Between July and October, states across the country hold their annual state fairs.
The events are known for things like Ferris wheels and corn on the cob, sculptures made entirely of butter, and the state’s largest pig. But state fairs can also spread disease more easily—people and animals from farms across the state come into close contact.
This year is particularly worrying because for the first time, infections with the H5N1 virus (bird flu) have been detected in dairy cows in 13 US states. The virus has also infected four dairy workers in Michigan, Texas and Colorado.
However, this does not stop many fair visitors from lining up in front of the cattle that are just peeking out from behind the stable fences.
Mel Ventimiglia stood with his grandchildren next to several cows in a barn at the Indiana State Fair in Indianapolis. He said bird flu was not an issue for him.
“I haven’t heard anyone talk about it except you,” he told Side Effects. “Hopefully I’ll forget it pretty quickly.”
At another nearby cattle barn, farmer Randy Mason says he is taking basic precautions to prevent his cattle from getting sick during the fair, but he is not particularly worried.
“In my opinion, a lot of this is being overblown,” he said. “You get one or two cases and then – like everything the government does – it gets blown out of proportion.”
But across the country, cases of bird flu have been confirmed in nearly 200 flocks, according to the U.S. Centers for Disease Control and Prevention.
This has prompted those responsible at some state fairs to impose stricter regulations to contain the spread of the virus.
In Minnesota, where cases of bird flu have been identified in dairy cows, the state now requires all cows to test negative for bird flu before being brought to the state fair.
However, this is not the case in many other states, including Indiana, where there are no confirmed cases of bird flu.
“Because we didn’t have a diagnosis, we didn’t take these additional measures,” said Bret Marsh, Indiana State Veterinarian.
He said the state has instructed farmers to monitor their animals for signs of bird flu, warned farmers about the risk of spreading disease when attending the show and advised them to quarantine animals for 30 days after showing – but without a positive test, Marsh said, the state does not need to impose stricter restrictions.
Why are state fairs a problem?
However, scientists largely agree that there are not enough tests being done to clearly determine which states have cows infected with bird flu.
Amesh Adalja, a scientist at the Johns Hopkins Center for Health Security, said there are no confirmed cases of bird flu in cattle in states like Indiana because they are not looking for it.
“You should assume this virus is in the state of Indiana, we just haven’t found it yet,” he said. “That’s the message they should be getting across, not ‘Our cows are free.’ That’s a foolish thing to believe.”
That’s why places like state fairs, where people come into contact with various animals, are particularly worrying. Scientists fear that bird flu could mutate into a human virus if given the opportunity.
Currently, the virus only appears to have infected humans who come into direct contact with the udders and equipment used on infected cows, and has caused cases of pink eye, or conjunctivitis, in humans. The broader concern is that the virus could mutate into a respiratory virus that would spread more easily from person to person.
And fairs have always been places where this transition from animal to human takes place.
In 2012, a major outbreak of swine flu resulted in over 300 infections in the U.S., with most of those linked to attendance at agricultural fairs. And last year, the CDC reported that two people contracted swine flu after attending pig shows.
Every time a flu virus jumps to a new host, it has the opportunity to evolve and potentially turn into a virus that can easily transmit to humans.
Experts fear that the risk of H5N1 evolving into a human virus could increase significantly if the virus spreads to pigs in particular, as pigs are an ideal breeding ground for viruses from different species. This means that the different viruses can share genetic material and learn from each other, potentially mutating and becoming better able to infect humans.
“One of the things that people mention so often in relation to Covid-19 is the animal markets in China, where many different animals and species interact with each other,” Adalja said. “Similar things happen at fairs in the United States. It’s really no different.”
Andrew Bowman, a professor of veterinary preventive medicine at Ohio State University, agrees that mixing animals and people at state fairs poses a risk.
“We were thinking about new pandemic viruses that might emerge in Southeast Asian live animal markets. And we thought, ‘Oh, we would never do something like that in the U.S.’ Well, trade shows kind of mimic that,” he said.
The risk to humans is still low
However, experts like Bowman say that’s no reason to miss the State Fair altogether.
“I still go to the fair, and my family still goes to the fair. I had a milkshake when I was there,” Bowman said.
He added that vulnerable populations, such as people with weakened immune systems, should avoid visiting cattle barns this year.
“Be careful and think carefully about what kind of contacts you need,” Bowman said. “Can I perhaps enjoy the animal exhibitions from a little further away without being in the middle of it all?”
In June, the CDC issued guidelines for state fairs to help curb the spread of bird flu, including a ban on pouring milk on the ground because raw milk from infected cattle is likely to contain live virus. The guidelines also advise keeping cows from different herds separate and urge visitors to wash their hands before leaving a barn.
Earlier this year, the U.S. Department of Agriculture issued a rule requiring cows to test negative for the virus before crossing state borders.
Nevertheless, the CDC believes the risk to humans from the bird flu virus remains low.
Side Effects Public Media is a health reporting cooperative based at WFYI in Indianapolis. We work 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.
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