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Montana Veterinary Diagnostic Laboratory
Salmonella Enteritidis (SE) Sample Submission
1911 West Lincoln Street Bozeman, MT 59718-4132
Web Portal: https://mvdl.mt.gov
Email: mvdl@mt.gov Website: http://liv.mt.gov/Diagnostic-Lab
Phone 406-994-4885 Fax 406-994-6344
Lab Use Only: Clear Form
Owner/Submitter: ___ Billing Address: ___
Address: ___
Owner/Submitter [1]
Billing Address
Billing Address
Owner/Submitter [2]
Owner/Submitter [3]
<table><tr><td>Copy of Report To:</td><td>Colony</td><td>Wilcox</td><td>Other:</td><td></td></tr><tr><td></td><td>Fax</td><td>Email</td><td>Other:</td><td></td></tr><tr><td></td><td>Fax/Email/#:</td><td></td><td></td><td></td></tr></table>
Other
Colony
Wilcox
Other:
Other
Fax
Email
Other:
Fax/Email
Phone: ___ Email: ___
Phone
Email
Fax: ___ Other: ___
Other
Fax
Ranch/Collection Site: ___
Ranch/Collection Site
Sample Profile: Chick Papers
Pullets Weeks: ___
Pre-Production Weeks: ___
Mid-Production (Layers) Weeks: ___
Push Outs Weeks: ___
Other: ___
Pullets
Weeks
Pre-Production
Weeks
Mid-Production (Layers)
Weeks
Push Outs
Weeks
Other:
Other:
Other
Collection Date/Time: ___
Collection Date/Time
Sampled By (please print/type): ___
Sampled By (please print/type
Sampled By (signature affixed): ___
Sampled By (signature affixed
Number/Type Specimens: ___
Number/Type Specimens
Flock ID: _____ House/Barn ID: _____
Copy of Report To: Colony Wilcox Other: _____
Fax Email Other: _____
Fax/Email/#: _____
Flock ID
House/Barn ID
Test Procedure Requested (choose one): PCR Culture
PCR
Culture
Sample ID Number: Lab Use Only:
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For information on how to collect environmental samples (swabs) from a poultry house, refer to the FDA Website: https://www.fda.gov/food/laboratory-methods-food/environmental-sampling-and-detection-salmonella-poultry-houses
COLLECTION
Disinfect the top of a can of evaporated milk and open with a disinfected can opener
Moisten the drag swab with evaporated milk and collect the sample
Place each drag swab in a separate 18 ounce Whirl-Pak™ bag containing sufficient evaporated milk (about 1 tablespoon) to keep the swab moist in transit
An 18 ounce bag enables us to add test materials to your sample
PLEASE DO NOT use small sandwich bags, snack bags, or an excess of evaporated milk
Press the air out of the Whirl-Pak™ bag and seal by twirling the bag three times while holding the wire end tabs, or folding the end over tightly three times
Bend the wire tabs over the bag edges to hold the seal
Make sure the outside of the Whirl-Pak™ bag is clean, dry and clearly labeled to correspond to the SE Submission Form
Please use a separate SE Submission Form for each barn sampled
Place all sealed Whirl-Pak™ bags from a barn in a gallon Ziploc® bag
Specify PCR or Culture test on SE Submission Form
Complete the SE Submission Form and place it in a separate, clean Ziplock® bag to prevent contamination of the paperwork if a leak should occur
Keep the samples cool (40°F – 45°F) during collection if sample collection requires more than 6 hours
Label Whirl-Pak™ bag
- Remove Perforation/ Add milk/ Add swab - Twirl to close - Press tabs to seal
SHIPPING
Place samples in a shipping container with frozen gel packs to keep samples cool (40°F – 45°F)
Ideally, samples should be shipped the same day as collected and received by MVDL within 48 hours
Ship to: MVDL, 1911 West Lincoln, Bozeman, MT 59718 via priority overnight delivery (FedEx or UPS)
Note: discounted flat rate shipping is available through our web portal; please log in at https://mvdl.mt.gov or contact us for more information
Notify MVDL by calling 406-994-4885 with shipment date and number of samples in shipment
For best turn-around-time, ship on Monday and Tuesday
If chick paper collection occurs on a Friday, refrigerate samples and ship on Monday
Do not ship samples on Friday or Saturday
RECEIPT AND TESTING OF SAMPLES
Upon arrival, MVDL will assess and record transit time and temperature to verify that samples are acceptable for testing
MVDL will notify the submitter prior to testing if sample quality or sample identification is questionable
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