# Swine Barn Biosecurity: Protocols and Implementation


## Key Takeaways

- **Personnel hygiene is paramount:** Shower-in/shower-out protocols, coupled with changing into farm-specific clothing and footwear, are critical to prevent pathogen introduction via personnel, directly addressing transmission routes on skin and clothing.
- **Effective cleaning and disinfection requires a multi-step process:** This involves thorough removal of organic matter (manure, feed) before applying approved disinfectants at correct concentrations and for specified contact times to eliminate pathogens from surfaces and equipment.
- **External contamination pathways demand rigorous control:** Visitor and vehicle management, including logging entries, enforcing downtime (12-48 hours minimum), and disinfecting vehicles (especially feed trucks via wheel wash stations and auger disinfection), are essential to mitigate indirect transmission risks.
- **Within-herd disease spread is managed through movement and isolation strategies:** Quarantine of new arrivals (minimum 30 days), age segregation, and all-in/all-out movement by room or barn are vital to break pathogen transmission cycles between susceptible age groups.
- **Feed, water, and pest management are integral to biosecurity:** Secure feed storage, regular water quality testing (e.g., for coliforms), and integrated pest management programs are necessary to reduce contamination risks from these critical inputs and mechanical vectors.
- **Consistent protocol adherence and validation are crucial for success:** Inconsistent application of protocols, inadequate cleaning before disinfection, and improper disinfectant use are common failure points; regular audits and validation methods like ATP testing are necessary to ensure efficacy.

---

[Biosecurity in swine production](/knowledge/veterinary-medicine/veterinary-public-health/biosecurity-swine-production-preventing-zoonotic-disease-introduction-spread) is the set of management practices designed to prevent the introduction and spread of disease-causing pathogens within and between pig herds. For swine producers and farm managers, implementing effective biosecurity protocols directly affects herd health, productivity, and economic sustainability. This article covers the core principles of swine barn biosecurity, practical entry and exit protocols, cleaning and disinfection procedures, visitor and vehicle management strategies, and disease prevention measures that can be applied across different farm sizes and production systems.

## At a Glance: Core Biosecurity Principles for Swine Barns

The following table summarizes the primary biosecurity domains, their key practices, and the main objectives for each area.

| Biosecurity Domain | Key Practices | Primary Objective |
| --- | --- | --- |
| Barn Entry and Exit | Shower-in/shower-out, change of farm-specific clothing and footwear, boot baths | Prevent pathogen introduction via personnel |
| Cleaning and Disinfection | Remove organic matter, apply approved disinfectants, allow adequate contact time | Eliminate pathogens from surfaces and equipment |
| Visitor and Vehicle Management | Log all entries, enforce downtime, restrict access to essential personnel only | Control external disease introduction routes |
| Animal Movement and Isolation | Quarantine new arrivals, separate age groups, manage sick pigs | Prevent within-herd disease spread |
| Feed and Water Biosecurity | Secure feed storage, test water sources, control pests | Reduce contamination risk from inputs |
| Mortality and Manure Management | Proper carcass disposal, manure handling protocols, composting | Minimize environmental pathogen load |

## Understanding Disease Transmission Pathways in Swine Operations

Pathogens enter and spread through swine barns via several established routes. Direct contact between infected and susceptible pigs is the most efficient transmission mechanism. Indirect transmission occurs through contaminated fomites including boots, clothing, equipment, vehicles, and feed delivery systems. A qualitative study to identify potential biosecurity risks associated with feed delivery documented that feed trucks and delivery personnel represent a significant external contamination pathway that requires specific protocols.

Airborne transmission is another concern, particularly for respiratory pathogens. Research on modeling airborne virus concentrations in filtered swine barns with negative-pressure ventilating systems has demonstrated that ventilation design and filtration can influence pathogen movement within and between barns. Producers should evaluate their ventilation systems as part of an overall biosecurity plan.

Rodents, birds, flies, and other pests serve as mechanical vectors for numerous swine pathogens. Pest control programs must be integrated into the biosecurity plan. Water sources can also harbor pathogens if not properly managed.

## Barn Entry and Exit Protocols

### Personnel Hygiene and Shower Procedures

The most critical biosecurity intervention at the barn entry point is the shower-in/shower-out protocol. Personnel should remove all street clothing and footwear in a designated dirty area, shower thoroughly using soap and water, and then dress in farm-provided clean clothing and boots in a clean area. This sequence prevents pathogens carried on skin, hair, or clothing from entering the animal housing area.

Farm managers must provide adequate shower facilities with hot water, soap, and clean towels. The shower area should have a clear physical separation between dirty and clean sides. A bench or barrier at the midline helps maintain this separation. All personal items including jewelry, watches, and mobile phones should either be left outside or sanitized before entry.

### Boot and Footwear Management

Boots are a high-risk fomite because they contact manure, urine, and soil. Dedicated farm boots that never leave the premises are the preferred approach. When boots must be shared or when visitors enter, boot baths containing an appropriate disinfectant solution should be placed at all entry points. Boot baths must be maintained with fresh disinfectant at the correct concentration and replaced according to the product label or when visibly soiled.

Footwear protocols should include scrubbing boots to remove organic matter before immersion in disinfectant. Organic material inactivates many disinfectants, so cleaning must precede disinfection. Boots should remain in contact with the disinfectant for the label-specified contact time, typically one to five minutes.

### Clothing and Equipment

Farm-specific coveralls or uniforms should be worn by all personnel inside the barn. These garments should not be worn outside the farm premises. Laundering should occur on-site or through a commercial service that understands biosecurity requirements. Disposable coveralls are an acceptable alternative for visitors or temporary workers.

Equipment including thermometers, syringes, needles, and surgical instruments must be cleaned and disinfected between uses and between different animal groups. Needles should be changed between litters or pens to prevent blood-borne pathogen transmission.

## Cleaning and Disinfection Procedures

### Step-by-Step Cleaning and Disinfection Protocol

Effective cleaning and disinfection follows a specific sequence. Each step must be completed properly before moving to the next.

1. **Remove all animals** from the area to be cleaned. Depopulate the barn or room completely.
2. **Remove all movable equipment** including feeders, waterers, and panels. Clean and disinfect these items separately.
3. **Remove organic matter** by dry scraping manure, feed, and bedding from all surfaces. Dispose of waste properly.
4. **Pre-soak surfaces** with water to loosen remaining organic material. Use a low-pressure spray to avoid aerosolizing pathogens.
5. **Apply detergent** using a foam applicator or high-pressure sprayer. Allow the detergent to sit for the label-recommended contact time.
6. **Rinse thoroughly** with clean water to remove all detergent and loosened organic matter.
7. **Apply disinfectant** at the correct concentration and coverage rate. Ensure all surfaces are wetted completely.
8. **Allow adequate contact time** as specified on the disinfectant label. This is typically 10 to 30 minutes.
9. **Rinse if required** by the disinfectant label. Some products require rinsing before animals return.
10. **Allow surfaces to dry completely** before reintroducing animals. Drying further reduces pathogen survival.

### Disinfectant Selection and Application

No single disinfectant is effective against all pathogens. Selection should be based on the target pathogens of concern, surface type, water hardness, temperature, and organic matter load. Common disinfectant classes used in swine barns include quaternary ammonium compounds, peroxygen compounds, chlorine-based products, and phenolic compounds.

Producers should rotate disinfectant classes periodically to prevent the development of resistance. Always follow label instructions for dilution rates, application methods, and safety precautions. Some disinfectants are corrosive to metal surfaces or harmful to pigs if not rinsed properly.

### Validation of Cleaning and Disinfection

Visual inspection alone is insufficient to confirm that cleaning and disinfection have been effective. Producers can use adenosine triphosphate (ATP) bioluminescence tests to measure organic residue on surfaces after cleaning. [Bacterial culture](/blog/guides/bacterial-culture) swabs or contact plates can assess microbial load after disinfection. These monitoring tools help identify areas where protocols need improvement.

Records of cleaning and disinfection activities should include the date, area cleaned, products used, concentrations, contact times, and any test results. This documentation supports traceability and continuous improvement.

## Visitor and Vehicle Management

### Visitor Access Protocols

All visitors should be restricted to essential personnel only. Non-essential visitors including sales representatives, consultants, and service technicians should be limited and scheduled during periods of low disease risk. Visitors must complete a health declaration form and sign a logbook before entry.

A minimum downtime period of 12 to 48 hours since last contact with other swine should be enforced for all visitors. Longer downtime periods of 48 to 72 hours may be appropriate during disease outbreaks or for visitors coming from high-risk areas. Visitors should follow the same shower-in/shower-out protocols as farm staff.

### Vehicle Entry and Disinfection

Vehicles including feed trucks, livestock transporters, and service vehicles can introduce pathogens through contaminated tires, undercarriages, and cab interiors. A designated vehicle entry point with a wheel wash station should be established. The wheel wash should contain an approved disinfectant and be maintained at the correct concentration.

Drivers should remain in their vehicles whenever possible. If drivers must exit, they should use disposable boot covers or farm-provided footwear. Feed delivery protocols should include disinfection of the auger and boot area before entering the farm. The qualitative study on feed delivery biosecurity risks emphasized that communication between the farm manager and the feed company is essential to ensure protocols are followed consistently.

### Delivery and Service Scheduling

Schedule deliveries and service visits to minimize the number of vehicles entering the farm per day. Group deliveries when possible. Service technicians should carry their own clean tools and equipment that have been disinfected before arrival. Tools should not be shared between farms without thorough cleaning and disinfection.

## Animal Movement and Isolation

### Quarantine Protocols for New Arrivals

All incoming pigs should be quarantined in a separate facility or area for a minimum of 30 days. The quarantine area should be physically separated from the main herd and have its own entry protocols, equipment, and ventilation. Personnel should attend to quarantine animals last in the daily work routine to prevent pathogen transfer.

During quarantine, observe animals daily for signs of disease. Collect diagnostic samples as needed to test for pathogens of concern including [porcine reproductive and respiratory syndrome](/knowledge/viruses/general/porcine-reproductive-and-respiratory-syndrome-genomic-surveillance-and-vaccine-strategies-using-bioinformatics) virus (PRRSV), [swine influenza](/knowledge/veterinary-medicine/clinical-methods/swine-swine-influenza-diagnosis-management) virus, and [Mycoplasma hyopneumoniae](/knowledge/bacteria/livestock-bacteria/mycoplasma-hyopneumoniae-enzootic-pneumonia-pigs). Only animals that remain healthy and test negative should be introduced to the main herd.

### Within-Herd Movement Protocols

Pigs should be moved in an all-in/all-out manner by room or barn whenever possible. This practice breaks the cycle of pathogen transmission between age groups. Continuous flow systems where pigs of different ages are housed together increase disease risk.

When moving pigs between pens or rooms, use dedicated equipment for each group. Disinfect handling equipment between groups. Avoid moving sick pigs through common alleyways or handling facilities. Establish a hospital pen or isolation area for sick animals that is physically separated from healthy pigs.

### Age Segregation

Separating pigs by age group reduces the transmission of pathogens that are more prevalent in certain age classes. Weaned pigs should be housed separately from grow-finish pigs. Sows and gilts should be housed in dedicated breeding and gestation areas. Nursery pigs should have their own facilities with appropriate environmental controls.

Research on husbandry practices and gut health outcomes in weaned piglets has highlighted that management practices including hygiene, stocking density, and feed management during the weaning period significantly affect piglet health and disease susceptibility. Biosecurity protocols should be especially rigorous in nursery facilities.

## Feed and Water Biosecurity

### Feed Storage and Handling

Feed should be stored in clean, dry, rodent-proof bins or silos. Spilled feed should be cleaned up promptly to avoid attracting pests. Feed delivery systems including augers, conveyors, and feeders should be inspected regularly and cleaned as needed.

Feed ingredients can introduce pathogens if contaminated. Source feed from reputable suppliers who follow biosecurity protocols. Consider heat treatment or chemical treatment of feed ingredients to reduce pathogen load. Feed samples should be collected and stored for potential diagnostic testing if disease occurs.

### Water Quality and Treatment

Water is a potential vehicle for pathogen introduction. Test water sources regularly for bacterial contamination including coliforms and E. coli. Water lines and drinkers should be cleaned and disinfected periodically to remove biofilm. Chlorination or other water treatment methods can reduce pathogen load.

Water medication systems must be cleaned between uses to prevent residue buildup and microbial growth. Flush lines with clean water after each medication cycle.

### Pest Control

Rodents, birds, and insects can carry pathogens into the barn and spread them within the facility. Implement an integrated pest management program that includes exclusion, sanitation, trapping, and targeted pesticide use. Seal all openings in barn walls, doors, and vents. Maintain vegetation around barns to reduce rodent harborage.

Bird netting should be installed over openings to prevent bird entry. Fly control programs should include larvicides, adulticides, and environmental management to reduce breeding sites. Regular monitoring of pest populations helps evaluate program effectiveness.

## Mortality and Manure Management

### Carcass Disposal

Dead animals must be removed promptly from the barn to reduce disease transmission risk. Carcasses should be stored in a dedicated, covered, leak-proof container until disposal. Disposal methods include rendering, incineration, composting, or burial depending on local regulations and farm capabilities.

Composting is a common on-farm method that can inactivate many pathogens if done correctly. The compost pile must reach and maintain adequate temperatures for sufficient time. Carcasses should be covered with carbon-rich material such as sawdust or straw. Monitor compost temperature and turn the pile as needed.

### Manure Handling

Manure contains high concentrations of pathogens and must be managed to minimize environmental contamination. Manure storage facilities should be located away from barns and water sources. Spreading manure on fields should follow best management practices to reduce runoff and aerosolization.

When pumping or agitating manure, take precautions to protect workers from harmful gases including hydrogen sulfide and ammonia. Respiratory issues in beef and pork production have been documented, and manure handling is a recognized hazard. Use appropriate personal protective equipment and ensure adequate ventilation.

## Monitoring and Record Keeping

### Essential Records for Biosecurity

Maintaining accurate records is essential for evaluating biosecurity effectiveness and for traceability in the event of a disease outbreak. The following records should be kept:

- Visitor log with name, date, time in/out, last pig contact, and health declaration
- Vehicle entry log with license plate, company, and disinfection details
- Animal movement records including source, destination, and health status
- Quarantine records with observation notes and test results
- Cleaning and disinfection logs with product, concentration, and contact time
- Mortality records with cause of death and disposal method
- Pest monitoring records with trap counts and treatment dates
- Feed and water test results
- Vaccination and treatment records

### Biosecurity Audits and Scoring

Regular biosecurity audits help identify gaps and measure improvement over time. The assessment of biosecurity practices and development of a scoring system in swine farms using item response theory provides a framework for evaluating biosecurity implementation. Producers can adapt this approach to create a farm-specific scoring system that covers all relevant biosecurity domains.

Audits should be conducted at least annually by a trained individual who is not directly involved in daily farm operations. Results should be reviewed with the farm team and used to update protocols. External audits by a veterinarian or biosecurity consultant can provide an objective assessment.

## Common Failure Patterns in Swine Barn Biosecurity

### Inconsistent Protocol Adherence

The most common biosecurity failure is inconsistent adherence to established protocols. Research on barriers and breakthroughs in U.S. swine biosecurity has explored the role of human behavior in biosecurity compliance. Factors including time pressure, fatigue, lack of training, and complacency contribute to protocol violations.

Farm managers should address these factors through regular training, clear signage, and a culture that prioritizes biosecurity. Positive reinforcement and accountability systems can improve compliance. Protocols should be practical and efficient to reduce the burden on staff.

### Inadequate Cleaning Before Disinfection

Organic matter inactivates many disinfectants. Failure to remove manure, feed, and bedding before applying disinfectant is a common error that renders disinfection ineffective. Staff must be trained to clean thoroughly before disinfecting. Use of detergent and proper rinsing are essential steps.

### Improper Disinfectant Use

Using disinfectants at incorrect concentrations, insufficient contact times, or inappropriate temperatures reduces efficacy. Water hardness and pH can also affect disinfectant performance. Always follow label instructions and use test strips to verify concentration when available.

### Neglecting High-Risk Areas

Certain areas of the barn are often overlooked during cleaning and disinfection. These include ventilation inlets and outlets, light fixtures, electrical boxes, and ceiling surfaces. Pathogens can accumulate in these areas and re-infect the barn after cleaning. Develop a checklist that includes all surfaces and equipment.

### Failure to Update Protocols

Biosecurity protocols must evolve based on new disease threats, research findings, and farm experience. Biosecurity measures to control hepatitis E virus on European pig farms and biosecurity practices useful for porcine reproductive and respiratory syndrome control and eradication demonstrate that specific pathogens may require targeted interventions. Regularly review and update protocols with input from your veterinarian.

## Worker Safety and Welfare Considerations

### Personal Protective Equipment

Biosecurity protocols often require the use of personal protective equipment (PPE) including coveralls, boots, gloves, and respirators. PPE also protects workers from exposure to zoonotic pathogens, dust, gases, and chemicals. Provide appropriate PPE and train workers on proper use, maintenance, and disposal.

Respiratory protection is particularly important in swine barns where ammonia, hydrogen sulfide, and organic dust can reach harmful levels. The expert panel recommendations on respiratory issues in beef and pork production emphasize the need for respiratory protection programs that include hazard assessment, respirator selection, fit testing, and training.

### Chemical Safety

Disinfectants, detergents, and pesticides used in biosecurity programs can be hazardous to human health. Store all chemicals in labeled, secure containers away from feed and animal areas. Provide safety data sheets for all products and train workers on safe handling, spill response, and first aid.

### Animal Welfare During Biosecurity Procedures

Biosecurity procedures should be implemented in a way that minimizes stress to animals. Avoid prolonged fasting before cleaning and disinfection. Ensure that animals have access to clean water and feed after returning to cleaned areas. Handle animals calmly and quietly during movement for quarantine or isolation.

## Professional Escalation Criteria

### When to Consult a Veterinarian

Farm managers should consult a veterinarian in the following situations:

- Unexplained increase in mortality or morbidity
- Clinical signs consistent with a reportable or emerging disease
- Positive diagnostic test results for a pathogen of concern
- Failure of biosecurity protocols to prevent disease introduction
- Need for diagnostic testing or disease surveillance planning
- Development of a herd health or biosecurity plan

### When to Contact Regulatory Authorities

Certain swine diseases are reportable to state or federal animal health authorities. Producers should contact their state veterinarian or USDA APHIS if they suspect a foreign animal disease or a disease on the reportable list. The USDA APHIS swine disease information page provides guidance on reportable diseases and reporting procedures.

### When to Engage a Biosecurity Consultant

Consider engaging a biosecurity consultant in the following situations:

- Designing a new facility or renovating an existing barn
- After a disease outbreak to identify root causes and improve protocols
- When expanding herd size or changing production systems
- When preparing for a disease eradication program
- When internal audits reveal persistent biosecurity gaps

## Frequently Asked Questions

### What is the most important biosecurity practice for a swine barn?
The most important biosecurity practice is the shower-in/shower-out protocol for all personnel entering the barn. This single intervention dramatically reduces the risk of pathogen introduction on skin, hair, and clothing. Combined with farm-specific clothing and footwear, shower protocols form the foundation of an effective biosecurity program.

### How long should visitors stay away from pigs before entering my farm?
A minimum downtime of 12 to 48 hours since last contact with other swine is recommended for visitors. During disease outbreaks or for visitors from high-risk areas, a downtime of 48 to 72 hours may be appropriate. The specific downtime should be based on the disease status of your herd and the visitor's recent pig contact history.

### What disinfectant should I use in my swine barn?
There is no single best disinfectant for all situations. Selection depends on the target pathogens, surface type, water quality, and organic matter load. Common options include quaternary ammonium compounds, peroxygen compounds, and chlorine-based products. Rotate disinfectant classes periodically and always follow label instructions for dilution and contact time.

### How often should I clean and disinfect my swine barn?
The frequency of cleaning and disinfection depends on the production system. In all-in/all-out systems, clean and disinfect between each group. In continuous flow systems, clean and disinfect individual rooms or pens between groups. High-traffic areas such as entryways and alleyways should be cleaned and disinfected more frequently, at least weekly.

### Can I use the same equipment for different pig groups?
Dedicated equipment for each pig group is preferred. If equipment must be shared, clean and disinfect it thoroughly between groups. Pay special attention to equipment that contacts pigs directly including feeders, waterers, and handling tools. Needles and syringes should be changed between litters or pens.

### How do I know if my cleaning and disinfection is effective?
Visual inspection is the first step but is not sufficient. Use ATP bioluminescence tests to measure organic residue after cleaning. Use [bacterial culture](/blog/guides/bacterial-culture) swabs or contact plates to assess microbial load after disinfection. Regular testing helps identify areas where protocols need improvement and provides documentation of effectiveness.

### What should I do if a disease outbreak occurs despite my biosecurity protocols?
Immediately contact your veterinarian to confirm the diagnosis and determine the pathogen involved. Review your biosecurity protocols to identify potential breakdowns. Increase the rigor of all protocols including shower procedures, visitor restrictions, and cleaning and disinfection. Implement movement restrictions within the farm. Follow your veterinarian's recommendations for treatment, isolation, and disease control.

### How do I train my staff on biosecurity protocols?
Provide initial training for all new employees and annual refresher training for existing staff. Use a combination of written materials, demonstrations, and hands-on practice. Post clear signage at all entry points and in key areas. Conduct regular audits and provide feedback. Address non-compliance promptly and constructively. Involve staff in protocol development to increase buy-in and practical feasibility.

## Related Farming Guides

- [Swine Barn Cleaning Disinfection And Downtime](/knowledge/animal-farming/swine/swine-barn-cleaning-disinfection-and-downtime)
- [Cold Weather Management For Swine Barns](/knowledge/animal-farming/swine/cold-weather-management-for-swine-barns)
- [Manure Management For Pig Farms](/knowledge/animal-farming/swine/manure-management-for-pig-farms)
- [Pig Barn Ventilation And Thermal Comfort](/knowledge/animal-farming/swine/pig-barn-ventilation-and-thermal-comfort)
- [Pig Lameness Monitoring And Flooring Management](/knowledge/animal-farming/swine/pig-lameness-monitoring-and-flooring-management)

## Related Clinical & Scientific Guides

* [Pig Enrichment Programs and Behavior Monitoring](/knowledge/animal-farming/swine/pig-enrichment-programs-and-behavior-monitoring)
* [Swine Handling Facility Design for Safe Pig Movement](/knowledge/animal-farming/swine/swine-handling-facility-design-safe-pig-movement)
* [Swine Feeding Management for Grow-Finish Pigs](/knowledge/animal-farming/swine/swine-feeding-management-for-grow-finish-pigs)


## References and Further Reading

- [www.ars.usda.gov](https://www.ars.usda.gov/animal-production-and-protection)
- [www.aphis.usda.gov](https://www.aphis.usda.gov/livestock-poultry-disease/swine)
- [www.merckvetmanual.com](https://www.merckvetmanual.com/management-and-nutrition)
- [Barriers and Breakthroughs in U.S. Swine Biosecurity: A Key Informant Exploration of the Role of Human Behavior in Enhanced Biosecurity Compliance.](https://pubmed.ncbi.nlm.nih.gov/42007471). Transboundary and emerging diseases, 2026.
- [Assessment of biosecurity practices and development of a scoring system in swine farms using item response theory.](https://pubmed.ncbi.nlm.nih.gov/31027714). Preventive [veterinary medicine](/blog/careers/veterinary-medicine-careers-from-clinical-practice-to-public-health), 2019.
- [Husbandry practices and gut health outcomes in weaned piglets: A review.](https://pubmed.ncbi.nlm.nih.gov/29767154). Animal nutrition (Zhongguo xu mu shou yi xue hui), 2017.
- [Biosecurity measures to control hepatitis E virus on European pig farms.](https://pubmed.ncbi.nlm.nih.gov/38983773). Frontiers in [veterinary science](/blog/news/veterinary-science), 2024.
- [Biosecurity practices useful for porcine reproductive and respiratory syndrome control and eradication on commercial swine farms using machine learning models.](https://pubmed.ncbi.nlm.nih.gov/41389574). Preventive veterinary medicine, 2026.
- [Respiratory issues in beef and pork production: recommendations from an expert panel.](https://pubmed.ncbi.nlm.nih.gov/20665307). Journal of agromedicine, 2010.
- [A GENERAL PURPOSE LABORATORY for SMALL-SCALE IN-BARN SWINE DISCOVERIES](https://doi.org/10.13031/aea.14411). Applied Engineering in Agriculture, 2021.
- [Modeling airborne virus concentrations in filtered swine barns with negative-pressure ventilating systems](https://doi.org/10.13031/trans.12561). Transactions of the Asabe, 2018.
- [A qualitative study to identify potential biosecurity risks associated with feed delivery](https://api.elsevier.com/content/abstract/scopus_id/84964780485). Journal of Swine Health and Production, 2014.

> This article is educational and is not a substitute for veterinary diagnosis, treatment, public-health guidance, or regulatory reporting.