HPAI and the Health of the Agricultural Community

Why Talk about HPAI and the Health of Agricultural Communities?

A farmer's job requires stewardship of their land and attending to their stock, but these tasks can become much more challenging during a disease outbreak. Highly Pathogenic Avian Influenza (HPAI) H5N1 has focused attention on biosecurity practices to protect our herds and flocks. Even though the human aspect of managing a disease outbreak can be taxing on farmers and farm workers, it has received much less attention.  The financial repercussions producers may incur due to an outbreak, along with the loss of livestock in some cases, can be overwhelming, even with preparation

Producers can reduce the likelihood of a disease outbreak by implementing biosecurity measures and educating employees, family members, and other visitors to the farm. Beginning in March 2024, several states reported dairy herds displaying signs caused by HPAI. And, while the CDC notes that the risk from the avian flu in humans is low, cases of avian flu have been reported in people working on dairy farms as well as workers on commercial poultry farms due to the close and direct contact with the animals and birds (CDC, 2025).

In reported cases of HPAI among dairy workers, it was found that routes of exposure included workers engaged in tasks connected to milking or cleaning the milking parlor (Mellis et al., 2024). Importantly, none of the infected workers reported using personal protective equipment (PPE) recommended for working with infected animals, in particular a face mask such as an N95 and eye protection. Farmers and farm workers may be reluctant to use it as wearing eye protection in restricted spaces with warmer temperatures can limit visibility and affect their ability to safely perform their jobs (Bagdasarian et al., 2024). The limited access to PPE may also play a role in worker exposure and illness. In Colorado, following the detection of HPAI A (H5N1), officials found that PPE use increased on dairies with the support of farms receiving PPE supplies from local and state public health agencies.  In particular, the use of eye protection increased (Marshall et al., 2024). Farm owners and managers can work with their state and local health agencies to source PPE, or they can purchase it from supply companies.

Steps to Take to Protect People on the Farm

These are general biosecurity recommendations that can be adapted depending on the level of risk and outbreak status:

• Have PPE available on your farm. Periodically review how and when to use PPE with all staff on the farm, including medium and high-risk
• For a medium-risk activity, such as infected birds or animals on the farm, the recommendation is to wear safety glasses or goggles, gloves, and a NIOSH-approved particulate respirator.
• For high-risk activities such as handling sick or dead infected animals or birds, the recommendation is to also wear coveralls, boots or boot covers, and hair covers. It is also recommended to wear waterproof aprons and face shields.
• For more information on measures to take based on the level of exposure, see 
• Reducing Exposure for Workers to Avian Influenza A Viruses.
• If not wearing PPE, the CDC recommends avoiding direct or close contact with:
  • Any animals that are or might be sick, or animals that have died.
  • Feces, urine, litter, milk from infected animals, along with the internal organs or udders from lactating dairy cows.
  • Surface and water that might be contaminated with feces, urine, or waste milk from potentially infected animals.
• Make sure handwashing stations are supplied with the necessities - warm water, soap, disposable towels, and a waste receptacle. Wash your hands!
• Provide facilities for workers to change clothes and boots at the farm.
• Have an everyday biosecurity plan for your farm and implement it to decrease the risk of an outbreak. Review the disease transmission risks associated with people and their movement. USDA APHIS (2025) highlighted the risks associated with personnel working on multiple farms or visiting other farms to provide support services. Penn State Extension has several resources to help you develop a biosecurity plan, including a recorded webinar that talks through the Pennsylvania Biosecurity plan template and one about everyday biosecurity practices.
• If a herd or flock is infected, watch for these symptoms in people: cough, sore throat, runny or stuffy nose, headache, fever (greater than 100°F) or chills, difficulty breathing or shortness of breath, fatigue, diarrhea, and be extremely alert for eye redness. It is recommended to seek help from a healthcare provider if these symptoms are severe.

For additional information on worker health and PPE, go to Reducing Exposure for Workers to Avian Influenza A Viruses.

Additional Effects of an Outbreak on the People

Even if you and the other people on the farms do not get sick, experiencing an HPAI outbreak on the farm can take a toll on people’s mental health and well-being. Previous work among farmers who experienced disease outbreaks on their farm shows that there is a toll from the increased workload caring for sick animals, emotional and physical fatigue, decreased production, and in some cases, animal depopulation on the farm. As a result of an outbreak, farmers report being overly attentive or focusing constant attention on their flock or herd (hypervigilance), stress, anxiety, depression, trauma, and financial challenges (Crimes and Enticott, 2019; Noller et al., 2002; Peck et al., 2022; Purc-Stephenson and Doctor, 2025).

 Farmers and farm workers who have experienced a disease outbreak mentioned that the following helped:

• Consult information about outbreak response and who to contact. In Pennsylvania, sources of information include the Pennsylvania Department of Agriculture, the Pennsylvania Animal Diagnostic Laboratory System, and the Pennsylvania Center for Dairy Excellence. Your dairy or poultry veterinarian is also always a great source of information and will know to whom to refer your questions.
• Implement biosecurity protocols and farm emergency risk management
• Consider your well-being and seek support. This includes talking with family, friends, other farmers, and veterinarians. Outbreaks are tragic events, and talking with people is an important source of support.
• Talk with a primary care doctor, behavioral health specialist, or a faith leader. While it is less commonly done, it is helpful during hard times.
• Call a crisis helpline. There are several helplines focused on serving the unique needs of agricultural communities, including the AgriStress Helpline^SM for Pennsylvania: 833-897-2474 (call or text) or Farm Aid at the national level: 1-800-327-6243. Help is available in English and in Spanish.
• Check in on the others on the farm and offer help if they are not doing well (including by sharing this information). Not everyone reacts the same way. Even if you feel OK, others might not.
• Seek out financial support. Sources of support to help with the shortfall experienced on the farm include the Pennsylvania Department of Agriculture Highly Pathogenic Avian Influenza Recovery Reimbursement Grant and the USDA Emergency Assistance for Livestock, Honeybees, and Farm-Raised Fish (ELAP) Program.

For More Information

To learn more about avian flu and steps to reduce risks, there are several resources you can consult.

From Pennsylvania, this includes:

• Penn State’s Q&A article about what you need to know about avian flu,
• The Pennsylvania Department of Agriculture Guidance,
• The Center for Dairy Excellence HPAI Dairy Industry Conference Calls page provides updated information and archived recordings for the PA dairy industry.
• The Center for Dairy Excellence and Penn State Extension are also collaborating to make available Everyday Biosecurity Kits, which include biosecurity tools, resources, and signage from the National Dairy FARM Program and SMS Secure Milk Supply. A biosecurity plan template is part of the kit.

Additionally, for more information focused on workers’ health and well-being, you can consult:

• Centers for Disease Control Information for Workers Exposed to H5N1 Bird Flu
• The avian flu toolkit from the Upper Midwest Agricultural Safety and Health Center,
• Guidance for dairy workers in English and in Spanish from the Migrant Clinician Network.
• Resources for farmworkers from the Northeast Center for Occupational Safety and Health.
• Guidance for developing a safety plan to reduce exposure to Avian Influenza A Viruses.
• Penn State Extension: Resources to Support Mental and Financial Well-being in Agriculture

References

Bagdasarian, N, Wineland, H, and Callo, SL. 2024. Personal protective equipment guidance for highly pathogenic avian influenza H5N1 should be adapted to meet the needs of dairy farm workers. J Infectious Diseases 230:543-544. doi.org/10.1093/infdis/jiae380.

Centers for Disease Control and Prevention. 2025. H5N1 bird flu surveillance and human monitoring: weekly snapshot for week ending June 14, 2025. 

Crimes, D., & Enticott, G. (2019). Assessing the social and psychological impacts of endemic animal disease amongst farmers. Frontiers in Veterinary Science, 6, 342.

Marshall, KE, Drehoff, CC, Alden, N, Montoya, S, Stringer, G, Kohnen, A, Mellis, A, Ellington S, Singleton, J, Reed, C, Herlihy, R, and Colorado Field Team. 2024. Personal protective equipment use by dairy farmer workers exposed to cows infected with highly pathogenic avian influenza A (H5N1) viruses – Colorado, 2024. MMWR 73(44):999-1003. dx.doi.org/10.15585/mmwr.mm7344a2.

Mellis, AM, Coyle, J, Marshall, KE, Frutos, AM, Singleton, J, Drehoff, C, Merced-Morales, A, Pagano, HP, Alade, OR, White, EB, Noble, EK, Holiday, C, Liu, F, Jefferson, S, Li, Z, Gross, FL, Olsen, SJ, Dugan, VG, Reed, C,…and Levine, MZ. 2024. Serologic evidence of recent infection with highly pathogenic avian influenza A(H5) virus among dairy workers – Michigan and Colorado, June-August 2024. MMWR 73(44):1004-1009. dx.doi.org/10.15585/mmwr.mm7344a3

Noller, G., Doolan-Noble, F., Jaye, C., & Bryan, M. (2022). The psychosocial impact of Mycoplasma bovis on southern New Zealand farmers: The human cost of managing an exotic animal disease incursion. Journal of Rural Studies, 95, 458-466.

Peck, D. F., Grant, S., McArthur, W., & Godden, D. (2002). Psychological impact of foot-and-mouth disease on farmers. Journal of Mental Health, 11(5), 523-531.

Purc-Stephenson, RJ, and Doctor, J. 2025. “The hill in front of you”: a qualitative study of the mental health impact of livestock diseases and depopulation on farmers. J of Agromedicine Online ahead of print. DOI:10.1080/1059924X.2025.2470967.

USDA Animal and Plant Health Inspection Service (APHIS). 2025. Highly pathogenic avian influenza H5N1 genotype B3.13 in dairy cattle (PDF) – National Epidemiologic Brief.