A study published Thursday by the Centers For Disease Control and Prevention suggests bird flu infections in humans are being significantly undercounted in the U.S.

A new study shows that bird flu has silently spread from animals to some veterinarians. The study published Thursday by the Centers for Disease Control and Prevention echoes two smaller ones that detected evidence of infection in previously undiagnosed farmworkers.

It also could mean there are more “virus–infected dairy cattle in states where infection in dairy cattle has not yet been identified,” the CDC says. Human cases of bird flu still remain rare, with only 68 cases confirmed in the United States by the CDC.