Editorial: Avian Influenza (H5N1): Agricultural and Poultry Workers on the Front Line of Exposure – a Short Route to a Global Pandemic?

For three days Maria is ill with influenza, sneezing and suffering a mild fever and headache. But it’s normal because it’s the ‘flu season. She arrives at work feeling tired and soon her sneezing and coughing is worse. Too much dust, but that’s normal too. This morning she’s working in the Live Birds Retrieval area at the plant, taking live chickens from the crates and hanging them feet-first in the shackles. In the last crate four chickens are already dead. She reaches into the crate and puts them into a plastic garbage bag for disposal. At that moment she inhales some dust contaminated with feces of the dead birds. The dust carries the avian influenza virus H5N1 into her lungs, were it will begin to infect her cells. The H5N1 virus swaps genes with the human influenza virus she already has. It mutates and, in the medical community’s worse case scenario, becomes capable of human-to-human transmission. Maria continues sneezing for the rest of the day. It’s the ‘flu season, so it’s normal. Maria is now ‘patient zero’ in the beginning of a new human influenza pandemic.

This fictional scenario – as frightening as it may seem – is not meant to add to the panic over avian influenza. Nor is it suggesting that a global pandemic is inevitable. In its present form the avian influenza type H5N1 virus cannot be transmitted from people to people. But scientists around the world are nervously tracking the mutation of the avian influenza H5N1 virus as it adapts to new environments and interacts with other influenza viruses. There is a very real concern that if the H5N1 virus mutates and becomes capable of human-to-human transmission, then we could witness a global influenza pandemic like the one in 1918 which killed more than 50 million people.

Avian influenza outbreaks have occurred in 30 countries in Asia, Europe, Africa and the Middle East, infecting and killing hundreds of thousands of birds, and prompting the culling of millions more in a desperate attempt to contain its spread. As of 6 March 2006, we know of 173 people infected with the H5N1 strain of avian influenza virus; and 95 of these people died. Among the 95 deaths officially reported were 3 poultry workers (China, Thailand, and Indonesia). But there are unknown numbers of poultry workers who have been exposed to the virus (with blood tests in Japan and Indonesia, for example, showing prolonged, low-intensity exposure without signs of serious illness) and many cases have gone unreported.

In its current form, the transmission of the virus from birds to people occurs as a result of direct contact with the blood or feces of infected birds, or contact with surfaces and dust contaminated with the feces of infected birds. This is what has killed 95 people so far. And this is also what makes the story of Maria – and the millions of Marias employed in the poultry industry globally – so important. Agricultural and food workers in the poultry industry come into daily, direct contact with live birds, as well as blood, body fluids, feces and all kinds of surfaces and dust contaminated with feces. This means that they are not only on the front line of exposure to the avian influenza H5N1 virus as an occupational hazard, they are also the most likely vector for a mutated form of the virus capable of human-to-human transmission. Despite this very serious risk to public health, few national and international policies and guidelines seriously address this linkage between poultry workers and public health.*

Given the role of poultry workers as the levee holding back the flood waters of a potentially devastating global pandemic, it is time to put the situation of poultry workers at the very centre of public debates and policy discussions on how to prevent this disaster. It is also vital that agricultural and food workers’ unions play an active role in raising public awareness of a fundamental aspect of our capacity to deal with this infectious disease: those who work on poultry farms and in poultry breeding facilities and processing plants are on the front line of the battle against avian influenza. What this means is that poultry workers have the potential to identify infected flocks and ensure that outbreaks are quickly and properly contained. They are also in the best position to determine whether minimum food safety standards are being implemented, and whether processed poultry meat and eggs are handled in ways that minimize the risk of infection. The active role of unions in demanding, monitoring and implementing health and safety measures protects the public interest, and in doing so, can rebuild public confidence in the safety of poultry products. Most important of all, such measures to poultry workers will reduce the opportunities for the mutation of the virus into something far more lethal.

But workers like Maria cannot fulfil this role unless they are accurately informed and appropriately trained. In many countries workers cannot act if they risk dismissal or punishment for reporting suspected outbreaks to the authorities; if they lack the protective equipment and facilities necessary for both their own safety and food hygiene; if they have no access to public health care and treatment; or if their livelihoods are at risk because they will not be compensated for lost wages or layoffs resulting from containment measures. As we recently saw in Nigeria, agricultural workers were not only forced to slaughter and dispose of infected chickens without gloves, they also avoided medical tests for fear of discrimination and dismissal if found to be infected with the virus. Already working for poverty wages, the threat of unemployment was ultimately greater than the threat of avian influenza. This brings us to the most basic point of all: if agricultural and food workers are kept in the dark or deliberately misinformed, or if they are denied their rights, including the right to organize, their ability to be proactive in battling avian influenza (or even to know about the virus and the risks it poses) is seriously diminished. In other words, when trade union rights are repressed, workers on the front line in the battle against a global viral pandemic are effectively disarmed.

Read more about H5N1 and the link between workers’ rights, working conditions, food safety and public health

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*Agencies like the Centre for Disease Control and Prevention (CDC) in the US recognize that international data on human cases of infection may not reflect the reality, since only the most severe cases are reported. Centre for Disease Control and Prevention (CDC), Key Facts About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus (7 February 2006):
https://www.cdc.gov/flu/avianflu/