Bird flu cases are likely being missed in dairy workers, experts say

Dr. Barb Petersen, a dairy veterinarian in Amarillo, Texas, had been caring for sick cows for several weeks in March when she and a colleague finally identified the cause of illness in the herd: the H5N1 strain of avian flu.

This was the first time the virus had been detected in cattle.

Sick cows, said Petersen, owner of Sunrise Veterinary Service, tended to produce milk that didn’t look quite right and suffered from mastitis, an inflammation of the udders.

At the same time, she said, dairy workers — including those who never had close contact with the sick cows — also became ill.

“People had some classic flu symptoms, including high fever, night sweats, chills, lower back pain,” as well as stomach upset, vomiting and diarrhea, Petersen said. . “They also tended to have “fairly severe conjunctivitis and swelling of the eyelids.”

Petersen noted that the people were never tested for H5N1; it is possible that their symptoms are the result of another illness.

Since the cow outbreak was announced in late March, avian flu has been detected in 33 dairy herds in nine states: Colorado, Idaho, Kansas, Michigan, New Mexico, North Carolina, South Dakota, Ohio and Texas.

So far, only one person, a dairy worker in Texas, has tested positive for the virus. That person’s case was mild, the Centers for Disease Control and Prevention said. The only symptom involved was conjunctivitis, or conjunctivitis.

At least 44 other people may have been exposed, the CDC said. Some were tested, while others were told to monitor their symptoms, such as cough, sore throat, conjunctivitis, fever, headache and diarrhea.

Dr. Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, said he has heard of flu-like illnesses on affected dairy farms.

“It’s certainly not a large amount,” he said, “but there are probably a lot of cases that are not documented.”

Several factors may prevent sick dairy workers from seeking medical care or farmers from reporting a positive case among their livestock.

Farming, especially in rural areas where there are fewer medical centers, is often a 24/7 job with no sick leave. Additionally, false information circulating in farming communities is hugely fueling fear that dairy farmers could lose their livelihoods if they are labeled as harboring H5N1, Poulsen said.

“The biggest concern we hear from our dairy farmers is, ‘I don’t want to do testing because it’s going to depopulate my herd,'” he said. “Misinformation is really a challenge because it really isn’t.”

“Our job right now is to protect farmworkers,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “We can’t do that unless we know where the virus is or isn’t. »

It is still unclear exactly how the bird flu virus spreads from cows to humans, although some experts say it could be through several routes, such as contact with milk, contaminated milking equipment or even milk. respiratory droplets.

“I think everything is on the table at this point,” said Dr. Andrew Bowman, a veterinary epidemiologist at Ohio State University.

On Thursday, the Food and Drug Administration said genetic traces of the virus had been detected in 1 in 5 samples of pasteurized milk.

Preliminary results announced Friday by the agency indicate that pasteurization kills the virus, adding that tests “did not detect any live, infectious viruses” in commercially sold milk. The FDA said it was testing 297 samples from 38 states.

The FDA said it also tested several powdered formulas for infants and young children and found no evidence of the bird flu virus. It’s unclear how many formula samples the agency had tested.

During this time, experts recommend that anyone in contact with dairy cattle wear protective equipment, including safety glasses, waterproof aprons and boots that can be disinfected.

Poulsen encouraged dairy farmers to be as upfront as possible about the virus. The longer it takes to replicate in cows and other mammals, the stronger it could become, he said.

“The more we let this go unchecked or unchecked,” he said, “it becomes a much bigger problem that could make Covid look easy.” »

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Gn Health

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