Veterinary Epidemiology and Zoonosis

                MODEL PROFORMA FOR COLLECTION OF EPIDEMIOLOGICAL DATA

1. Basic data

Sl.No: ..........................                                   Meteorological data: ..............................................

Date: ..........................                                    Month: ...................... Season: ................................

                                                                                Rain fall: ..................................................................

                                                                                Day temperature: ....................................................

                                                                                Weather: ..................................................................

2. Vital statistics

Owner’s Name: .........................................................                          Species wise population

Address (Village/farm): ..........................................                                  Adult              Young

Veterinary hospital/Dispensary: ............................                 Buffalo  ................       ...............

Total no. of animals in the village / farm                                     Cattle    .................       ..............

                                                                                                                        Sheep    ................        ...............

Sp. affected ..............................................................                 Goat      .................       ...............

No. affected .................  No. dead ............................                 Other    .................       ...............

Age ............................................................................

Vaccine             Vaccination status                  Time of vaccination                     Brand/Batch No.

FMD                    ...............................                   .........................................          ............................ 

HS                        ..............................                    .........................................          ............................ 

BQ                        ..............................                    .........................................          ............................ 

Anthrax             ..............................                    .........................................          ............................ 

Any others        ..............................                    .........................................          ............................  

3. History of the 1^st case observed

Date ..........................................................................................................................................

If died, when ............................................................................................................................

Signs and symptoms observed ................................................................................................

..................................................................................................................................................

Location of 1^st case .................................                        Near canal:           Y/N

                                                                                                          Near pond:            Y/N

                                                                                                          Near forest:           Y/N

                                                                                                          Any other: ...........................................

4. Subsequent cases observed

Date: .....................................                                                No ........................................................

If deaths, Date ......................                                                No .......................................................

Any change in symptoms in subsequent cases .......................................................................

..................................................................................................................................................

Post – mortem findings ...........................................................................................................

..................................................................................................................................................

Treatment given, if any ...........................................................................................................

Response ..................................................................................................................................

5. Possible sources of infection

New entrance in animal population in the village/farm:

a) New purchase:  Y/N, if yes,                                     b) source ....................................................

i.Migratory animals ...............................                i) due to animal fare ..................................

                                                                                                 ii) animal herds of nomads …...................

                                                                                                 iii) due to natural calamity ......................

                                                                                                 iv) Any other ..............................................

ii.Migratory birds, if any ...................................

6. Source of water               

Stagnant water ........................................................................................................................                                                                                 

Sources of contamination ......................................................................................................

Biological matter ....................................................................................................................

7. Vectors ................................................................................................................................

8. Other factors

Any change in management ................................................................................................... 

Husbandry: 1) A.I./Natural ii) Source of bull/Semen  .........................................................

Fodder source ........................................................................................................................

Feed source ............................................................................................................................

Find factor(s) which is (are) common to most of the affected animals but absent

in most of the healthy animals ..............................................................................................

Factor (s) common between affected and healthy animals ................................................

9. Environmental factors

History of chemical insecticide spraying nearby..................................................................

Use of fertilizers ....................................................................................................................

10. Collection of sample for laboratory investigations

Sample collected ........................................                 Date of collection................................

No .........................                   Purpose (HP/Culture & Isolation/Serology) ..........................

Affected animals ...................................................................................................................

Normal animals (control) ....................................................................................................

Results ..................................................................................................................................

12. Economic impact

Production loss in affected animals (Rs.) ...........................................................................

Medication (Rs.) ...................................................................................................................