Poor tracking of bird flu is leaving dairy workers at risk
Even as it has become increasingly clear that the bird flu outbreak on the nation’s dairy farms began months earlier – and is probably much more widespread – than previously thought, federal authorities have emphasized that the virus poses little risk to humans.
Yet there is a group of people who are at high risk for infection: the estimated 100,000 men and women who work on those farms. There has been no widespread testing to see how many may be infected. None have been vaccinated against bird flu.
That leaves the workers and their families vulnerable to a poorly tracked pathogen. And it poses broader public health risks. If the virus were to find its way into the wider population, experts say, dairy workers would be a likely route.
“We have no idea if this virus is going to evolve to become a pandemic strain, but we know today that farmworkers are being exposed, and we have good reasons to think that they are getting sick,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.
A majority of dairy farmworkers are Spanishspeaking immigrants, often in the country illegally, who may not have paid sick leave or be protected by occupational safety laws. They may lack access to medical providers, and their employers can be intolerant of absences.
“This sector of workers is not only at the very, very highest risk because they’re having that direct, intimate contact with discharge, raw milk, with infected animals, but they’re also at the very, very highest level of risk in terms of having no social safety net,” said Elizabeth Strater, an organizer with United Farm Workers.
Interviews with more than three dozen federal and state officials, public health experts, farmers and workers’ organizations show how little is known about what’s occurring on farms: how many workers may be affected, how the virus is evolving and how it is spreading among cows.
So far, the virus, called H5N1, has been detected in cattle herds in nine states. While veterinarians have said there are unconfirmed reports of farmworkers with flu-like symptoms, only 30 have been tested as of Wednesday.
Barring extraordinary circumstances, state and federal health officials do not have the authority to demand access to farms. Instead, the Food and Drug Administration and the Department of Agriculture are testing milk and ground beef on grocery shelves for the virus.
A tangled regulatory system complicates the situation, said Dr. Jay Varma, who served in the
CDC’s foodborne diseases branch and oversaw food safety as a deputy commissioner at New York City’s health department.
The agriculture department regulates large commercial farms and can mandate testing of animals – although it has not yet done so – but not of farmworkers. The department “doesn’t ever want to be in a position where it has to declare that food supply from the U.S. is unsafe, because some of those food products may be exported to other countries, and that can have a huge economic impact,” Varma said.
The CDC has authority over ports of entry into the U.S., but domestically the agency needs state approval to do much of its work. The FDA, Occupational Safety and Health Administration, the Environmental Protection Agency, and Citizenship and Immigration Services all have roles to play, but each has its bureaucratic layers and institutional culture.
This patchwork can be an impediment during a disease outbreak, some experts said. In 2009, the response to a cluster of bacterial infections in a salami product was delayed because the Department of Agriculture regulated the meat, the FDA was responsible for the cracked black pepper that coated it, and the CDC was in charge of investigating the people who became ill.
Dr. Nirav Shah, principal deputy director of the CDC, dismissed the notion that bureaucracy was an obstacle as “overly simplistic” and said the agencies responding to the outbreak talk numerous times a day to coordinate their activities and to work with state partners.
“This stuff is hard,” he said. But “we’re working together on this because we have common goals.”
Wary of scrutiny, very few farms have granted entry to health officials. Dairies found to have infected herds could see as much as a 20% dip in income. Farmers already face stagnant milk prices and high feed and transportation costs.
Because of the relatively small number of cases – 36 affected herds out of some 26,000 nationwide and one infected farmworker – some farmers see the bird flu as a distant threat. Even those who support public health efforts are hesitant to let federal officials on their properties.
Mitch Breunig, who owns Mystic Valley Dairy in Sauk City, Wisconsin, said that if his veterinarian determined it was “prudent,” he would test a cow with bird flu symptoms, but “I really don’t want the CDC coming to my farm.”
So far, the outbreak has affected not small farms, but the giant dairies that increasingly dominate the industry and often rely on migrant workers.
The owners of such farms “don’t care about our health; they just care that we do our jobs,” said Luis Jimenez, who works on a dairy in upstate New York and founded a group supporting immigrant farmworkers in the country illegally.