H5N1 at the County Fair

STAT conversations with exhibitors in NE Iowa highlights barriers to testing

As an Iowa farm boy and later on-farm 4-H father and club leader, I have many fond memories of days at the County (and Iowa State) Fairs many years ago. I even have photographic proof of participation:

Here is my younger brother and me 60 years ago m/l with our swine project at the Humboldt County Iowa County Fair. I may have had a dairy heifer that year, also, but no photographic proof to show for it! Note the rolled cuffs on the newly purchased blue jeans - a real rural Iowa male fashion statement, with the bonus of lasting through the coming school year! Iowa farm families were nothing if not practical.

As I recall, influenza (H1N1) was an episodic fall disease in pigs only, treated with sulfathiazole and expectorants for 3-5 days in the water. It surely wasn’t on the radar during fair season in the 1960’s, even in pigs! Poultry HPAI had not yet entered the scene as a reportable disease of concern either. Even in my veterinary school years in the mid-70’s I don’t not recall extensive lessons on influenza beyond a lecture or 2 on swine influenza and the great human pandemic as a public health lesson.

This morning STAT ran a report from NE Iowa at the Winneshiek County Fair Dairy Show (please subscribe if required to read the entire article- STAT is very much worth the minimal monthly investment):

Bird flu outbreak at county fair time: precautions in the dairy barns | STAT (statnews.com)

County fairs bring together the entire swath of rural residents in surrounding counties, offering a diverse and honest look at “where people are at” in assessing issues that many of us assume everyone should see just like we do.

Here is a segment of the article that demonstrates the challenges we all face in assuming that everyone would want to test dairy herds for H5N1 status:

Even within a 10-mile radius, though, there could be irreconcilable views. To Hannah Vagts, the 16-year-old “County Dairy Princess Alternate,” who’d earned her sash and tiara milking on two farms, testing was what made the fair feel safer for animals when so much about this virus is still unknown. To D.M., the co-owner of a herd of 500, who wanted to be identified only by initials, testing was the reason he was sitting this year’s cow shows out.

“They’ll test the cows’ milk, that way they’ll find out if there’s any more of it out there, which is none of their business, as far as I’m concerned,” he said. If bird flu had arrived on his farm, he didn’t want to know. He’d of course isolate any sick animals in the sick pen, and discard their milk, the way he always does. The cows are his livelihood. He takes care to keep them healthy, and to keep his product pristine. But he’s too afraid of the stigma that might accompany a positive test — so afraid that he wouldn’t even apply to the federal program that would reimburse him for liquid pounds he couldn’t sell, leaving money on the table. Vets were hearing such views from other clients, too, and nationally, only around 30 producers have applied for government compensation.

“If it shows up, you don’t know if your creamery is going to keep taking your milk,” he said, even though the protocol is for sales to start back up again after a 30-day hiatus.

We are as a group self-selected to understand “One Health”, collaborative actions, and necessity for sharing of data to advance our public health safety and well-being. However, we must recognize the counter-narrative of entrepreneurship, self-reliance, and right to privacy that are also bedrocks of the social structure in much of rural America.

My purpose here is not to lecture or shame anyone; rather, I think we just need to keep up the dialogue and continue to develop creative ways to gather the critical information we must collect on viral genomics and human risk, while still respecting livestock stakeholders’ dignity and right to privacy. much as we would like to “just order testing”, the reality is that we don’t have the social capital under current risk assessments to do that. Producers may increasingly collaborate, leading to increased testing; alternatively, greatly increased zoonotic potential may necessitate more drastic testing requirements. Nothing remains static, least of all H5N1!

Maybe there is ultimate wisdom in the 4-H pledge:

Clearer thinking, greater loyalty, larger service, better living - a great life-long pledge I’ve known for 62 years!

John