USA—The US Departments of Health and Human Services (HHS) and Agriculture (USDA) have intensified efforts to safeguard farm workers from the H5N1 avian influenza outbreak affecting dairy cattle.

Despite the Centers for Disease Control and Prevention (CDC) assessing the general public’s risk as low, farm workers in close contact with infected animals face heightened infection risks.

In response to the outbreak, the US government has allocated US$93 million to enhance health surveillance, provide Personal Protective Equipment (PPE) to farm workers, conduct timely virus analyses, and disseminate safety guidance through social media. This initiative aims to keep communities healthy, safe, and well-informed.

“If farm workers or others with contact with infected animals are feeling sick or exposed to livestock and need PPE, they should contact their state health department for assistance,” stated the HHS.

Symptom awareness and protective measures

Symptoms of H5N1 infection include cough without fever and eye discomfort with watery discharge. States can request face shields, face masks, gloves, and goggles from the Strategic National Stockpile (SNS) to protect farm workers.

As of late May 2024, CDC data reported 96,565,226 wild birds and 79 dairy herds infected with the virus. Outbreaks have been identified in nine states among cows and in 48 states among poultry.

Human infections and surveillance

Since 2022, the CDC has reported four human H5N1 cases in the US, three of which involved dairy farm workers in Michigan and Texas between April and May 2024. The first case in the US from poultry exposure was recorded in April 2022 in Colorado.

Human infections with avian influenza A viruses are rare but can occur after close, unprotected contact with infected birds or contaminated environments.

The CDC uses its flu surveillance systems to monitor H5N1 activity in humans and advises the public to avoid direct contact with wild birds and consume pasteurized milk to reduce infection risk.

Commercial milk safety

The FDA and USDA have assured consumers that the commercial milk supply remains safe due to pasteurization and the diversion or destruction of milk from sick cows.

The WHO also noted that the virus does not appear to transmit easily between people, following an April public health warning.

Federal and state measures

The US government has implemented several measures to mitigate the virus’s spread.

The Administration for Strategic Preparedness and Response (ASPR) is distributing PPE through the SNS to protect farm workers.

Conversely, the CDC is conducting genomic analysis of HPAI (H5N1) virus isolates to identify genetic changes that could affect virus transmission and treatment.

Meanwhile, the USDA has issued a Federal Order mandating testing before interstate movement of lactating dairy cattle, a 30-day ban on interstate movement for affected herds, and a requirement for labs to share positive tests with federal authorities.

To keep workers informed about the latest developments, the USDA and HHS are conducting regular briefings and providing written resources in multiple languages.

The CDC is investing in targeted social media and ad campaigns in areas with infected herds to educate poultry and livestock farmers, dairy farmers, and other farm workers about their risk and recommended protective measures.

Investments in epidemiology and surveillance

To further understand the disease’s transmission and severity, the CDC has allocated an additional US$93 million for epidemiology, surveillance, data analytics, wastewater and genomic surveillance, testing and laboratory capacity, vaccine activities, and outreach to high-risk populations.

State and local health authorities are actively monitoring exposed persons for illness, with Michigan’s public health officials maintaining direct daily contact with some affected workers.

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