Highly Pathogenic Avian Influenza in Dairy Workers

Highly pathogenic avian influenza (HPAI) has been spreading among U.S. dairy herds. Previously, a Texas man developed conjunctivitis caused by HPAI after working with sick dairy cows. Now, two dairy workers in Michigan have been reported to have HPAI infection.

The first worker developed conjunctivitis after milk from an infected cow splashed in his eyes. A conjunctival swab was positive for HPAI; 1 week later, a repeat conjunctival swab was negative. The second worker developed nasal congestion, cough, and other respiratory symptoms after exposure to the oral secretions of sick cows. A nasopharyngeal swab was positive for HPAI; the worker recovered after initiation of oseltamivir. Sequencing of the two viruses showed that both were closely …