State fairs in the time of bird flu: Why health experts urge caution

Between July and October, states across the country hold their annual state fairs.

The events are known for things like Ferris wheels, corn-based hot dogs, sculptures made entirely of butter and the state’s largest pig. But state fairs can also be places where it’s easier to spread disease, as they bring humans and farm animals from around the state into contact.

This year, this is especially worrying, as H5N1 or bird flu infections have been confirmed in dairy cows in 13 US states for the first time. The virus has also infected four dairy workers in Michigan, Texas and Colorado.

But that doesn’t stop many fair-goers from lining up in front of the cattle trying to get out of the fences of their barns.

Mel Ventimiglia was with his grandchildren standing next to several cows in a barn at the Indiana State Fair in Indianapolis. He said bird flu isn’t even on his radar.

“I haven’t heard anyone mention it except you,” he told Side Effects. “I hope to forget about it pretty quickly.”

At another nearby barn, farmer Randy Mason says he takes basic precautions to prevent his cattle from getting sick while at the fair, but he’s not particularly worried.

“In my opinion, it is very exaggerated,” he said. “They get one or two cases and then, like everything the government does, it becomes exaggerated and disproportionate.”

But nationwide, bird flu infections have been confirmed in nearly 200 flocks, according to the Centers for Disease Control and Prevention.

That has led officials at some state fairs to enact stricter rules to prevent the spread of the virus.

In Minnesota, where cases of bird flu have been detected in its dairy herd, the state requires all cows to test negative for bird flu before coming to the state fair.

However, that is not the case in many other states, including Indiana, where there have been no confirmed cases of bird flu.

“Because we haven’t had a diagnosis, we haven’t taken those additional steps,” said Bret Marsh, Indiana state veterinarian.

Marsh said the state has told farmers to watch for signs of bird flu in their animals. They have also been told about the risks of spreading disease by attending the fair and have recommended that animals be quarantined for 30 days after exposure, but that without a positive result, the state does not need to impose stricter restrictions.

Why are state fairs a concern?

But scientists widely agree that not enough testing is being done to fully understand which states have cows infected with bird flu.

Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, said states like Indiana don’t have any positive cases of bird flu in livestock because they’re not looking for them.

“It should be assumed that this virus is in the state of Indiana, but we haven’t found it yet,” he said. “That’s what they should be broadcasting, not ‘our cows are free.’ It’s foolish to believe that.”

This makes places like state fairs, where humans come into contact with different animals, especially worrisome. Scientists fear that bird flu could mutate and become a human virus if given the chance.

At present, the virus appears to have spread only among humans who have been in direct contact with the udders and equipment used on infected cows, and has caused cases of conjunctivitis, or pink eye, in humans. The broader concern is that the virus could mutate and become a respiratory virus that would spread more easily from person to person.

And fairs have a history of being places where that contagion, from animals to humans, occurs.

In 2012, a major outbreak of swine flu resulted in more than 300 infections in the United States, most of them linked to exposure at agricultural fairs. And last year, the CDC reported that two people contracted swine flu after visiting pig exhibits.

Every time a flu virus enters a new host, it is given the opportunity to evolve and potentially become one that could easily spread between humans.

Experts fear the risk of H5N1 becoming a human virus could be greatly increased if the virus reaches pigs in particular, because they are a perfect vessel for mixing viruses from different species. This means different viruses can exchange genetic material and learn from each other, potentially mutating and becoming more fit to infect humans.

“One of the things that is most talked about regarding COVID-19 is animal markets in China, where there are a lot of different animals and species interacting with each other,” Adalja said. “Similar things happen at state fairs in the United States. There is not much difference.”

Andrew Bowman, a professor of veterinary preventive medicine at Ohio State University, agrees that the mixing of animals and people at state fairs poses a risk.

“We think about the new pandemic viruses emerging from live animal markets in Southeast Asia and think, ‘Oh, we would never do that in the U.S.’ Well, the fairs kind of mimic that,” he said.

The risk to humans remains low

Still, experts like Bowman say that’s no reason to miss the state fair altogether.

“I still go to the fair and so does my family. I had a milkshake when I was there,” Bowman said.

He added that at-risk populations, such as immunocompromised people, should consider avoiding livestock barns this year.

“You have to be careful and think carefully about what contacts you need,” Bowman said. “Can I enjoy the animal exhibits, perhaps from a little further away, and not be in the middle of them?”

In June, the CDC issued guidelines for state fairs to reduce the spread of bird flu, including a ban on dumping milk on the ground, because raw milk from infected cattle is likely to contain the live virus. The guidelines also advise keeping cows from different herds separate and encourage visitors to wash their hands before leaving a barn.

Earlier this year, the U.S. Department of Agriculture instituted a rule requiring cows to test negative for the virus before crossing state lines.

Still, the risk to humans from the bird flu virus remains low, according to the CDC’s assessment.

Side Effects Public Media is a health reporting collaborative based at WFYI in Indianapolis. We partner with NPR stations in the Midwest and surrounding areas, including KBIA and KCUR in Missouri, Iowa Public Radio, Ideastream in Ohio, and WFPL in Kentucky.

Copyright 2024 Side Effects Public Media