A Disease Without a Cure Spreads Quietly in the West

[Playinghardball]

BAKERSFIELD, Calif. — In 36 years with the Los Angeles police, Sgt. Irwin Klorman faced many dangerous situations, including one routine call that ended with Uzi fire and a bullet-riddled body sprawled on the living room floor.

But his most life-threatening encounter has been with coccidioidomycosis, or valley fever, for which he is being treated here. Coccidioidomycosis, known as “cocci,” is an insidious airborne fungal disease in which microscopic spores in the soil take flight on the wind or even a mild breeze to lodge in the moist habitat of the lungs and, in the most extreme instances, spread to the bones, the skin, the eyes or, in Mr. Klorman’s case, the brain.

The infection, which the Centers for Disease Control and Prevention has labeled “a silent epidemic,” is striking more people each year, with more than 20,000 reported cases annually throughout the Southwest, especially in California and Arizona. Although most people exposed to the fungus do not fall ill, about 160 die from it each year, with thousands more facing years of disability and surgery. About 9 percent of those infected will contract pneumonia and 1 percent will experience serious complications beyond the lungs.

The disease is named for the San Joaquin Valley, a cocci hot spot, where the same soil that produces the state’s agricultural bounty can turn traitorous. The “silent epidemic” became less silent last week when a federal judge ordered the state to transfer about 2,600 vulnerable inmates — including some with H.I.V. — out of two of the valley’s eight state prisons, about 90 miles north of here. In 2011, those prisons, Avenal and Pleasant Valley, produced 535 of the 640 reported inmate cocci cases, and throughout the system, yearly costs for hospitalization for cocci exceed $23 million.

The transfer, affecting about a third of the two prisons’ combined population, is to be completed in 90 days, a challenge to a prison system already contending with a federal mandate to reduce overcrowding. Jose Antonio Diaz, 44, who has diabetes and was recently relocated to Avenal, is feeling “very scared of catching it,” said his wife, Suzanne Moreno.

Advocates for prisoners have criticized state agencies for not moving the inmates sooner. “If this were a factory, a public university or a hotel — anything except a prison — they would shut these two places down,” said Donald Specter, the executive director of the Prison Law Office, which provides free legal assistance to inmates.

The pending transfer has underscored the complexities and mysteries of a disease that continues to baffle physicians and scientists. In Arizona, a study from the Department of Health Services showed a 25 percent risk of African-Americans with newly diagnosed valley fever developing complications, compared with 6 percent of whites.

“The working hypothesis has to do with genetic susceptibility, probably the interrelationships of genes involved in the immune system,” said Dr. John N. Galgiani, a professor at the University of Arizona and the director of the Valley Fever Center for Excellence, founded in 1996. “But which ones? We’re clueless.”

Kandis Watson, whose son Kaden, 8, almost died, had a gut feeling that “something was not right,” she said, when Kaden began feeling sick two years ago. The pediatrician prescribed antibiotics, but Kaden’s health deteriorated, with a golf ball-size mass developing at the base of his neck. The infection enveloped Kaden’s chest, narrowing his trachea.

Kaden was essentially breathing through an opening the size of a straw, said Dr. James M. McCarty, the medical director of pediatric infectious diseases at Children’s Hospital Central California in Madera, where Kaden spent six months. Today the boy is back to his mischievous self, surreptitiously placing a green plastic lizard in his mother’s hair.

But how he contracted valley fever is still guesswork. “I think he got it being a boy, digging in the dirt,” Mrs. Watson said.

Kern County, where Bakersfield is located, had more than 1,800 reported cases last year. At Kern Medical Center, Dr. Royce H. Johnson and his colleagues have a roster of nearly 2,000 patients. Many, like Mr. Klorman, have life-threatening cocci meningitis.

“I got a bad break,” said Mr. Klorman, who is known as Joe. Until illness forced his retirement, he preferred a squad car to a desk job. Now he travels four hours round trip three times a week so Dr. Johnson can inject a powerful antifungal drug into his spinal fluid. In other patients, the disease has been known to eat away ribs and vertebrae.

More at: http://www.nytimes.com/2013/07/05/health/a-disease-without-a-cure-spreads-quietly-in-the-west.html?pagewanted=all&_r=1&

[Sen. Walter Sobchak]

1. This sounds vaguely like the plot of the video game my girlfriend is playing right now

[Auntie Bush]

2. I'd sure hate to get that disease. Hope it stays out west.

[byeya]

3. It has been around for years but seems to be spreading and making infection easier.

Fungal diseases are hard to cure because fungus, not a plant, not an animal, is harder to kill because it is closer on the evolutionary scale to us than bacteria.

[Hell Hath No Fury]

4. I know someone who go that --

years ago from digging up his backyard in Sam Jose. His case was so unusual he ended up in the case books. A very scary and bizarre disease.

[sweetloukillbot]

5. It's been a reality for life in Phoenix since I was a kid

I remember ads that said if you lived in Phoenix for more than 5 years, you've had Valley Fever. I had it when I was about 10, don't remember anything drastic with it - I was just really, really sick for a couple weeks. The biggest threats I've seen lately have been with dogs - it is a serious issue with dogs, its hard to detect and can kill them. It is also pretty debilitating for them for over a month. But this sounds much nastier than I ever remember it being.

[ProudProgressiveNow]

7. I live in Phoenix also...

got it when I was 14.... kicked my ass for 3 months....

[thelordofhell]

8. Arizona.........dry........dusty

Dusty.........DUSTYYYYYY!!!!

I remember those commercials too

[sweetloukillbot]

10. Those commercials scared the SHIT out of me when I was a kid... n/t

[kestrel91316]

6. Fortunately, you can only get coccidioidomycosis from the environment and NOT

from other people. We had a weird outbreak of it after the northridge quake in 1994 - some landslides up in Simi Valley sent a bunch of contaminated dust into the air.

[Cleita]

9. I've heard of it. My county is the next once west of Kern County. A lot of people blame it on the

agriculture particularly the pig and turkey farms that have polluted everything around with pig and turkey waste that's not properly taken care of. Guess who the Rep is there, conservative superstar in the House, Kevin McCarthy Republican Whip. As long as conservatives who are in the pocket of the large agri businesses like Monsanto, are running things nothing will be done to fix it.