MMWR Morb Mortal Wkly Rep. 2024 Nov 7;73(44):1004-1009. doi: 10.15585/mmwr.mm7344a3.
Since April 2024, sporadic infections with highly pathogenic avian influenza (HPAI) A(H5) viruses have been detected among dairy farm workers in the United States. To date, infections have mostly been detected through worker monitoring, and have been mild despite the possibility of more severe illness. During June-August 2024, CDC collaborated with the Michigan Department of Health and Human Services and the Colorado Department of Public Health and Environment to implement cross-sectional serologic surveys to ascertain the prevalence of recent infection with HPAI A(H5) virus among dairy workers. In both states, a convenience sample of persons who work in dairies was interviewed, and blood specimens were collected. Among 115 persons, eight (7%; 95% CI = 3.6%-13.1%) had serologic evidence of recent infection with A(H5) virus; all reported milking cows or cleaning the milking parlor. Among persons with serologic evidence of infection, four recalled being ill around the time cows were ill; symptoms began before or within a few days of A(H5) virus detections among cows. This finding supports the need to identify and implement strategies to prevent transmission among dairy cattle to reduce worker exposures and for education and outreach to dairy workers concerning prevention, symptoms, and where to seek medical care if the workers develop symptoms. Timely identification of infected herds can support rapid initiation of monitoring, testing, and treatment for human illness, including mild illness, among exposed dairy workers.
自 2024 年 4 月以来,美国的奶牛场工人中陆续检测到高致病性禽流感(HPAI)A(H5)病毒的散发病例。迄今为止,这些感染主要是通过工人监测发现的,尽管有可能出现更严重的疾病,但感染症状都较为轻微。2024 年 6 月至 8 月期间,CDC 与密歇根州卫生与公众服务部以及科罗拉多州公共卫生与环境部合作,实施了横断面血清学调查,以确定奶牛场工人中最近感染高致病性禽流感 A(H5)病毒的流行率。在这两个州,采用便利抽样的方法对在奶牛场工作的人员进行了访谈,并采集了血液样本。在 115 人中,有 8 人(7%;95%CI=3.6%-13.1%)具有近期感染 A(H5)病毒的血清学证据;所有报告都接触过奶牛或清洗过挤奶间。在具有感染血清学证据的人群中,有 4 人回忆起在奶牛生病时自己也生病了;症状在奶牛中检测到 A(H5)病毒之前或几天内开始出现。这一发现支持有必要确定并实施策略来预防奶牛之间的传播,以减少工人接触,并向奶牛场工人进行有关预防、症状和出现症状时应在哪里寻求医疗的教育和宣传。及时发现感染的畜群可以支持对暴露于奶牛场的受感染工人进行快速的监测、检测和治疗,包括轻微疾病。