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A US farm worker who contracted bird flu while working with dairy cattle in Texas appears to be the first known case of the virus being transmitted from mammals to humans, according to a new study.
The dairy worker sought care in late March after experiencing painful red, swollen, weeping blood vessels. He didn't have a fever though, and his lungs were clean, according to a letter written on the matter published in New England Journal of Medicine on friday.
He stated that he had no contact with sick or dead birds or other animals, but with other infected herds in the same part of the state, he frequently had direct contact with dairy cows.
Even though the man did not become seriously ill, the case is important because it proves that people can become infected with H5N1 after coming into contact with cows. At the same time, the study's authors say it leaves important questions unanswered about the virus's “pandemic potential” and shows how difficult it will be to track infections in this vulnerable population of workers. Illness can mean lost work days and pay.
“Especially for farm workers, these people are really living in economic despair, and what they don't want to do, they don't try something if they don't have paid sick leave. Because they can't send them home and tell them to stay home and not work, said Elizabeth Strater, director of strategic campaigns for the United Farm Workers.
Strater said the UFW, like other groups, has heard rumors that there are dairy workers who are sick but don't want to be tested, but they have been unable to confirm anything.
Health officials in Texas said they tested other sick dairy workers, including those with red eye, but other illnesses, not bird flu.
“The people who were tested volunteered to be tested,” said Laura Anton, senior press officer for the Texas State Health Service.
“Other people with symptoms may not want to be tested, so we can't say with absolute certainty that no one has H5N1. We can say with certainty that some people on dairy farms have tested positive for other respiratory viruses that are commonly circulating in humans,” said Anton.
Antiviral drugs were administered to a person who tested positive for bird flu and recovered without any lasting problems, and immediate family members received the drug as a precaution, the letter said.
The patient's eyes and lungs revealed something interesting: the eyes were infected with HIV. That means the worker caught it in his eyes – by rubbing his contaminated hands or splashing contaminated milk – not in his lungs, the virus did not migrate there or the virus could not survive in him. Lungs are primarily designed to infect birds, not cells in the human respiratory tract.
The letter on the matter was written by researchers from the US Centers for Disease Control and Prevention, along with doctors from the Texas State Department of Health Services and researchers from the Texas Tech Bioterrorism Response Laboratory.
Health officials said they could not investigate further how the man was infected because “epidemic tests could not be carried out” on the farm where he worked. They also failed to test other workers on the same farm.
Such testing is necessary to answer questions about how the worker became infected, whether others were infected and, if so, how long they were infected and what symptoms they experienced.
The CDC is looking for a farm that can conduct such a detailed study.
“Understanding the current outbreak of avian flu among dairy cattle is a critical priority for protecting human health,” the agency said in a statement to . “Discussions are underway with farms in several states to participate in the CDC-led epidemiologic study. In the meantime, states continue to test symptomatic farm workers and monitor infected animals. CDC continues to closely monitor a robust, nationwide influenza surveillance system. So far, no unusual flu activity has been detected.
At a news briefing Friday, White House spokeswoman Karen Jean-Pierre said the administration is “monitoring the situation closely and taking this very seriously.”