The CDC study provides the largest window to date into how the bird virus first detected in March in dairy cows may be spreading to people. It suggests that the virus has infected more humans than the 46 farmworkers identified in the U.S. as of Thursday. Nearly all were in contact with infected dairy cows or infected poultry.

The Centers for Disease Control and Prevention (CDC) is updating its recommendations for testing, treatment and protection for workers who may be exposed to animals infected with bird flu. The update comes after the agency found evidence of dairy workers with positive antibodies,