Idaho’s avian flu outbreak in dairies is largely self-monitored; experts warn of potential health risks – KTVB.com
                            July 16, 2024
                              Threat to human health at this point is low, according to the  CDC. But that could change at any moment with each new mutation  of the virus.
      BOISE, Idaho  This article originally appeared in      theIdaho      Press.    
      Idaho dairy producers are navigating one of the worst      outbreaks of an avian flu strain in the U.S., and from an      animal health and public health standpoint, the situation is      largely self-monitored.    
      Threat to human health at this point is low, according to the      Centers for Disease Control and Prevention. But that could      change at any moment with each new mutation of the virus.    
      I dont know if this will turn out to be a pandemic, but      were watching all the ingredients, and were watching that      sequence, said Dr. David Pate, retired president and CEO of      St. Lukes Health System. Certainly, if you were planning      out how we think a pandemic would occur, this is what you      would be planning out.    
      In response to the COVID-19 pandemic, Pate and another Idaho      doctor, Dr. Ted Epperly, wrote the book Preparing for the      Next Global Outbreak and Pate has been watching the avian      flu outbreak closely. He argues that more should be done to      prepare in case the situation becomes more dangerous for      human health.    
      Idaho officials and dairy producers are monitoring animal      health, regulating quarantine of infected animals, providing      workers with personal protective equipment and offering      testing of farm workers who have been exposed.    
      Dairy operators, dairy workers always operate in a world      where they have to take care of themselves for infectious      conditions, said Dr. Christine Hahn, state epidemiologist      and state Division of Health medical director. Cows have      other germs they can spread  so they already have protocols      in place.    
      She said the state health department is providing information      and support for those regarding protecting workers. But the      decisions on how and what to implement are up to the      operators.    
      AVIAN FLU OUTBREAK IN IDAHO    
      As of July 3, which was the most recent data available, there      have been 27 cattle herds in Idaho affected by the virus,      according to data from the USDA. Nationwide, there have been      nearly 140 herds infected since the illness was first      detected in U.S. dairy cattle in March, marking the first      time the strain H5N1, known as highly pathogenic avian      influenza, had been found in cows.    
      This is a big hit to Idaho, which has more than 400 dairy      operations and ranks third in U.S. for milk production,      according to the Idaho Dairymens Association.    
      So far no human cases have been detected in Idaho, and a      total of four reports of confirmed human cases due to contact      with dairy cattle have come out of Texas, Michigan and      Colorado. All but one of the cases has presented through mild      eye symptoms, according to information from the CDC, and one      was a mild respiratory illness.    
      Studies by the U.S. Department of Agriculture and the Food      and Drug Administration have found that the pasteurization      process of heating milk effectively deactivates the virus,      meaning consuming commercial milk is safe as long as its      pasteurized, officials said.    
      The outbreak was first reported in Texas, and soon after      appeared in an Idaho dairy that had just received cattle from      Texas, said Idaho Department of Agriculture state      veterinarian Dr. Scott Leibsle.    
      As of July 12, there are 18 facilities in nine Idaho counties      under quarantine, including two in Canyon County. The last      reported detection in Idaho was on June 20, and producers      feel that the state may have reached its peak and is showing      signs of decline in the spread of the virus, said Idaho      Dairymens Association CEO Rick Naerebout.    
      However, this may change when migratory birds start returning      to the state for the winter, he said.    
      Theres been testing of wild birds near impacted dairies and      positive cases of the virus found in those birds, Leibsle      said. Its unclear which species is infecting the other one,      he said.    
      NOT A PANDEMIC NOW, BUT WHATS THE THREAT?    
      The H5N1 virus in its current form is not very effective at      infecting humans, Pate said. And when a human does contract      the virus, it has occurred from prolonged contact with      infected animals and it doesnt seem to spread human to      human.    
      The concern is that the virus could be deadly when it is      contracted.    
      The virus has rarely impacted the U.S., but around 890 people      have reported being infected worldwide since 2003, according      to the World Health Organization. Of those, more      than 50% died. Most of the cases were in Egypt, Indonesia,      and Vietnam.    
      For comparison, COVID-19 had about a 1.7% case fatality rate,      Pate said.    
      This is about 52%, so you can see were talking about a      whole different level of severity, he said.    
      The other difference was many of the reported cases and      deaths were younger, healthier people, Pate said.    
      Without mass testing however, its difficult to determine if      the high reported fatality rate is because only severe cases      were tested for.    
      Pate highlighted an effort by the state of Michigan, which      has had two human cases, to test for antibodies in farm      workers to determine if they had a prior infection but did      not show symptoms.    
      Over the years, the virus has been found in sea lions and sea      elephants in South America, foxes in Canada and France and      other mammals around the world. In the last couple of years,      the virus has popped up in new animals, Pate said.    
      It was disturbing because the more animal species that get      infected, the more the virus can mutate, Pate said.    
      The situation is not worth panicking over, he said, but it      may present an opportunity to prepare.    
      We almost never see any of the steps that lead up to a      pandemic, Pate said. We know the kinds of viruses are      likely to cause pandemics or are higher up on our list  but      we rarely see any of the steps until it starts in humans.    
      He said he cant know if the virus will develop into a      pandemic, but the risks are increasing all the time.    
      Pate contends that not enough is being done to monitor the      situation. He said that more antibody testing, such as whats      being done in Michigan, should take place and family members      and household pets of exposed farm workers should be tested      to determine if and how its being spread.    
      He is also calling for better transparency with the data.      Because different agencies are handling different aspects of      the situation, he said, it can be difficult to collect all      the relevant data. And some of the information isnt      available. The USDA counts herds that have been infected, but      doesnt provide information on how many cows in the herd or      the percentage of positive cases within those herds.    
      From a testing perspective, he thinks the government should      be encouraging labs and medical centers to develop tests that      are more readily available to the public to test for H5N1.      There are tests available for influenza, but not this      particular strain. When flu season arrives in the fall and      winter, it may make monitoring the situation more difficult,      he said.    
      Pate is also an advocate for putting resources toward      vaccines. In late May, U.S. health officials announced they      were taking steps to acquire or manufacture H5N1 vaccines for      farm workers, veterinarians, and government officials who may      be most at risk, Reuters reported.    
      As the virus continues to spread to different animals, it      changes through a process known as reassortment.    
      But its kind of like, if you have enough quarters and      enough time, you sit at the slot machine, youre eventually      going to hit the jackpot, Pate said.    
      It may be the case that the virus never develops in a way      that presents a major risk to humans, but Pate argues there      should still be a significant response.    
      We should be taking advantage of this, because this is our      opportunity to learn and develop our preparedness, he said.    
      HOW ARE IDAHO DAIRIES RESPONDING?    
      Out of necessity, producers are always closely monitoring      their herds, Naerebout said.    
      We operate on very thin margins, theres not a lot of room      for error or a lot of room for disruptions in production in      your dairy operation, he said. So theyre always monitoring      milk production, quality of milk, all of these different      pieces of data that they can observe to try and make sure      that cows are performing at their peak.    
      When a cow is infected with avian flu, her milk production      can see a dramatic decrease. A cow can go from producing 80      pounds of milk a day to just 5 pounds the next day. Other      symptoms include a fever, lethargy, loss of appetite,      constipation and thickened or yellowed milk.    
      If theres a suspected case, the state Department of      Agriculture recommends producers contact their veterinarian      immediately. The veterinarian then contacts the department to      set up potential testing. In cattle, the virus shows up most      prominently in the milk, which is sent to a state lab for      testing.    
      Sick animals are sent to a separate pen, away from the rest      of the herd. Milk from animals in the sick pen is not sent      out for sale, and operators have been pasteurizing it before      discarding it to avoid contamination of water or food      supplies for other animals, Leibsle said.    
      When outbreaks have occurred, around 10%-15% of the herd has      been infected, Leibsle said, although Naerebout observed this      has been highly variable among operators in the state.    
      Samples from animals in the sick pen are sent to the state      for testing, typically on a weekly basis, Leibsle said. Its      in their best interest to test regularly in order to be able      to send their animals back into production once theyre      healthy.    
      To clear a quarantine, you have to show me evidence that      theres no virus left, he said. Just waiting an arbitrary      period of time is not sufficient.    
      Milking machines are flushed and sanitized between cattle to      avoid spreading the virus that way.    
      Use of aprons, gloves and boots are already common practice      among dairy workers, officials said. The health department      used CDC resources to provide personal protective equipment      to those who requested it. The public health division      recommended eye protection as well, as many of the human      cases have shown as conjunctivitis in the eye.    
      However, dairy workers often choose not to use a mask or      goggles because of the discomfort or safety concerns due to      limited vision, Hahn and Naerebout said.    
      We are leaving a lot of those decisions up to the dairy      operators and their workers, because they need to be safe      overall and were just offering the best protection that      were aware of from this particular virus, Hahn said.    
      The term highly pathogenic means that in birds, where the      virus first presented, the illness was very fatal. In cattle,      the animals seem to be recovering within two to four weeks,      Leibsle said.    
      The reduced production can still be a strain on the      operators, Naerebout said.    
      Dairy producers are coming off an 18-month downturn in the      industry, he said, in which production costs have been      outpacing income. The added hit of a 20% reduction in      production for a month can add to that stress.    
      Its not going to be a business-killer-type event, where      this by itself is going to put a dairy producer out of      business, but it definitely adds to an already stressful      situation, given what theyve battled through over the last      18 months, Naerebout said.    
      HOW IS THE GOVERNMENT RESPONDING?    
      In Idaho, the leaders from the state Department of      Agriculture and Idaho Department of Health and Welfare have      been meeting regularly to coordinate efforts to protect      animal and human health.    
      On a federal level, the USDA and CDC are monitoring and      providing resources.    
      To address the financial impact, the USDA announced toward      the end of May that it would make available funding to      compensate producers for lost milk production, as well as      funding for measures to improve biosecurity.    
      However, no Idaho producers have participated in this program      currently, according a USDA spokesperson.    
      The federal agency had been slow to clarify which producers      were eligible, Naerebout said. As of July 1 the agency      announced it would begin accepting applications for financial      assistance.    
      Only dairies that initially reported their positive cases to      the USDA are eligible, he said.    
      Were honestly a bit frustrated with the USDA on that      front, Naerebout said. ... It has been very difficult for      dairy producers to track and get comfortable with what USDAs      expectations would be and how the programs would work.    
      A USDA spokesperson said there are 24 producers in six states      participating in its support programs.    
      Idahos Division of Public Health provides free testing to      those who request it and provides CDC fact sheets with      information about the virus, in both English and Spanish,      Hahn said. The state works with the Idaho Dairymens      Association and local health districts to distribute      information and PPE.    
      The CDC provided funding for increased surveillance of the      flu.    
      To ensure potential community spread of the virus is being      monitored as well, the state has requested that all positive      influenza tests in humans be sent to the state lab to test      for H5N1. Hahn said that the division is also in      communication with medical providers to track if theres an      increase in influenza cases.    
      Public health districts have antiviral medication available      for those who may contract it and it is available for free      for anyone infected.    
      An added challenge to testing and monitoring by government      entities is that 90% of the dairy workforce are foreign-born.      Many of those workers are in the state on a migrant visa and      many are undocumented.    
      The reality is in agriculture, we have a decently high      number of undocumented individuals in our workforce,      Naerebout said, and so there is going to be that concern      that they dont want their legal status discovered. So,      theyre quite often not going to go and want to have      interactions with health and welfare or other agencies just      out of fear of their legal status being discovered.    
      Pate said that historically, this is the case for other      illnesses as well, and its an obstacle to those workers      receiving the treatment that they need.    
      Hahn said the health agency is aware that this is a challenge      and tries to work with the dairies to ensure that workers      know that they can safely speak up if they arent feeling      well, but its still a concern.    
      Naerebout said he doesnt see an issue with workers telling      their supervisors that theyre sick, and managers are also      keeping an eye on their employees to ensure that sicknesses      dont spread throughout.    
      You try and manage it just like you would any other      situation where you dont want that worker exposing coworkers      to anything, he said.    
      This article originally appeared in the Idaho      Press,read more on      IdahoPress.com.    
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Here is the original post: 
Idaho's avian flu outbreak in dairies is largely self-monitored; experts warn of potential health risks - KTVB.com