In the midst of California’s dairy heartland, workers equipped with respirators, face shields, and gloves are facing one of the most significant bird flu outbreaks recorded. This month alone, California has confirmed 16 human infections of bird flu, with advocates highlighting that the state is falling short in safeguarding dairy workers from the virus.
Only a small fraction of individuals—39—have undergone testing for the H5N1 strain, which has severely affected cattle, as reported by the California Department of Public Health. Alarmingly, these confirmed human cases are believed to account for nearly the entirety of the nation’s cattle-to-human transmission cases, according to statistics from the Centers for Disease Control and Prevention.
Fortunately, health officials note that the cases identified in California have been relatively mild, with no recorded hospitalizations. Infected workers have shared that they experience flu-like symptoms alongside pink eye. State health officials assert that there have been no confirmed instances of human-to-human transmission, indicating that the risk to the general population remains minimal.
However, the current surveillance framework for bird flu puts significant pressure on farmers to report any animal and employee illnesses, which presents its challenges. Elizabeth Strater, a spokesperson for United Farm Workers, emphasized the shortcomings, stating, “Workers are actively avoiding testing, I can assure you. We have heard directly from farmworker communities and veterinarians that they can see workers who are unwell.”
Many low-income workers face financial hardships and are unable to take a 10-day unpaid isolation period if they test positive, leading to reluctance in pursuing testing.
Since the onset of the virus in California farms two years ago, millions of poultry have been culled. In a concerning turn, the highly contagious strain has recently spread to cattle, presenting an added risk to those who handle these animals. Reports indicate that the virus has infected 178 dairies across California since its emergence in August, with little sign of decline in infections among cattle. It is thought that the transmission of the virus from cows to humans stems from extended close contact with diseased animals.
“The most troubling data we have is how little data there is,” Strater commented. “Hundreds of herds have tested positive, while only a handful of individuals have been tested—it’s alarming.” Dr. Erica Pan, the chief epidemiologist from the state health department, shared that routine influenza monitoring has led to nearly 5,000 bird flu screenings since February.
She explained that unlike COVID-19 testing, which called for widespread surveys, bird flu testing requires eye swabbing by a clinician, hence limiting the number of screenings. “This is about identifying symptoms and then conducting tests rather than testing asymptomatic individuals,” Pan added.
To combat this outbreak, state and local health departments are concentrating on distributing personal protective equipment (PPE) and providing training to workers on its appropriate usage. More than a million pieces of protective gear have been handed out to local health departments and farms in California. Additionally, 5,000 doses of the seasonal flu vaccine have been made available for farmworkers, reducing the likelihood of severe co-infections despite lacking efficacy against bird flu itself.
Farmers in neighboring states have reportedly been resistant to cooperate with local health workers. However, Tricia Stever Blattler, who manages the Tulare County Farm Bureau, mentioned that this has not been the case locally, where farmers have been compliant with health initiatives.
The outbreak is centered in Tulare County, the nation’s leading milk producer, which identified the first human cases in early October. Since that time, related cases have surfaced in nearby areas. Stever Blattler noted that extreme temperatures earlier in the month posed challenges in getting workers to wear additional protective gear, but this issue has lessened with cooler weather now.
The rapid spread of the disease and its severity among cattle has taken the industry by surprise, creating widespread economic repercussions. “Our dairies are working hard to catch up with the situation,” Blattler said. “They aim to foster a safer working environment while also enhancing the care and surveillance of the cattle.”
Carrie Monteiro, a representative from Tulare public health, acknowledged farmers’ cooperation in efforts to curtail the virus’s transmission. “They are diligent in ensuring that we provide the necessary care to their workers and the required medication for recovery,” Monteiro affirmed.
The county’s testing capabilities have expanded to encompass 15 community doctors, though reliance on symptomatic individuals presenting themselves remains a key aspect. Following a positive test, affected individuals and their households are monitored for 10 days and are given antiviral flu treatment.
Still, Strater expressed a desire for more action from the state to assure farmworkers, who often undertake challenging roles for little pay, that they will be compensated if they fall ill on the job, which could encourage them to seek testing. While federal assistance programs are available for farmers to cover lost production, PPE, and precautions against infection, equivalent support for workers has yet to be initiated.
The state’s Department of Industrial Relations has asserted that employees who contract bird flu are entitled to workers’ compensation, irrespective of their immigration status. Employers are mandated to furnish a workers’ compensation claim form to affected employees and are responsible for reporting cases to local health authorities.
“I would like to see public health agencies collaborating with industrial relations to reassure people about getting tested,” Strater stated. “If you test positive, your lost wages should be entirely covered through workers’ compensation.”