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In April 2024, a Texas dairy worker tested positive for H5N1 after contact with cattle presumed to be infected. The worker had conjunctivitis—an eye infection or inflammation—as the only reported symptom and recovered. Tests linked the worker’s virus closely to viruses found in cattle, supporting a likely animal-to-human infection. But investigators did not establish exactly how the virus reached the worker, and the eye symptom alone does not prove it entered through the eyes.
What happened in the Texas case?
On April 1, 2024, Texas reported the first U.S. human H5N1 case associated with presumed infected dairy cattle. The Centers for Disease Control and Prevention (CDC) confirmed the infection using RT-PCR testing and genetic sequencing. The worker reported conjunctivitis without other signs or symptoms, received oseltamivir, and recovered. CDC’s May 30, 2024 report documents the case and investigation.
What connects the infection to cattle?
The worker had been exposed to cattle presumed infected with H5N1, and sequencing found that the viruses detected in the worker and cattle belonged to clade 2.3.4.4b and were closely related. Combined with the exposure history, that is evidence supporting a likely spillover from animals to a person. CDC nevertheless described transmission from cows to the worker as presumed; the investigation did not identify a specific infectious contact or directly observe transmission.
How did the virus enter the worker’s body?
The case investigation did not determine the route. It did not establish whether infection followed exposure through the eyes, respiratory tract, or another route, nor which farm task, material, or contact was responsible. Conjunctivitis is the symptom the worker experienced—not proof that the virus entered through the eye. The available evidence supports an animal-exposure link but cannot answer the narrower question of precisely how infection occurred.
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What did later cases and surveillance show?
The Texas case was part of a broader animal-exposure concern, but historical counts should not be mistaken for current totals. In a CDC snapshot current through May 22, 2024, approximately 350 exposed farm workers were being monitored, and 52 dairy-cattle herds in nine states had been identified as infected. Those figures describe that date, not the present.
CDC’s July 7, 2025 situation update described additional sporadic human cases associated with dairy-cow exposure and said surveillance showed no indicators of unusual influenza activity in people. CDC’s U.S. H5N1 risk assessment likewise describes reported human cases as sporadic and primarily linked to animal exposure, with no evidence of human-to-human spread in the evidence it summarizes. These are dated assessments, not guarantees that risk cannot change.
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The historical scale of H5N1 in people also needs careful context. CDC reported 909 human A(H5N1) cases from 23 countries between 1997 and late April 2024; 52% of those reported cases were fatal in that period. CDC cautioned that many cases were likely unreported and that the true case-fatality proportion was expected to be lower. That historical global figure does not describe the Texas worker’s individual outcome or the current risk to people in the United States.
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CDC’s July 2025 assessment described the general-public risk as low and risk as greater for people with job-related or recreational exposure to infected animals, including cows. For workers exposed to infected animals or contaminated materials, CDC advises recommended personal protective equipment (PPE), symptom monitoring, and prompt medical evaluation if symptoms develop. Follow current CDC and employer guidance; no particular equipment brand or model is endorsed here.
Raw milk is a separate exposure concern. CDC reported high levels of H5N1 in raw milk from infected cows, advised people to avoid raw milk and raw-milk products, and said pasteurization inactivates the virus and the commercial milk supply is safe. The recommendation for PPE applies to people working around infected animals or contaminated materials; it is not a substitute for avoiding raw milk.
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