Farm workers at high risk for bird flu, but tests are out of reach • Nebraska Examiner

Agricultural workers are among the most exposed to the avian flu virus, but advocates say many of them lack resources to turn to if they get sick.

So far, only two people in the United States have tested positive for avian flu after being exposed to the wave of the virus spreading among cows. They were both dairy farm workers. Texas and Michigan workersexperienced eye irritation.

Scientists have warned that the virus could mutate and spread from person to person like seasonal flu, sparking a pandemic. By monitoring farmworkers, researchers can track infections, learn how at-risk they are, and be alerted if the virus becomes more contagious.

People typically get tested when they seek treatment for an illness, but farmworkers rarely get treatment because many don't have health insurance or paid sick leave, said Elizabeth Strater, strategic campaigns director for the National Farm Workers Union. They're less likely to go to the doctor unless they're seriously ill.

Strater said there are about 150,000 people who work on U.S. dairy farms. She said many worker advocates believe the virus is spreading to more people than test results indicate. “The methods being used to monitor at-risk workers are very passive,” she said.

The federal government will pay for the tests.

Federal officials told reporters on May 22 that only 40 U.S. dairy workers had been tested for the virus, but others were being “actively monitored” for symptoms.

Federal Authorities Recently Announced Farm workers will be paid $75 each to be tested for the virus as part of a new program to incentivize farmers to allow their dairy cows to be tested.

Officials at the federal Centers for Disease Control and Prevention said they recognize the importance of gaining cooperation and trust from dairy workers on the front lines.

CDC spokeswoman Rosa Norman said in an email that the incentive payments compensate employees for their time helping to monitor the number of cases, the severity of infections, and whether the virus is spreading between people.

She said the CDC is now Low risk to public health.

But Strater is skeptical of farmworkers' incentives to get tested for the virus. If they tested positive, they would likely be told to go to a clinic and take time off work, neither of which Strater said workers can afford.

“I have to feed my family on the weekends and $75 seems like a really bad deal,” she said.

Work Absenteeism is a Bigger Concern

Lubbock, Texas, public health director Katherine Wells said health officials in that state will provide short-term medical care to farmworkers, such as giving them the flu drug Tamiflu. Such arrangements don't necessarily cover hospitalization if it's needed, Wells said.

She said workers' bigger concern seems to be that if they test positive, they will have to take time off work or may lose their jobs.

Many agricultural workers I came from another countryAnd they often work in harsh conditions for low wages.

Monica Schock Spana, a medical anthropologist at the Johns Hopkins University Center for Health Security, said migrants may fear that drawing attention to their cases will inflame anti-immigrant sentiment.

Society is long A history of criticism Marginalized communities have been accused of spreading infectious diseases: Latino immigrants were blamed during the 2009 H1N1 “swine flu” pandemic, for example, and some members of the media used the epidemic to push for immigration crackdowns.

Bethany Boggess Al-Kawter, research and public health program director at the National Farmworker Health Center, said many dairy workers have little to no information about the new disease spreading among the cows they work with. “Education is essential to any testing effort, and workers need time to ask questions,” she said.

These conversations should take place in farmworkers' language and with people they're likely to trust, she said.

George Benjamin, executive director of the American Public Health Association, said public health officials must make it clear that workers' immigration status will not be reported as part of H1N1 investigations. “We're not trying to be the police,” he said.

Dawn O'Connell, secretary of Health and Human Services, said at a press conference on May 22 that nearly 5 million doses of a vaccine for the H5N1 avian influenza virus, which is circulating among cattle, are on the way, but that officials have not yet decided whether to vaccinate farmworkers when the vaccine is ready later this year.

The CDC in early May asked states to provide personal protective equipment to farm owners to protect farmworkers from the avian flu virus, and state health departments in California, Texas and Wisconsin, all of which have large dairy industries, said they had offered to provide such equipment.

Four dairy farms have requested protective gear from the state's stockpile, said Chris Van Dusen, a spokesman for the Texas Department of State Health Services. Other farms may already have what they need, he said. Spokesmen for the California and Wisconsin health departments said they had not immediately received requests from farmers for more equipment.

Personal Protective Equipment

Strater, the United Farm Workers Union official, said the provision of protective equipment needed to be practical.

Most dairy workers already wear waterproof aprons, boots and gloves, she said. Asking them to also wear N95 face masks in the humid, hot environment of milking is unrealistic, she said. In that environment, plastic face shields seem like a better option, she said, especially to prevent milk from getting into workers' eyes and causing infection.

Other types of agricultural workers, such as those who handle chickens, may also be infected, but scientists say the virus circulating in cattle could be particularly dangerous because it has adapted to mammals.

Strater said he was most concerned about dairy workers who spend 10 to 12 hours a day in confined spaces with their cows.

“A cow's face is about five inches away from the milk and the udder all day,” she says. “There's a difference in the intimacy of having your face so close to infectious material.”

This article was first KFF Health NewsFormerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism about health issues. KFF — An independent source of health policy research, polling and journalism.