The New York Times found that dairy workers are most vulnerable to Bird Flu

State and local levels of surveillance for the zoonotic influenza outbreak: a dairy worker in Texas who was diagnosed with mild and Transient

A dairy worker in Texas is the only one who has tested positive so far for a mild case of infections. In the past, the population of agricultural workers has been under protected for zoonotic diseases. When it comes to H5N1, the dairy work force — which includes on-farm workers and milkers, people working in the milk processing plants and in slaughterhouses, truck drivers and other professionals who come onto farms — is among those with the highest exposure.

It is critical to track any possible cases, according to epidemiologists. The dairy worker in Texas who caught the disease was mild and Transient so they are worried that those infections could be going undetected.

Also, notes Gray, the virus is probably much more geographically widespread in cattle than the reported cases show, “possibly spilling over much more to humans than we knew, or then we know.”

Federal health officials monitor influenza activity in emergency departments and hospitals. Hundreds of clinical laboratories that run tests are tasked with reporting findings. And in early April, a CDC health alert was sent to clinicians advising them to be on the lookout for anyone with flu-like symptoms or conjunctivitis who’d worked with livestock.

The associate professor of veterinary preventive medicine at The Ohio State University says that there is some decent human exposure occurring based on how many documented cases there are in cows. We don’t know.

There have been 36 herds affected in nine states. About 25 people have been tested for the virus and more than 100 people have been monitored for the symptoms, according to federal health officials.

These people are in “the footprints of where the bovine detections are,” says Dr. Demetre Daskalakis, who’s with the Centers for Disease Control and Prevention, although he didn’t provide details on the actual locations.

It’s not surprising that there wasn’t testing early on in the outbreak. In places like Texas and Kansas, veterinarians weren’t thinking about bird flu when illnesses first cropped up in early March and it took time to identify the virus as the culprit.

Jessica Leibler, an environmental epidemiologist at Boston University School of Public Health, thinks the total number of tests done on humans is low.

Leibler, who has studied the risks of novel zoonotic influenza and animal agriculture, suggests testing as many workers as possible in order to be sure there was no spillover from these facilities to human populations.

The federal government has been quick to assess the safety of the dairy supply. On Wednesday, the Food and Drug Administration released findings, showing that infectious virus wasn’t present in about 200 samples collected from dairy products around the country. Initial results on ground meat are also reassuring.

Only complicating matters — the true scale of the outbreak in cattle remains murky, although new federal testing requirements for moving cattle between states may help fill out the picture.

“I worry a bit that if we wait until we see a spike in those systems that perhaps we would already be seeing much more widespread community transmission,” says Dr. Mary-Margaret Fill, deputy state epidemiologist for the Tennessee Department of Health. Instead she says there should be proactive testing.

Dr. Young says doctors in the Texas Panhandle have been careful about any cases of flu but so far have not seen anything out of the ordinary.

“We just haven’t seen people who fit that description in order to suddenly be testing a lot more,” says Young,regional chair of the Department of Family and Community Medicine at the Texas Tech Health Sciences Center School of Medicine in Amarillo.

Gray says it can be hard to detect and measure the illness in these rural workers for many reasons — their remote location, a reluctance to seek out health care, a lack of health insurance, concerns about immigration status, and a reticence among farmers “to wave the flag” that there are infections.

Gingrich says dairy cattle farmers don’t get compensated for reporting infections in their herds, unlike poultry farmers who get indemnity payments for losses related to the slaughter of birds.

Gray has managed to start collecting samples from humans and cattle at several dairy farms that recently dealt with the virus. He made the study in response to the H5N1 outbreak because they were concerned about the spillover on farms.

They’ll look for evidence of exposure to bird flu because of his background and promise that the farms won’t be revealed in the published work.

“We know the chickens will die, but the pigs might not be very sick, so we can’t say for certain whether or not it will affect the workers,” he says.