Got Virus?
Our government, bowing to the dairy industry, is not being open enough about what’s brewing in our milk.
Our public health leaders need to stop issuing bland reassurances that our milk is just fine and explain to us how they can be so sure.
As a health reporter, I’ve heard such reassurances before, just as new epidemics were surging. It happened in China in 2002, when SARS was covered up for months. It happened in Britain during the mad cow scandal; for five years, the Thatcher government insisted British beef was safe — until a spate of human deaths in 1995 proved it was not. It happens in this country. In 2016, hesitant to offend the tourism industry, the CDC waited two weeks before advising pregnant women to avoid travel to the Caribbean islands where Zika was spreading. In 1993, Jack in the Box denied that its undercooked hamburgers were tainted with E. coli. That outbreak ultimately killed four children and hospitalized 171 other Americans.
Our national dairy industry is clearly fighting a major epidemic of H5N1 avian flu. We are not being told exactly how big it is, but it has been spreading at least since December and has already infected herds from Texas to Michigan to Idaho to North Carolina — a huge swath of the country. In a national sampling, 20 percent of samples contained viral fragments.
We’ve been repeatedly reassured that milk is safe because pasteurization kills the virus. But the FDA issued that opinion on April 23, even before it had done a national sampling or had proof that pasteurization actually did kill H5N1. There are more than 25,000 dairy farms in this country serving more than 1,000 dairy plants. Those plants are inspected “at least twice yearly,” according to the USDA. Milk is a competitive business with high transport costs, lots of spoilage and, in some states, caps on prices. It’s not a high-profit enterprise and some plants are aging. It’s hard to believe that semi-annual or even quarterly inspections can guarantee that the millions of gallons of milk that flow through those dairies every day are always heated enough to be 100% safe. If the USDA is stepping up routine enforcement, they should tell us how. State health agencies should also explain what they are doing, since the USDA regulates interstate shipping and many states (including New York) rely heavily on local supplies.
And then there’s raw milk — a secretive industry because many states ban its sale and the Federal government bans interstate transport. Some farmers get around that by creating coops or “cow shares” in which each customer is legally a part owner, rather than a buyer. A 2022 study found that one percent of Americans consume raw milk products regularly and 4 percent do occasionally.
Last week, Iowa State University researchers issued a terrifying study describing an outbreak in 24 cats who drank raw milk and colostrum on a Texas dairy farm whose cows were teeming with virus. They fell ill within a day, suffered “copious oculonasal discharge,” lost control of their limbs, walked in circles, became lethargic and went blind. More than half died.
Cats are not humans — any more than canaries are coal miners — but the virus clearly went straight to their brains and killed them. That’s an ominous sign.
Why is the CDC director not on television telling Americans to avoid raw milk right now? Where is the national plan to test dairy workers, who are often uninsured immigrants exposed to mists of raw milk when hooking up milking machines or power-washing floors?
Why are worried parents not being encouraged to heat milk before giving it to their children or to substitute oat or almond milk, at least until this bovine epidemic is clearly under control? (I still pour milk in my coffee, but I microwave it first. If I had young children, I would be nervous.) Whenever a city’s water is perfectly safe but slightly off-color, residents are reassured that, if they’re anxious, they can boil it. But water, unlike milk, is not sold by a powerful private industry. (When it was, in nineteenth-century London, the water companies denied being to blame for cholera outbreaks even as their intake pipes sucked in sewage from the Thames.)
Why are major news outlets so blasé? If one child dies, this will be a bigger story than tents on campuses or how awake Donald Trump can stay in court. Has Covid left us so pandemic’d out that we’re too tired and distrustful to worry anymore? Are we too easily reassured by our health agencies? (In the early days of monkeypox, many reporters accepted CDC assurances that “ring vaccination”would control the epidemic, when it clearly could not; the agency ultimately gave in and offered vaccines to all sexually active gay men.)
I am not yet fearful that H5N1 will kill millions of us. I did fear that in 2006, when the virus had killed 60 percent of the roughly 300 people it infected. But the threat receded. Since a brief surge in Egypt in 2015, there have never been more than a dozen confirmed cases in any year, and most victims survived. Transmission was by bird blood or feces — it killed poultry slaughterers, feather pluckers and consumers of duck-blood pudding. Although there were a few clusters in which human-to-human transmission was suspected, it was never proven.
Over the years since, the virus has split into many variants. The virologist Ron Fouchier of Erasmus Medical Center has speculated that some changes made it better at infecting wild birds. (Flus originate in ducks and geese; H5N1 has now been found in everything from pigeons to turkeys to bald eagles.) In theory, such changes might have lowered the threat to us. But they would almost undoubtedly not eliminate it. And a study released this week suggests that cows, like pigs, could become “mixing vessels” in which different flu strains can swap genes, breeding new ones.
We have been reassured that the variant now in our cattle makes them only mildly ill. The one Texas dairy worker known to have been infected by cows suffered only pinkeye. But there are ominous notes even in the dry CDC case report: a real investigation, with sampling of cows, equipment and other workers was “not able to be conducted.” The worker, who had no eye protection or mask, did not return to the public clinic for follow-up or let investigators test his household. CBS News quoted a Texas state health official saying the worker “did not disclose the name of their workplace.” Science magazine has reported that dead farm cats have been found since February and that veterinarians have noticed lethargic-looking workers with pinkeye and coughs who refuse to be seen by doctors.
An uncooperative industry with intimidated workers is the perfect setting for a clandestine epidemic that would help the virus adapt to humans.
No doubt the dairy industry fears alarmist headlines that will kill sales. But our health agencies must be more open about how big the potential threat we are facing is, and what’s being done to stop it. At a minimum, one of the most dangerous and disgusting industry practices must be banned: feeding “poultry litter” — nutrient-rich chicken feathers and feces — to cattle. The Iowa State study tentatively blamed the dairy farm outbreak on “feed contaminated with feces from wild birds,” but that seems hard to believe. How could passing ducks and gulls excrete the rivers of poop that would have been needed to almost simultaneously infect herds all over the country?
We are being tucked under a comforter of reassurance with a glass of warm milk. We should rebel against that and demand more openness and more aggressive action from our public health leaders.
This article (in a condensed milk version) was first published by The Free Press on May 7, 2024
Donald G. McNeil Jr., who for decades covered global health for The New York Times, is the author of The Wisdom of Plagues: Lessons from 25 Years of Covering Pandemics.
