Washington state health officials said four agricultural workers tested presumptively positive for avian influenza, marking the first presumed human cases in the state.

Four agricultural workers in southeast Washington have preliminarily tested positive for bird flu after working with an infected poultry flock at a commercial egg farm. The cases, if confirmed, would be the first time people in Washington have contracted the virus since officials began tracking its rise across the U.

The worker are the first presumed human cases of highly pathogenic avian influenza, H5N1, under investigation in Washington state, the Washington state Department of Health said Sunday. The workers have had mild symptoms and have been offered antiviral medication by the Benton Franklin Health District. None have required hospitalization.