CDC Issues Updated Guidance to Help Prevent Spread of Flu at Agricultural Fairs

Summary

What CDC knows

An outbreak of H5N1 bird flu among poultry and dairy cows continues to spread in the United States. Four human cases with exposures to sick cows have been reported.

What CDC is doing

CDC has issued updated guidance to help prevent the spread of flu, including from cattle to people, at livestock fairs or exhibitions across the country. CDC continues to respond to the public health challenge posed by the multistate outbreak of H5N1 bird flu in cows and other animals in the United States.

With agricultural and livestock fairs happening all around the country this summer and fall, the chances for people to be in close contact with pigs, poultry (e.g., chickens, turkeys, ducks, geese), and cattle increase. Livestock fairs and shows are an important learning opportunity for people of all ages interested in agriculture.

Background

At the same time, animals exhibited at agricultural fairs and shows can carry and spread influenza A viruses that are different from the seasonal influenza A viruses that commonly spread among people.

As the multistate H5N1 bird flu outbreak in poultry, cows and other animals continues to spread, CDC is recommending that fair exhibitors take actions to help prevent the spread of influenza A viruses between animals and between animals and people.

Multistate bird flu outbreak is ongoing

Since the first report of H5N1 bird flu in U.S. dairy cows this March, four associated human cases have been detected. All four people had direct contact with sick cows before they got sick, had mild illness, and have recovered. These are the first reported instances of cow-to-human spread of H5N1 bird flu.

The number of dairy cow herds infected with H5N1 bird flu continues to grow. As of July 11, 146 dairy cow herds in 12 states have confirmed cases of A(H5N1) virus infections. CDC is working with the U.S. Department of Agriculture, the Food and Drug Administration, and state and local public health and animal health officials to respond to this public health challenge.

The risk of H5N1 bird flu to the general public is low at this time. People with close, prolonged, or unprotected exposures to infected birds or other animals (including livestock), or to environments contaminated by infected birds or other animals, are at greater risk of infection. Farm workers on affected farms, for instance, are at higher risk of infection than others in the population.

Influenza viruses can spread in livestock fairs

While rare, influenza A viruses can spread from animals (including pigs, poultry, and cattle) to people and also from people to animals. For example, swine influenza viruses spread commonly in pigs and avian influenza viruses spread commonly in wild birds and cause outbreaks in poultry and now cows. People can be infected by swine and avian influenza viruses and vice versa. People most often get infected with animal influenza A viruses after being in close contact with infected animals.

It is rare for people to get sick from these viruses, but when they do, the sickness has varied from mild to severe. In some cases, it has led to hospitalization or death.

CDC offers guidance to fair exhibitors

Livestock exhibitors can take the following actions to help protect themselves, friends and family, other visitors, and livestock and prevent the spread of flu:

• If you are sick with flu-like illness, stay home to avoid spreading illness to other people or animals.
• Plan to keep pigs, poultry, and cattle at the fair or exhibition for shorter periods of time to prevent or interrupt the spread of flu between animals (72 hours or less is ideal).
• Don’t take toys, pacifiers, cups, bottles, strollers, or similar items into the animal areas.
• Don’t eat, drink, or touch, or put anything in your mouth or touch your eyes while in animal areas (barns, show arenas).
• Wash your hands often with soap and running water after touching animals, animal associated equipment, or their environments (like a barn or enclosure). If soap and water are not available, use an alcohol-based hand sanitizer.
• Where possible, avoid direct contact with pigs, poultry, cattle, and other animals that look or act ill. (Direct physical contact with the animal includes touching, holding, kissing, being bitten, licked, and scratched.)
• If you must come in contact with animals that may be ill, wear personal protective equipment (PPE), which includes protective clothing, gloves, goggles, and a respirator or well-fitting mask that covers your mouth and nose. Parents and caregivers should review considerations for specific groups of people when selecting a respirator or mask for children.

Protect your animals

• If your animals are sick or are from herds with a recent history of respiratory disease, keep them at home to prevent further spread of illness.
• Watch animals for illness before and during the fair. In dairy cows, decreased milk production can be a sign of influenza virus infection. Other signs of illness include loss of appetite, fever, tiredness, eye redness, signs of discomfort, cough, or runny nose.
  • Call the fair veterinarian and/or the fair manager right away if you suspect illness.
  • Remove sick animals from the exhibition area right away.
  • If possible, avoid close contact with sick animals.
• Clean and disinfect all tack, feeders, waterers, equipment, and show supplies before and after bringing them to the fair or show. Do not share equipment used for other animals.

Other resources

CDC has issued interim recommendations for preventing, monitoring and public health investigations of H5N1 bird flu in animals and people.

An appendix to CDC’s interim H5N1 bird flu guidance categorizes the degree of risk by exposure.

In addition, USDA also has fair guidance that focuses on reducing the risk of influenza spread between animals.