There is great concern from clinicians we talk to that many of the migrants we serve, specifically those who work for large agricultural companies that raise and slaughter pigs and chickens (CAFOs-- concentrated animal feeding operations) are at high risk for not only contracting H1N1 but also because of frequent migration and crowded living conditions they are likely to spread the virus rapidly. Even a greater “theoretical concern” that we have is that these workers may be a source of new novel more virulent strains of the H1N1 virus because of their constant daily close exposure to pigs and chickens. We have tried to explain to the CDC, NIOSH, OSHA that this group of workers should be in the category of “high risk” and therefore eligible for both early vaccine and treatment if illness occurs.
Unfortunately, we have been unsuccessful for a variety of reasons. This population, as you probably know, are for the vast majority, recent immigrants and frequently undocumented. So, it is always “controversial” when we try to highlight this population.
A recent article: http://www.ehponline.org/members/2009/117-9/focus.html [2] more completely describes many of my concerns.