A second health worker in contact with the Missouri patient who tested positive for H5N1 also developed respiratory symptoms but wasn’t tested for influenza, the Centers for Disease Control and Prevention said Friday. The Missouri bird flu patient, who didn’t have known contact with poultry or dairy cows, was hospitalized in August and tested positive for the H5 virus. The person, who had severe underlying conditions, has since recovered.

The CDC reported last week that a health care worker who cared for the patient developed mild respiratory symptoms and tested negative for influenza. Additionally, a person who lived with the Missouri patient also became sick on the same day . The household contact had gastrointestinal symptoms, an agency spokesperson said, which can sometimes be associated with an influenza infection.

Initially, Dr. Nirav Shah, the CDC’s principal deputy director, had stated on a call with reporters last week that none of the patient’s close contacts showed signs or symptoms of illness, calling the situation a possible “one-off.” Since then, the three contacts have been identified, but it’s still not clear if they were sick with the H5 virus.

The CDC has collected blood samples from the Missouri patient and household contact. It will do so-called serological testing that could confirm a previous H5N1 infection, although the tests could take several weeks. The CDC said Friday that the second health care worker wasn’t tested for influenza beca.