Dermatitis

• Mixed

• Uneven

• Spike

• Feed Knockdown

• Unknown

• Describe:

• Comments (If Applicable)

Correction

• Describe The Correction:

On Farm Necropsy

• Yes

  No

Submitted to Laboratory?

• Yes

  No

AI Swabs Submitted

• Yes

  No

Was a Feed Sample Submitted

• Yes

  No

Script Request

• Script Request Submitted?

  Yes

  No

• Tack A Picture Of Your Script Request Form

  Media

• Has a written and/or verbal instruction on administering medication occurred?

  Yes

  No

• Date communicated

  Date

• Was This house Treated last flock?

  Yes

  No

• Is This The Second Flock In This House Being Treated?

  Yes

  No

• Is This The Third Flock In This House Being Treated?

  Yes

  No

• Is This The Fourth Flock In This House Being Treated?

  Yes

  No

• Is This The Fifth Flock In This House Being Treated?

  Yes

  No

• Is This More Than The Fifth Flock Being Treated In This House?

  Yes

  No

Flock Supervisor Sign-off and Date

• Please sign when complete

  Sign

Antibiotic Treatment (Details in Prescription)

• Penicillin

• Tetracycline

• Lincomycin

• Tylosin

• BMD

• SULFA

• Other

• Describe Treatment:

Non-Antibiotic Treatment (Run According to Label Directions Unless Instructed Otherwise By Vet)

• Amprol

• Copper Sulfate

• Manage / Maintain

• Ioprin / Asperdine

• Activo

• CID Clean

• Water Acidifier (PWT, SB Plus, Amacil)

• Other

• Describe The Treatment

Management

• Cull Affected Birds

• Describe Alternative Management:

• Further Actions:

Reviewing Veterinarian Signature

• For VET use ONLY.

• Select VET

  Select

• Delayed Review by Veterinarian

  Yes

  No

• iAuditor Platform or Mobile Issue

• Other

• Vet Review Date:

  Sign

• For Vet Use ONLY.

• Script Completed (NOTE: Farm Name, House #, Date are the Title)

• Notes:

• Add media

  Media