Farmworkers face high-risk exposures to bird flu, but testing isn’t reaching them

Farmworkers face some of the most significant risks from the bird flu virus, but advocates highlight that many lack the resources to cope if they fall ill.

So far, only two people in the U.S. have tested positive for bird flu, having been exposed to an outbreak among cows. These individuals, dairy farm workers in Texas and Michigan, experienced eye irritation.

Scientists warn that the virus could mutate to spread from person to person like the seasonal flu, potentially causing a pandemic. Monitoring farmworkers could help track infections, assess the virus’s danger, and detect if it becomes more infectious.

However, testing generally occurs when people seek medical treatment, which farmworkers rarely do due to a lack of health insurance and paid sick leave, noted Elizabeth Strater, director of strategic campaigns for United Farm Workers. They typically avoid doctors unless severely ill.

Strater mentioned that around 150,000 people work in U.S. dairies. Many worker advocates believe the virus has likely spread more widely than tests indicate. “The surveillance method for at-risk workers has been very passive,” she said.

Federal officials reported on May 22 that only 40 people associated with U.S. dairy farms had been tested for the virus, although others are being “actively monitored” for symptoms.

Federal authorities have recently introduced a program offering farmworkers $75 each to be tested for the virus, along with incentives for farm owners to test their herds.

CDC spokesperson Rosa Norman explained that the incentive compensates workers for their time, aiding in the monitoring of infection rates, illness severity, and potential human-to-human transmission. The CDC currently believes the virus poses a low public health risk.

However, Strater is skeptical of the $75 incentive. Testing positive might lead workers to seek medical care and stay home, which many cannot afford. “That’s a bad deal for 75 bucks when they need to feed their families,” she said.

Katherine Wells, Lubbock, Texas’s public health director, stated that health officials would provide short-term care, such as Tamiflu, but not necessarily cover hospitalization. The main concern for workers is the potential loss of work or jobs if they test positive.

Many farmworkers are immigrants working in challenging conditions for low pay. Monica Schoch-Spana, a medical anthropologist at Johns Hopkins Center for Health Security, noted that attention to cases among farmworkers could incite anti-immigrant sentiment. During the 2009 H1N1 “swine flu” pandemic, Latino immigrants faced verbal attacks and calls for stricter immigration policies.

Bethany Boggess Alcauter, from the National Center for Farmworker Health, emphasized the need for educational efforts alongside testing, allowing workers to ask questions in their language and with trusted individuals.

Georges Benjamin, executive director of the American Public Health Association, stressed that public health officials must assure workers their immigration status won’t be reported during the investigation. “We’re not going to be the police,” he said.

Dawn O’Connell from the Department of Health and Human Services announced that nearly 5 million doses of an H5N1 vaccine are being prepared, with no decision yet on offering these to farmworkers later this year.

The CDC has requested states to share personal protective equipment (PPE) with farm owners to protect workers from bird flu. Health departments in California, Texas, and Wisconsin have offered to distribute PPE. Chris Van Deusen, Texas health department spokesperson, said four dairy farms requested PPE from the state stockpile, while other farms might already have the necessary supplies. California and Wisconsin health departments did not immediately receive PPE requests from farm owners.

Strater from United Farm Workers emphasized that PPE must be practical. Dairy workers already use waterproof aprons, boots, and gloves, but N95 masks might not be feasible in the wet, hot conditions of milking operations. Plastic face shields could be a better option to prevent milk from spraying into workers’ eyes and causing infections.

Other agricultural workers, such as those handling chickens, also risk infection. However, the virus in cows is particularly concerning as it has adapted to mammals. Strater is especially worried about dairy workers who spend 10 to 12 hours daily in close quarters with cows.

“Their faces are inches from the milk and udders all day,” she said. “The close proximity to infectious material is a significant concern.”