Bird Flu has Hit Cows in Kansas and Sparked Precautions in Missouri. Here’s What that means for You People are at low risk from the strain of avian influenza that has now been detected in dairy cattle in a dozen states. But scientists say the more it spreads, the more chances it has to become a problem for people.

Don’t drink raw milk.

It’s one piece of public health advice almost every doctor, scientist and public health official can get behind. Especially as bird flu jumps from chickens to cows to a handful of farmworkers.

Yet on the north side of Excelsior Springs, Be Whole Again Farm hasn’t noticed the public health guidance having much effect on business. The 38-cow dairy sells about 750 gallons of unpasteurized milk every week.

Rachel Moser, who owns the farm with her husband, Scott, said public health warnings about raw milk are overblown. And selling it directly to consumers is perfectly legal in Missouri.

As she has reminded her customers, bird flu has yet to infect a Missouri cow. Moser said her farm monitors every cow every day for signs of illness and always has. If there were any concern, milk would be discarded. So Moser said the likelihood of someone catching the virus from drinking the raw milk they sell is extraordinarily low.

“Are they honestly expecting every raw milk dairy to just shut down?” she said early one June morning, while cows rotated through the farm’s milking parlor, munching on barley grass as milking machines whirred in the background.

Erosion of Trust in Public Health

The reality is that a growing group of people is wary of public health words of warning and distrustful of the agencies behind them. Worn out after years of COVID precautions, polling has shown that people — especially Republicans — lost trust in public health officials as the pandemic wore on. 

Just last week, Republican lawmakers held hearings on how the COVID pandemic began and questioned Dr. Anthony S. Fauci, the now-retired government immunologist, about advice he gave as the virus spread.

Public health experts worry that growing distrust could pose its own public health risk. If people, especially in large numbers, don’t listen to doctors and scientists, experts worry that the job of corralling the next disease spread becomes more daunting.

“Trust is foundational,” U.S. Centers for Disease Control and Prevention Director Dr. Mandy K. Cohen said last week at the national convention of the Association of Health Care Journalists. “But, also, trust takes time. … You can lose trust quickly, but (building) trust does take time.”

Cohen said public health agencies need to double down on getting accurate information to the public. In the face of growing misinformation on the internet and elsewhere, Cohen said public health agencies need to “flood the zone” with reliable facts.

“It’s important to say what you don’t know and that you’ll come back and answer more questions the next day,” Cohen said. 

We are Better Prepared for Bird Flu

As for the current strain of bird flu — highly pathogenic H5N1 avian influenza — Cohen said the United States is prepared. And even if the spread into humans increases, the situation looks nothing like what unfolded when COVID started.

“Avian flu is something we’ve been studying and preparing for for decades,” she said. “COVID (was) a completely novel virus where we did not have tests, we did not have treatment, we did not have vaccines.”

The country has all of that for bird flu, Cohen said. Vaccines would need to be manufactured, but the country has effective candidates ready to go.

As things stand now, the virus is considered low risk for humans. There have been three known cases, although many experts believe that is an undercount since testing has been limited. Confirmed cases were in dairy farmworkers in Texas and Michigan whose symptoms were mild, primarily conjunctivitis — an eye inflammation commonly called pink eye.

The CDC said it is monitoring the situation carefully and has recommended that farmworkers and others in close contact with animals take precautions like wearing masks, gloves and other personal protective equipment when working with infected animals.

But among animals, the situation is different. This strain of the virus is spreading rapidly around the world through birds and mammals. 

Scientists are surprised— and concerned— about the unusual spread and some are calling it an ecological disaster. It’s been lethal to a growing number of species, including seals, sea lions, owls and bald eagles. In January, scientists detected the virus in a red fox in Jackson County.

Testing and Tracking the Virus is Critical

Since the disease showed up in chickens, tens of millions have died. Once it infects a poultry farm, entire flocks must be destroyed. The U.S. Department of Agriculture compensates farms for those kinds of losses to encourage them to take action. Federal taxpayers spent more than $500 million on payments like that in 2023, according to The New York Times.

Now the USDA is giving dairy farmers financial incentives to encourage them to test cattle.

Experts said it is vitally important that the virus is tracked and tests are done so scientists know how it is evolving or mutating.

When the virus jumped from birds to cows — probably because a bird dropping contaminated a cow’s food or water supply — it did it without changing or mutating significantly. The people who got sick were dead-end hosts. They didn’t pass it on.

The danger, scientists said, is that the virus will find a way to transform so it can circulate among humans. The more it spreads, the more likely that is. 

The 1918 influenza pandemic that killed tens of millions of people started with an avian flu, though not the strain circulating now.

If it jumps from cows to pigs, said Dr. Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, the virus could mutate so it could bind to the respiratory tract, which would make it more dangerous to people.

“Pigs are like little influenza incubators,” he said. “Influenza viruses tend to change in pigs.”

The USDA has confirmed cases of the virus in dairy cattle herds in 12 states. That includes Kansas, where four farms in the western part of the state had outbreaks in late March and early April. So far, no cases of the virus in cattle have been reported in Missouri. 

When a cow is infected, it doesn’t die. Farmers have to take its milk out of production and that costs them money. But after a period of quarantine, the farmer can go back to milking the cow.

Still, financial consequences of lost production can be significant and give farmers good reason to do their part to contain the virus, said Dr. Justin Smith, animal health commissioner for the Kansas Department of Agriculture.

“The industry itself approached it with a wary eye,” Smith said of the virus. “But at the same time, they didn’t dismiss it. They understood that there was truly an impact.”

Scientists are unsure how the virus spreads from cow to cow. But it has found a welcoming environment in the cows’ udders. From there, it may be spread from cow to cow through milking equipment. 

Minimizing Spread to People

The danger right now is that infecting domestic cows gives the virus many more chances to reach humans. And every time it finds a human host, it has a chance to become more dangerous.

People need to minimize that scenario, said Richard Webby, a scientist who studies influenza at St. Jude Children’s Research Hospital.

This virus was first detected in humans in 1997. But the virus circulating now is quite different — something like that original viruses’ great-great-grandchild, Webby said.

Over the years, the virus has infected nearly 900 people, and shown a mortality rate of around 50%. But that rate is likely exaggerated, since only the sickest patients may have been diagnosed and counted. Still, scientists urge caution.

“This can be an extremely dangerous infection to get,” said Dr. Dana Hawkinson, medical director of the Infection Prevention and Control program at The University of Kansas Health System. “It’s important to understand the dangers.”

So far, all three human cases involved farmworkers who were in close contact with infected cows. The CDC says there’s no indication that the cases are connected, which means human-to-human spread still isn’t happening.

In May, the CDC recommended that states distribute personal protective equipment to farmworkers. Among steps the federal government is taking to prepare, states can request face shields, face masks, gloves and goggles from the national stockpile.

Officials emphasize that the food supply is safe. While studies have found remnants of the virus in the milk of infected cows, studies have shown that the process of pasteurization, heating milk to a specific temperature for a set period of time, kills the virus and makes milk safe to drink. Meat consumption is also considered safe.

But they continue to warn against consuming milk that hasn’t been pasteurized. Scientists speculate that cats that died on a Texas dairy farm drank the milk of infected cows. 

“I just want to reinforce that milk is safe and our dairy products are safe,” said Chris Chinn, director of the Missouri Department of Agriculture. “Pasteurization works. And, you know, I think that’s the most important message that we can get out. … Our food supply is safe.”

This article first appeared on Beacon: Missouri and is republished here under a Creative Commons license. Suzanne King is The Beacon’s health reporter in Kansas City. During her career, she has covered education, local government and business. Her reporting is partially funded by Health Forward Foundation.