Image source, Getty Images
- author, Madeline Halpert
- role, BBC News, New York
Freddy Morales has spent the past 12 years working on some of America’s thousands of dairy farms, spending much of his time in close proximity to America’s dairy cows.
Despite his job putting him in close contact with animals and requiring him to regularly inject medicine into their throats, Morales said that until very recently he had never heard of the avian flu virus spreading among U.S. cows and making some dairy workers sick.
“We don’t have the immunity we had before,” the 37-year-old told the BBC through a Spanish translator. “It really worries me to hear this.”
The disease has gained a new foothold in the United States, infecting dairy cows and at least eight humans in recent months.
Four dairy workers have tested positive for the H5N1 avian flu virus in an outbreak that has affected dairy farms in 13 states since April. The Centers for Disease Control and Prevention (CDC) confirmed last week that six chicken workers in Colorado have tested positive, and the CDC was testing a possible seventh person on Tuesday.
U.S. officials say the strain of the virus infecting poultry workers is closely related to one that has infected livestock and dairy workers, raising concerns about the rising number of infections.
So far, symptoms among farm workers have been fairly mild, and there have been no documented cases of person-to-person transmission.
But scientists, advocates and farm workers worry that the virus has been detected in 161 livestock herds and millions of chickens and turkeys despite incomplete testing, and that the recent cases may indicate a higher than realized infection among the nation’s 2.6 million farmworkers.
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The US currently has a piecemeal surveillance effort that varies by state, and experts say the virus may go unnoticed in some areas where testing is limited, giving it more opportunity to mutate into a more severe illness.
They stressed the need for more preventative measures, testing and information sharing to prevent avian influenza from spreading undetected.
Anthony Maresso, a professor at Baylor College of Medicine who has tracked bird flu in wastewater in Texas, reiterated the CDC’s warning that the chances of the virus spreading among the general public are “still quite low.”
But he warned that health officials needed to remain vigilant as this strain of bird flu could be “just the tip of the iceberg”.
“What we don’t want is for the virus to evolve so that it easily infects humans and then transmits among us in a way that causes a global influenza pandemic,” he said.
But Rick Nearabout, CEO of the Idaho Dairy Farmers Association, said farmers and workers, many of whom are in the country illegally, are hesitant to allow government testing because they worry the agency might not keep the data confidential.
“The trust is not there to provide information,” Naerebout said, “which has led to a major slowdown in our ability to test and get data.”
Bird flu infects cattle
The U.S. Department of Agriculture (USDA) reported that since avian influenza began spreading among U.S. poultry flocks in January 2022, approximately 100 million chickens and turkeys have been infected and either died or been culled to prevent further spread.
But U.S. dairy farmers were taken by surprise when the virus first began infecting cows, with the first cases recorded in Texas in March. Since then, the virus has spread to dairy farms in every state across the U.S. Unlike birds, cows infected with the virus usually seem to suffer from milder symptoms, such as fatigue and reduced milk production.
So far, the four dairy workers and six poultry workers have only experienced mild symptoms, with some reporting conjunctivitis and pink eye, and some respiratory symptoms more typical of influenza infection.
But Maresso and his team at Baylor University continue to detect the virus in sewage from 10 Texas cities, suggesting that the number of bird flu cases may be higher than known.
“The fact that this virus is fairly widespread in many different animals, both wild and domestic, and that it’s now interacting at a much closer level with humans, is a bit of a concern,” Maresso said.
The Texas Dairy Farmers Association, which advocates for the state’s dairy industry, claims avian flu is “largely no longer a problem in Texas”, and the Texas Department of State Health Services told the BBC that outbreaks among cows have improved significantly since March.
But the USDA also reported an outbreak in a Texas herd on July 8, and the state health department previously told Stat News that dairy industry groups were hindering efforts to better document infection rates by blocking experts from visiting farms.
Agriculture officials reported that the most recent cases of infection in livestock were in Colorado and Minnesota, where the virus was detected on July 19.
Inspectors’ “complex” problem
Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases, said that unlike early in the pandemic, the availability of tests is not an obstacle to monitoring the spread of avian flu.
Mr Daskalakis told the BBC that the government had the capacity to carry out 150,000 tests and planned to carry out a further million in the “near future”.
The main challenge now is getting farms to agree to testing their livestock and workers.
Labor groups and employees like Morales say farmworkers receive little information about testing, are not encouraged to take sick days and are not provided with personal protective equipment that public health experts say would help prevent avian flu.
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“I think that if they are told to use it and the reasons for it are explained to them, they will use it,” Morales said of the protective gear.
Another problem is that many U.S. farmworkers are undocumented and don’t have paid sick leave, meaning they can’t get tested or stay home when they’re sick, said Elizabeth Strater, strategic campaigns director for the National Farm Workers Coalition, a farmworker rights group.
The CDC offers farmworkers $75 to get tested for avian flu, but it’s not enough to cover the costs or lost wages if they have to take sick time, Strater said.
Farmers: “A difficult problem to solve”
Another challenge in avian influenza surveillance is the economic realities of US agriculture and the increasing financial burden that is particularly affecting dairy farms.
American dairy farmers have struggled more than most of the U.S. agricultural industry, and the number of dairy farms in the country has declined sharply over the past 50 years: There were 650,000 dairy farms in 1970, down to just 32,000 in 2020, according to data from the U.S. Department of Agriculture.
With profit margins falling, many farmers see the further economic hardship that bird flu could bring as an existential threat.
That makes it hard for farmers to trust government agencies, said Nahrebout of the Idaho Dairy Farmers Association, and he said many farmers are choosing to handle the outbreak on their own, without consulting health or other government agencies.
“Because of privacy concerns and concerns about their ongoing business, they’ve weathered it, made it to the other side and are continuing to do their job,” Naerebout said.
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Daskalakis said the CDC is focused on building trust in farm owners and workers so they feel comfortable contacting local health authorities.
But, he added, “Generally speaking, it’s a really hard problem to solve.”
Eric Deeble, an official at the USDA, told reporters last month that the department is working on a program that is expected to lead to a “surge” in the number of farms participating in various avian flu assistance programs.
The Department of Agriculture also said in a statement to the BBC that over a period of time it would pay farmers “90 per cent of the production loss per cow” due to avian flu infection.
But Neurebout said few dairy farmers believe the USDA can adequately compensate them, especially with the number of cattle raised in the U.S. growing rapidly.
“For our larger western herds, you’re talking hundreds of thousands of dollars,” he said.
“To prevent the virus from spreading”
While some states have faced obstacles to increased oversight, others have had success by building trust within the farming community.
Michigan has been praised for its efforts to connect public health officials with dairy farms to increase testing rates, and it is also participating in a CDC study to assess dairy workers’ risk of infection and the possibility of asymptomatic infection.
While the state has seen a high number of bird flu cases, including two among dairy workers, scientists and public health officials say this is the result of their efforts to monitor the spread of the virus.
Michigan’s chief medical officer Natasha Bagdasarian told the BBC there is now time to stop bird flu in a way that couldn’t be done with COVID-19, which spread quickly and proved highly deadly before a vaccine was available.
“We now have an opportunity to intervene quickly and prevent the virus from spreading within human populations and from person-to-person transmission,” she said.
Dr Arnold Monto, an epidemiologist at the University of Michigan, acknowledged that human-to-human transmission remains unlikely, but argued the situation poses a “high potential risk” if left unchecked.
“The only way we can control this long term is by detecting it,” he said. “With summer approaching and the state fair happening and animals being moved, unless we can get this under control, we just don’t know if it’s going to get worse before it gets better.”
