The Centers for Disease Control and Prevention (CDC) today announced a third human illness from H5 avian influenza in a dairy farm worker, but unlike the earlier cases, the patient is experiencing respiratory symptoms.
In astatement, the CDC said the latest sick dairy farm worker was exposed on a different farm than Michigan's earlier case. Michigan has been hit hardest by the dairy farm outbreaks and hasreported 22 outbreaks across 10 of the state's counties.
The Michigan Department of Health and Human Services (MDHHS) said the patient had worked closely with H5-infected dairy cows.
The patient reported symptoms, including cough without fever and eye discomfort with watery discharge, to local health officials. Michigan health officials are using a text-based monitoring system for people exposed to H5N1-infected cows.
The 2.3.4.4b H5N1 clade circulating globally is known to cause a range of illnesses, from no symptoms to severe or fatal outcomes.
Natasha Bagdasarian, MD, MPH, chief medical executive at the MDHHS,said health officials have been tracking the situation closely since the virus emerged in poultry and dairy cows. "Farmworkers who have been exposed to impacted animals have been asked to report even mild symptoms, and testing for the virus has been made available."
Oseltamivir was given, and the patient is isolating and recovering at home. Contacts are free of symptoms so far, and no other infections have been reported in the farm's other workers.
The patient's samples were positive for H5 on a CDC test conducted at Michigan's state health department lab, and tests by the CDC yesterday confirmed the findings. Genetic sequencing of the virus that infected that patient is under way at the CDC.
"The identification of an additional case of H5 is not surprising and shows the importance of a proactive public health response," the CDC said, adding that the risk to the general public remains low.
Bagdasarian said Michigan's first patient experienced eye symptoms after a direct splash to the eye from infected milk, and the second patient had direct exposure to a sick cow.
"Neither individual was wearing full personal protective equipment (PPE)," she said. "This tells us that direct exposure to infected livestock poses a risk to humans, and that PPE is an important tool in preventing spread among individuals who work on dairy and poultry farms."
The CDC had earlier issued interim PPE recommendations for dairy farm worker protection, and federal officials have encouraged states to provide PPE to farm workers. In new guidance, the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) yesterdayissued PPE recommendations for people visiting H5N1-infected herds.
Earlier cases in the United States include a Texas dairy farm worker who had conjunctivitis in early April and an individual from Colorado who had little to no symptoms after participating in poultry-culling operations and whose illness was reported in early April.
(CBS DETROIT) A second case of H5 influenza, also known as bird flu or avian influenza, was detected in another Michigan farmworker, marking the second human case in Michigan and the third in the country overall.
The Michigan Department of Health and Human Services says the new case was reported in a farmworker who worked closely with cows that tested positive for bird flu. That worker was employed at a different farm than the worker in the case announced on May 22.
Officials say the risk to the general public is still low, and the farmworker who tested positive was given antivirals and is currently recovering from respiratory symptoms, including a cough and eye discomfort with a watery discharge. The worker did not have a fever, according to the Centers for Disease Control and Prevention.
Household contacts with the infected farmworker haven't developed any symptoms, and no other workers at the same farm have reported bird flu symptoms.
"Michigan has led a swift public health response, and we have been tracking this situation closely since influenza A (H5N1) was detected in poultry and dairy herds in Michigan," chief medical executive Dr. Natasha Bagdasarian said. "Farmworkers who have been exposed to impacted animals have been asked to report even mild symptoms, and testing for the virus has been made available. With the first case in Michigan, eye symptoms occurred after a direct splash of infected milk to the eye. With this case, respiratory symptoms occurred after direct exposure to an infected cow."
Health officials say in both Michigan cases, neither farmworker was wearing full protective gear.
"Proper use of personal protective equipment is the best tool we have to protect farm workers," Michigan Department of Agriculture and Rural Development Director Tim Boring said. "MDARD is currently offering assistance to dairy farms in need of additional protective equipment. MDARD has and will continue to take bold actions to assist farms impacted by this disease."
The first case of bird flu in a humanwas detected in a Texas farmworker who was exposed to infected dairy cattle.
Bird flu was first detected in Michigan in dairy herds that arrived in Michigan from Texas, and have since been found in Clinton, Gratiot and Ionia counties.
Earlier this month, Michigan egg producer Herbuck's Poultry Ranch announced that it was laying off about 400 employees. The company said the virus impacted its hen population at some farms in Ionia County.
Michigan's Department of Agriculture and Rural Development issued guidelines for producers to help reduce the spread of avian influenza.
Michigan dairy farms and poultry operations must implement the following, under the order that went into effect on May 8:
Sara Powers is a digital producer for CBS Detroit. A Detroit native, Sara has been covering local topics such as breaking news, politics and entertainment for CBS Detroit since 2021.
AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
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How does bird flu spread to humans? Is raw milk safe to drink? What are the symptoms of bird flu in humans? Are STI rates increasing? Why are STIs on the rise?
Our guest is AMA Vice President of Science, Medicine and Public Health Andrea Garcia, JD, MPH, AMA Chief Experience Officer Todd Unger hosts.
Unger: Hello and welcome to the AMA Update video and podcast. Today, we have our weekly look at the headlines with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. Andrea, welcome back.
Garcia: Thanks, Todd. Appreciate the opportunity to be here.
Unger: Well, we're going to start off with a topic we've covered in the past several weeks, and that's bird flu. This past week, we learned about another human case of bird flu. Andrea, tell us more about it and what it could mean?
Garcia: Yeah, it was last Wednesday when the CDC reported that a second person, Michigan dairy worker, had tested positive for H5N1 bird flu. The individual works on a dairy farm where each 5N1 virus has been identified in cows. Although, federal officials have said the case does not change their assessment, that the risk to the public does remain low.
This has prompted an increased urgency for testing and treatments. Given this, we've seen the government introduce additional financial incentives for dairy producers to expand testing of their cattle and accelerate that timetable to ready nearly five million doses of vaccine in the case that the virus does become more widespread among people.
Unger: Well, first off, Andrea, was the worker seriously ill?
Garcia: Thankfully, no. That Michigan worker, like the one in Texas, experienced mild eye symptoms and has since recovered, according to state officials. A nasal swab of the worker had tested negative for influenza in Michigan, but an eye swab was then shipped to the CDC in Atlanta, where it tested positive for avian flu.
The CDC said that this case doesn't come as a surprise since they have ramped up surveillance. The agency spokesperson also praised Michigan for its efforts and swift response. Michigan has enrolled 170 farm workers into its active monitoring program, where they're receiving daily texts from the health department, asking these individuals if they're having symptoms.
This particular worker indicated that they were having symptoms, and the Michigan health officials responded really quickly with testing and reporting. And as of May 22, more than 350 people with exposure to dairy cows or infected unpasteurized cows milk are being monitored.
Unger: So what can we take away from all of this?
Garcia: Well, one thing CDC officials have found reassuring is that the nasal swab tested negative because it reduces, not eliminates, but reduces that likelihood of a respiratory route of transmission. Respiratory spread would make this virus much more contagious. CDC officials have also said that the case really underscores the importance of personal protective equipment being used by workers at dairy farms and slaughter facilities.
Federal and state officials have made PPE supplies available to dairy farms, but have not required its use.
Unger: Now, Andrea, earlier you mentioned five million doses for production. Is it time for those who are at high risk to get vaccinated?
Garcia: Well, the federal government said it's not planning for vaccination of workers and others who come into close contact with dairy cattle at this time. Factors that could prompt a vaccination campaign include transmission from animal to human, evidence of human-to-human transmission, or a case of H5N1 without any link to a dairy farm. As we talked about last week, CDC is also planning to continue flu monitoring through the summer.
That's something that we wouldn't ordinarily see them do. And physicians are being encouraged to consider bird flu when evaluating patients who have conjunctivitis or respiratory illness following an exposure to agriculture or livestock.
Unger: Now, Andrea, given the situation that we're seeing on the farms and with workers, is our commercial milk supply still considered safe?
Garcia: Yes, so most commercial milk in the United States is pasteurized. Pasteurization kills germs by heating milk to high temperatures. While FDA has found traces of the virus in 20% of dairy products sampled from grocery shelves nationwide, officials have not found signs of live infectious virus in those samples and have therefore said that pasteurized milk is safe to consume.
The New York Times recently noted, though, that this study could have global implications. If this outbreak becomes more widespread, not all countries do have central pasteurization.
Unger: And that's important, as we're going to find out from the next set of questions, because we're going to talk about the dangers of drinking raw milk, especially right now. A new study confirms that those fears are founded. Andrea, tell us more about that?
Garcia: Yeah, this was big news heading into the holiday weekend. There was a study published on Friday in the New England Journal of Medicine, and it found that mice rapidly became sick after being fed unpasteurized milk contaminated with H5N1. A New York Times article reported on that study that this is not altogether surprising.
At least half a dozen cats have died after consuming raw milk containing the virus. But the new data adds to the evidence that raw milk containing the virus may be unsafe for other mammals, including humans. And as we talked about last week, the FDA has said that consuming raw milk is unsafe. It's been unsafe for a long time now, well before this outbreak.
Unger: Absolutely. And yet, there's a lot of misinformation out there circulating about raw milk. Can you take us through some of the misconceptions and what physicians need to be telling their patients?
Garcia: Well, one misconception is that refrigeration kills the virus in raw milk. That study published on Friday showed otherwise. The virus actually declines slowly in cool temperatures. So the virus may remain infectious for several weeks in raw milk with refrigeration. Some have also said that raw milk just tastes better, it's more nutritious and it boosts immunity.
But actually, pasteurization does not have a significant impact on the nutritional value of milk. In most pasteurized cow milk is also fortified with vitamin D, which helps absorb calcium. According to the CDC, consuming raw milk can lead to serious complications or even death from a variety of pathogens, especially in people with weakened immune system.
If we look at the data from 1998 to 2018, outbreaks traced to raw milk consumption led to 228 hospitalizations, three deaths and illnesses in more than 2,600 people.
Unger: I think the message is pretty clear, avoid raw milk. Andrea, we'll continue to track this outbreak. But for now, let's turn to another global health issue. Last Tuesday, the World Health Organization published a report about a major concern for health officials.
Andrea, tell us more about the concern and what we need to know?
Garcia: Yeah, this particular WHO report was referring to STIs or sexually transmitted infections and found that for curable STIschlamydia, gonorrhea, syphilis and trichomoniasisare responsible for more than a million infections daily among people aged 15 to 49. Cases of syphilis in particular have been rising rapidly. According to the report, the number of new syphilis cases among people between the ages of 15 and 49 increased from 7.1 million in 2020 to 8 million in 2022.
Now, that's a pretty sharp increase in a relatively short period of time. Even more concerning is that there have been increases in the rate of congenital syphilis which occurs when people pass syphilis to their babies during pregnancy. Between 2020 and 2022, the rate per 100,000 live births per year rose from 425 to 523. That WHO report also noted that cases of antibiotic resistant gonorrhea are increasing, which was labeled as another concern.
As of 2023, there were nine countries that reported elevated levels from 5% to 40% of resistance to ceftriaxone, which is considered the last line treatment for gonorrhea.
Unger: Wow, so that is an issue on a global scale. Andrea, are we seeing the same kind of trends here in the U.S.?
Garcia: The most alarming concerns here in the U.S. center around the syphilis and congenital syphilis epidemics. CDC data show that the total number of syphilis cases increased more than 17% to 207, 255 cases between 2021 and 2022. And those numbers show that it's reaching the greatest number since we've seen since 1950. Congenital syphilis cases have more than tripled in recent years, with more than 3,700 cases reported in 2022 alone.
Unger: That's a pretty shocking set of numbers. Do we have any idea what's driving this?
Garcia: Well, lack of screening and lack of access to care are two likely culprits. Disruption caused by the COVID pandemic didn't help and likely delayed screening for many. I think in good news, the WHO noted that there have been gains in expanding services for STIs, HIV and hepatitis, and several countries have even eliminated mother to child transmission of HIV and syphilis.
To drive those rates down, that WHO report does outline some recommendations, including efforts to accelerate decriminalization and destigmatize those affected by STIs and other infections, as well as strengthening primary prevention, diagnosis and treatment to raise awareness. The AMA has also developed resources to help physicians improve routine screening for these infectious diseases. That includes a tool kit that covers routine screening for STIs. And we'll link to that resource in the description of this episode.
Unger: Excellent. That's all good to know and something physicians can certainly play a huge role in. Andrea, thanks so much for being here today. That's it for today's episode. If you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/join.
We'll be back soon with another AMA Update. In the meantime, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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The US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) today announced that tests have confirmed highly pathogenic H5N1 avian influenza in alpacas at an Idaho farm where the virus had struck a poultry flock.
The detection marks the first positive findings in alpacas, which are members of the camelid family.
Detection of the virus in the alpacas isn't unexpected due to the high amount of virus in the environment and the comingling of multiple livestock species on the farm, APHIS said.
The detection of the virus in farm animals on an affected poultry farm is similar to the H5N1 detection in baby goats at a Minnesota farm that experienced a poultry outbreak.
Genetic sequencing at the USDA's National Veterinary Services Laboratory (NVSL) reveals that the virus that infected the alpacas is the same B3.13 H5N1 genome circulating in dairy cows and is also the same genotype that infected poultry at the Idaho farm.
APHIS said the poultry on the Idaho farm were depopulated this month.
According to a notification from the World Organization for Animal Health, the alpacas and poultry were from a backyard farm in Jerome County. The virus was detected in 4 of the farm's 18 alpacas. The report said the alpacas had close contact with the infected birds.
In other developments, US officials also reported H5N1 in two feral cats found dead in Curry County, New Mexico, according to a WOAH notification. A local veterinarian submitted the cats for testing because there were H5N1-affected dairy farms in Curry County.
However, the cats' location wasn't directly related to a dairy or poultry farm with a known H5N1 outbreak.
Detections of H5N1 in cats at dairy farms experiencing outbreaks have recently been reported in multiple states.
The Michigan Department of Agriculture and Rural Development (MDARD) today said tests have confirmed H5N1 in another herd in Clinton County. Tests were conducted at the Michigan State University Veterinary Diagnostic Laboratory, and samples will be sent to the USDA's NVSL for additional confirmation.
The positive test marks the third outbreak in Clinton County and Michigan's 22nd such outbreak in dairy cattle.
Nationally, H5N1 has been detected in 67 dairy herds across nine states. In an update today, the USDA added 3 more detectionsone each from Idaho, Texas, and Michigan.
The Michigan Department of Agriculture and Rural Development (MDARD) today said highly pathogenic avian flu has been detected again in dairy cows, this time hitting another herd in Ottawa County.
The latest report pushes the state's total to 23 farms across 10 counties. The MDARD said samples from the cows were positive in testing at the Michigan State University Veterinary Diagnostic Laboratory and that samples will be sent to the US Department of Agriculture (USDA) National Veterinary Services Lab for additional confirmation.
The USDA yesterday added 2 more H5N1 outbreaks to its total yesterdayadditional confirmations from Idaho and Michiganraising the national total to 69 in nine states.
In related developments, the USDA yesterday announced an additional $824 million in emergency funding from the Commodity Credit Corporation to bolster efforts to better understand and contain the virus.
The new funding targets multiple activities, ranging from the development of diagnostics to field response activities to research on vaccines against highly pathogenic avian flu for cattle, turkeys, pigs, and goats.
Also, the agency announced the launch of a new voluntary H5N1 dairy herd status pilot program to give dairy farmers more ways to monitor the health of their herds, as well to ship cows faster while providing ongoing testing and information for the USDA.
The USDA said the main benefit for farmers who enroll in the program is that, once they show their herds are free of H5N1, they can conduct weekly tests on bulk milk to confirm the status. Also, animals in herds with negative bulk milk tests for 3 weeks in a row can be moved without additional pre-movement testing.
Over the past 2 weeks, five sites (2%) from three states were at a high level for influenza A detections in wastewater, the Centers for Disease Control and Prevention (CDC) said in its latest update. A total of 288 of 741 sites met reporting criteria.
Three sites in Oregon were at the high level: Jackson, Lane, and Lincoln counties. Other sites at the high level were in Illinois (Adams County) and Kansas (Saline County).
The CDC launched influenza A wastewater tracking in the middle of May as part of its surveillance for H5N1 avian flu. It emphasized that influenza A monitoring of wastewater doesn't determine the subtype or source, but might serve as a warning on where H5N1 might be circulating.
In an update on its H5N1 surveillance page, the CDC said systems show no indicators of unusual activity.
A third dairy worker in the U.S. has tested positive for the bird flu infection that is causing outbreaks in cattle in at least nine states.
The farmworker, from Michigan, was exposed to infected cows and is the first of the three recently confirmed cases to have respiratory symptoms, according to the Michigan Department of Health and Human Services. The previous two peopleanother in Michigan and one in Texasdid not show any respiratory symptoms but experienced discharge from the eyes. The dairy worker in the latest case worked on a different farm in Michigan than the previous case reported in the state.
According to the U.S. Centers for Disease Control and Prevention (CDC), the dairy worker in the latest case also experienced watery discharge from the eyes, but also reported coughing (with no fever). Tests on samples from the patient performed by Michigan's health department were positive for influenza A(H5), the avian influenza strain. Further tests conducted by CDC scientists confirmed the results.
It's not clear whether the respiratory symptoms indicate that the virus is changing; CDC scientists are conducting additional sequencing studies to determine if that's the case.
The CDC says there are no spikes in influenza cases among people in areas where the virus has been reported in cows, nor are there any unusual increases in emergency room visits or positive lab tests for influenza. So far, there have also been no reports that the virus was spread from one person to another in the infected workers households. In all three cases, the infected workers, as well as their families, were monitored and offered antiviral medications. The state of Michigan is continuing to work with farms to monitor for sick animals and symptoms in farmworkers and has tested 45 people so far, says Dr. Natasha Bagdasarian, chief medical executive at the Michigan Department of Health and Human Services.
For now, the CDC says the outbreak in cows does not pose a significant health threat to people who dont routinely work with the animals. Those who do, however, should wear protective equipment and practice caution when handling sick or dead animals, including birds and cows, as well as monitor and report any flu-like symptoms to their local health department.
In the first Michigan case, the farmworker was directed exposed to contaminated milk that splashed in his eye, and he was not wearing any protective equipment. In the latest case, the worker was not wearing a mask and worked directly with a sick animal, says Bagdasarian. "Two points to take home are that so far, people who are at risk are those who have direct, sustained exposure to sick animals, and second, that neither was wearing full personal protective equipment," she says. "So right now the risk to the general public is very low. There are no secondary cases of infections from these individuals, no sustained human-to-human transmission, and no cases outside of dairy workers."
Still, there are things that everyone else can do to protect themselves. Avoid raw milk, which has not been pasteurized, the CDC advises. The temperatures required for pasteurization generally inactivate the virus, so pasteurized milk remains safe to drink, according to the agency.
United States health authorities say the risk to human health from a strain of avian influenza spreading through dairy cattle remains low, even after a third case of human infection was recorded in Michigan.
The two previous cases, involving dairy workers in Michigan and Texas, reported mild conjunctivitis symptoms that authorities believe were the result of direct contact with milk or other fluids of infected dairy cattle.
But the third case, another Michigan dairy worker, has developed respiratory symptoms, according to the Centres for Disease Control (CDC).
"As with the previous two cases, the person is a dairy farm worker with exposure to infected cows, making this another instance of probable cow-to-person spread," the CDC said in a statement.
"This is the first human case of H5 in the United States to report more typical symptoms of acute respiratory illness associated with influenza virus infection, including A(H5N1) viruses."
This is just the fourth case of human infection by this strain of the H5N1 virus or HPAI (Highly Pathogenic Avian Influenza) in US history.
Its low transmissibility combined with the mild symptoms it produces means the CDC still considers the overall risk to human health to be low.
"This case does not change CDC's current A(H5N1) bird flu human health risk assessment for the US general public because all three sporadic cases had direct contact with infected cows," the CDC said.
"Risk depends on exposure, and in this case, the relevant exposure is to infected animals," it said.
"The risk to members of the general public who do not have exposure to infected animals remains low."
So far, the avian influenza has been detected in 68 dairy herds in nine US states.
North Carolina State University department of poultry science professor Matt Koci told the ABC that it's important for the virus's spread to be contained before it has a chance to mutate, and potentially become more infectious.
"In cows, at least, this strain is not fatal it seems like they're all recovering after a period of days to maybe a couple of weeks," Professor Koci said.
"We want to get this under control and mopped up as quickly as possible so we don't give the virus more time to potentially mutate and change.
"So far, there have been no indications that the virus is mutating or is changing in any way that would make this a greater risk to humans."
Professor Koci said while the poultry industry, which has been dealing with an avian influenza outbreak since 2022, hasdadapted to work under stricter biosecurity controls, the dairy industry was still catching up.
"This is something that dairy workers haven't had to deal with before, like poultry workers have," he said.
While raw milk samples taken from infected cattle have revealed high levels of the virus, recent testing by the Food and Drug Administration (FDA) found no live viruses in retail products.
Health authorities and experts say there's no risk to human health from dairy foods that have been pasteurised.
"The pasteurisation process is at a temperature and at a time that far exceeds anything that the virus could survive," Professor Koci said.
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Genomic analysis of the virus in cattle indicates the highly infectious strain was circulating well before the first cases were detected in Texas on March 23.
Scientists at the United States Department of Agriculture and National Veterinary Services Laboratory have traced the spillover from birds to dairy cattle to early December 2023.
The analysis, published on biological sciences server bioRxiv, also indicated all of the cases in US dairy cattle stem from a single transmission event.
Symptoms in sick cattle include reduced milk production, loss of appetite, fever, lethargy and thickened colostrum-like milk.
Avian influenza has been spreading across the globe for several years according to Massey University professor of infectious disease, epidemiology and pubic health, Nigel French.
"The H5N1 types have been spreading for some time, but this new variant, the 2.3.4.4b strain, which is the one that's circulating around the world and causing such a huge problem in wild birds, appears to have originated in in Eurasia and spread to every other continent except Oceania," he said.
The virus has also been been detected in sea lions in South America, walrus in the Arctic and mink in Europe.
The migratory waterfowl that have helped spread the virus across the globe do not transit through Australia, but the virus continues to spread to migratory birds that do pass through Australia.
This week, a different strain of avian influenza, called H7N3, was detected on two separate poultry farms in Victoria, with hundreds of thousands of birds culled to limit the spread of the virus.
In 2020, a similar strain led to an outbreak of avian influenza on free-range poultry farms in Lethbridge, Victoria, and the culling of over 400,000 birds.
By Tony Leys and Amy Maxmen Updated May 30, 2024 Originally Published May 29, 2024
Farmworkers face some of the most intense exposures to the bird flu virus, but advocates say many of them would lack resources to fall back on if they became ill.
As of May 30, only three people in the United States had tested positive after being exposed to a wave of bird flu spreading among cows. Those people, dairy farm workers in Texas and Michigan, experienced eye irritation. One of them also had a cough and sore throat.
Scientists warn the virus could mutate to spread from person to person like the seasonal flu, which could spark a pandemic. By keeping tabs on farmworkers, researchers could track infections, learn how dangerous they are, and be alerted if the virus becomes more infectious.
But people generally get tested when they seek treatment for illnesses. Farmworkers rarely do that, because many lack health insurance and paid sick leave, said Elizabeth Strater, director of strategic campaigns for the national group United Farm Workers. They are unlikely to go to a doctor unless they become very ill.
Strater said about 150,000 people work in U.S. dairies. She said many worker advocates believe the virus has spread to more people than tests are showing. The method being used to surveil at-risk workers has been very passive, she said.
Federal officials told reporters May 22 that just 40 people connected to U.S. dairy farms had been tested for the virus, although others are being actively monitored for symptoms.
Federal authorities recently announced they would pay farmworkers $75 each to be tested for the virus, as part of a new program that also offers incentives for farm owners to allow testing of their dairy herds.
Officials of the federal Centers for Disease Control and Prevention said they recognize the importance of gaining cooperation and trust from front-line dairy employees.
CDC spokesperson Rosa Norman said in an email that the incentive payment compensates workers for their time contributing to the monitoring of how many people are infected, how sick they become, and whether humans are spreading the virus to each other.
She noted the CDC believes the virus currently poses a low risk to public health.
But Strater is skeptical of the incentive for farmworkers to be checked for the virus. If a worker tests positive, theyd likely be instructed to go to a clinic then stay home from work. She said they couldnt afford to do either.
That starts to sound like a really bad deal for 75 bucks, because at the end of the week, theyre supposed to feed their families, she said.
Katherine Wells, director of public health in Lubbock, Texas, said that in her state, health officials would provide short-term medical care, such as giving farmworkers the flu treatment Tamiflu. Those arrangements wouldnt necessarily cover hospitalization if it were needed, she said.
She said the workers bigger concern appears to be that they would have to stay home from work or might even lose their jobs if they tested positive.
Many farmworkers are from other countries, and they often labor in grueling conditions for little pay.
They may fear attention to cases among them will inflame anti-immigrant fervor, said Monica Schoch-Spana, a medical anthropologist at the Johns Hopkins Center for Health Security.
Societies have a long history of blaming marginalized communities for the spread of contagious diseases. Latino immigrants were verbally attacked during the H1N1 swine flu pandemic in 2009, for example, and some media personalities used the outbreak to push for a crackdown on immigration.
Bethany Boggess Alcauter, director of research and public health programs at the National Center for Farmworker Health, said many workers on dairy farms have been told very little about this new disease spreading in the cows they handle. Education needs to be a part of testing efforts, with time for workers to ask questions, she said.
These conversations should be conducted in the farmworkers language, with people they are likely to trust, she said.
Georges Benjamin, executive director of the American Public Health Association, said public health officials must make clear that workers immigration status will not be reported as part of the investigation into the new flu virus. Were not going to be the police, he said.
Dawn OConnell, an administrator at the Department of Health and Human Services, said in a press conference May 22 that nearly 5 million doses of a vaccine against H5N1, the bird flu virus circulating in cattle, are being prepared, but that officials have not decided whether the shots will be offered to farmworkers when theyre ready later this year.
The CDC asked states in early May to share personal protective equipment with farm owners, to help them shield workers from the bird flu virus. State health departments in California, Texas, and Wisconsin, which have large dairy industries, all said they have offered to distribute such equipment.
Chris Van Deusen, a Texas health department spokesperson, said four dairy farms had requested protective equipment from the state stockpile. He said other farms may already have had what they needed. Spokespeople for the California and Wisconsin health departments said they did not immediately receive requests from farm owners for the extra equipment.
Strater, the United Farm Workers official, said protective equipment offerings need to be practical.
Most dairy workers already wear waterproof aprons, boots, and gloves, she said. It wouldnt be realistic to expect them to also wear N95 face masks in the wet, hot conditions of a milking operation, she said. Plastic face shields seem like a better option for that environment, especially to prevent milk from spraying into workers eyes, where it could cause infection, she said.
Other types of agricultural workers, including those who work with chickens, also face potential infection. But scientists say the version of the virus spreading in cows could be particularly dangerous, because it has adapted to live in mammals.
Strater said shes most worried about dairy workers, who spend 10 to 12 hours a day in enclosed spaces with cows.
Their faces are approximately 5 inches away from the milk and the udders all day long, she said. The intimacy of it, where their face is so very close to the infectious material, is different.
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A farmworker was infected with bird flu from a dairy cow, the third human case in the recent outbreak. Rich Pedroncelli/AP hide caption
Updated 3:10 p.m. ET
Michigans health department announced Thursday a human case of bird flu in a dairy worker. Its the third human case reported to date in the current U.S. avian flu outbreak among dairy cows.
Unlike the previous two cases which only involved eye infection, this patient has respiratory symptoms, according to a statement from Dr. Natasha Bagdasarian, chief medical executive with the Michigan health department. The patient had direct exposure to an infected cow and wasnt wearing any personal protective equipment.
This tells us that direct exposure to infected livestock poses a risk to humans, said Bagdasarian.
The Centers for Disease Control and Prevention said in a statement that its labs tested a sample from the Michigan patient and confirmed it was H5N1 bird flu. The patient had flu-like symptoms, including a cough and eye discomfort. The patient was treated with antivirals and is isolating at home. No other workers or household contacts of the patient have gotten sick so far.
The CDC said that risk to the general public remains low. Like the other two recent cases, this infection came from direct exposure to an infected animal. There is no indication of person-to-person spread of A(H5N1) viruses at this time, according to the CDC.
The CDC is monitoring data from influenza surveillance systems, and said there has been no sign of unusual influenza activity in people.
Nonetheless, scientists following the outbreak say this human case is troubling development.
Our concerns about this outbreak are coming true, says Dr. Rick Bright, a virologist and the former head of the Biomedical Advanced Research and Development Authority (BARDA). The longer the U.S. allows this outbreak to continue, without appropriate measures to stop it, without conducting testing in cows and people, more people will be at increased risk for exposure and infection.
Bright says its a problem that there's not better sharing of bird flu data in the U.S., and theres not more testing and precautions to prevent spread. He warns this will lead to more humans infected by animals. And that could eventually lead the virus to adapt itself to spread among humans. This virus will find a way to transfer more efficiently among humans. This is what happens with a virus like this, he told NPR.
Both the CDC and Michigan health officials emphasized the importance of protecting farm workers from possible exposure.
Michigan Department of Agriculture and Rural Development director Tim Boring said his department is offering support to dairy farms in need of protective gear. "Proper use of personal protective equipment is the best tool we have to protect farm workers."
Will Stone contributed to this report.
The cases have been linked to an outbreak among dairy cows.
May 30, 2024, 2:03 PM ET
4 min read
A second human case of bird flu has been confirmed in Michigan, bringing the total number of cases in the U.S. this year to three, health officials said.
The most recent case in Michigan is in a farmworker who was exposed to cows infected with bird flu, also known as avian flu, according to the Michigan Department of Health and Human Services (MDHHS).
The patient works on a different dairy farm than the first confirmed Michigan case, which was reported on May 22.
Health officials said the patient was given antiviral medications and is recovering from respiratory symptoms.
The Michigan cases come after the first case was confirmed in Texas in April.
However, the risk to the general public remains low, according to the Centers for Disease Control and Prevention (CDC). There is currently no evidence of human-to-human transmission,
MDHHS said farmworkers exposed to infected animals were asked to report symptoms, even if they're mild.
"With the first case in Michigan, eye symptoms occurred after a direct splash of infected milk to the eye," Dr. Natasha Bagdasarian, chief medical executive, said in a statement. "With this case, respiratory symptoms occurred after direct exposure to an infected cow. Neither individual was wearing full personal protective equipment (PPE). This tells us that direct exposure to infected livestock poses a risk to humans, and that PPE is an important tool in preventing spread among individuals who work on dairy and poultry farms."
MDHHS said it recommends seasonal flu vaccination for people working on poultry or dairy farms. The vaccine will not prevent bird flu infection, but can reduce the risk of coinfection with avian and flu viruses.
In early March, the U.S. Department of Agriculture (USDA) announced a bird flu strain that had sickened millions of birds across the U.S. was identified in several mammals this year.
At the time, three states had reported cases of bird flu in mammals in 2024, including striped skunks found in Washington state, a mountain lion in Montana and a raccoon in Kentucky.
A few weeks later, federal and state public health officials said they were investigating an illness among primarily older dairy cows in Kansas, New Mexico and Texas and causing symptoms including decreased lactation and low appetite.
The USDA said in a statement at the time that "there is no concern about the safety of the commercial milk supply or that this circumstance poses a risk to consumer health."
Several dairy cows have been infected, resulting in milk samples showing inactive remnants of the virus, but health officials say the food supply is safe.
Last week, the CDC said in a summary on Friday that it is preparing for the "possibility of increased risk to human health" from bird flu as a part of the federal government's preparedness efforts.
