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NPIP is different; that's an eradication program that just comes and tests for thyphoid/pullorum. it's required (I believe it still is?) for any selling, showing, etc.
Testing in the context in which I used it was specifically for a disease causing organism. In other words, if you fear MG or you have a respiratory illness and you don't know what it is (and I can guarantee that with few exceptions we don't really know exactly what the disease is if it's respiratory) then you get the vet to do a culture of the exudate (gunk) from the bird. The culture is literally growing bacteria on a plate, then they grow the one that grows out on a plate that has antibiotic dots on it to see which antibiotic works.
They can also test to see if it's a virus (using antigen tests). that way you don't waste your time on antibiotics which don't work on viruses.
So really the only real way of telling what respiratory illness a bird has, if any, is testing. Otherwise we're just making educated guesses.
..... Forgot something.
Don't be afraid of the NPIP program. These diseases are way less common now because the NPIP program is an eradication program, a program of testing and culling that has helped to **almost** eliminate these diseases from being a problem. The very fact that there is a testing program is why we can breathe easier about those two disease. One thing I would advise: Ask your tester to park OFF of your property. Do not let their car (which has been on properties with other poultry) onto your property. Always make sure they wear a fresh lab coat, shoe covers, and gloves. If they don't, politely refuse to have them come onto your property that day. better yet, when you talk to them on the phone to schedule appointment, make sure they know to bring those things for when they come to your place. This is for the purpose of biosecurity. You not only want to enforce biosecurity strongly at your place, you want to make sure they know it!
It also helps, before they come, to have an antiseptic shoe bath at the front of your premises and signage that asks people to please not enter your property without checking with you first.
We had a big scare with poultry and illnesses a few years ago. Your tester will remember who does and who doesn't makes sure EVERYone, including them, adheres to strict rules of biosecurity! This will always benefit you and your flock.
So - I was terrified the first time they came. I had no problems at all. They'll test existing birds once, new birds yearly, turkeys yearly. Waterfowl never.
One year, I actually refused to let a tester onto my place because he wouldn't do it when I was there. I explained that I refused to not be there because I am very strict about biosecurity. He insisted, and so I took off of work. He ended up being a real jerk about it, didn't show up because he supposedly fell in someone's pond and had to change. He said he'd be there AFTER I was gone again back to work. I told him I would not allow him on my property, then called his boss. He ended up losing his job. The BOSSES take biosecurity very seriously. if you get a "bad egg" that doesn't. you make darn good and sure that you change that bad habit of his. You can say 'no' to them - NPIP testing is voluntary unless you sell or show.