JEFFERSON CITY, Mo. (AP) – Health officials say a hospitalized patient in Missouri was infected with the bird flu, despite having no known contact with dairy cows or other animals.

The case is the 14th confirmed in the U.S. since March. That’s when the virus was detected for the first time in cows. The person was hospitalized on August 22nd with other medical conditions.

The bird flu infection was first detected through routine influenza surveillance rather than through targeted efforts to identify people infected through exposure to dairy cows and poultry.