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annm4peace

(6,119 posts)
Wed Aug 7, 2013, 12:23 AM Aug 2013

Serious medical crisis is looming in two California prisons. Valley fever a sometimes lethal fungus

http://fresnoalliance.com/wordpress/?p=8135


The Fungus Among Us
By Maria Telesco

At the time of this writing, a serious medical crisis is looming in two California prisons. Valley fever, which is caused by the sometimes-lethal aspergillus fungus, may be threatening 2,000–3,000 men at Pleasant Valley (Coalinga) and Avenal state prisons. The federal government’s Centers for Disease Control (CDC) reports that valley fever increased nationwide by 850% between 1998 and 2011. The largest increase of the disease has occurred in the region where the two prisons are located: Coalinga, in Fresno County, and Avenal, in Kings County, about 60 miles southwest of Fresno, and about 10 miles apart from each other, in an area where the fungus is endemic.

Media sources report that since 2006 there have been about 36 inmate deaths and “hundreds of hospitalizations” of men incarcerated at Avenal and Pleasant Valley with valley fever. Wind stirs up dusty desert dirt and releases the fungus, lying in wait beneath the surface, eager to smother its victims. Aspergillus is only one of several organisms that can cause the disease, but it has been identified specifically as responsible for multiple California prison deaths.

Valley fever, which is caused by fungi such as aspergillus and coccidioidomycosis, usually attacks the lungs but can affect bones, eyes and other body parts as well. Hardy forms of the fungus can survive for a long time in environments of extreme heat, cold and drought; it spreads through spores in the air when the dirt is disturbed. Federal government statistics say that hundreds of thousands of aspergillus and coccidioidal infections occur each year in the United States, although more than half of these infections do not produce symptoms. Not everyone who encounters the fungus gets sick, but those relatively few who do get sick can get very sick.

When dirt containing the fungus is dislodged by digging, construction work or strong winds, and airborne dust particles containing fungal spores are inhaled, construction and farm workers, military personnel, archaeologists and others in the area become vulnerable. They cannot catch it from anyone who has the disease; if they’ve had it and survived, they cannot get it again.

Valley fever is difficult to prevent. There is currently no vaccine; efforts to develop a vaccine are ongoing. Persons at risk of valley fever should avoid exposure to dusty air in locales where the disease is common. Those exposed to dust during their jobs or outside activities in these areas should consider respiratory protection, such as a mask, during such activities.

Medical authorities say African-Americans and Filipinos are most likely to be affected, along with others whose immune systems are compromised. There has been talk about transferring men who are vulnerable to the disease to other prisons. Due to various delays, only a few transfers have taken place so far.

However, help and hope may be on the horizon. Federal Judge Thelton Henderson, who oversees prison health issues (while many others overlook them), ruled on June 24 that the California Department of Corrections and Rehabilitation (CDCR) must transfer men from locations where the sometimes deadly aspergillus fungus is endemic to areas where it’s absent. The ruling applies specifically to inmates who are at risk for getting valley fever from the organism. He ordered the CDCR to start moving the men within seven days and complete the moves within 90 days. On July 2, CDCR officials stated they will comply with Judge Henderson’s order.

Associated Press reported on July 13 that some paroled prisoners who contracted valley fever while in prison are suing the state for lifetime medical care. While many cases of this fungus-caused disease have few or no symptoms, some are life-threatening and may be lifelong. Those victims of the disease might recover with or without medication and could be immune for life. Others, with more serious cases, remain sick for life; they require medication for their entire life and would likely die without it.

The state’s policy is to release seriously infected parolees with a one-month supply of medication. After that, the parolee is responsible for providing his own medications. There are few medications that can control the fungus in the patient and even fewer that can cure the patient by killing the fungus entirely.

Diflucan (generic name Fluconazole) and Sporanox or Onmel (generic name Itraconazole) may be taken by mouth in pill form. Depending on the amount of the drug needed and where purchased, the cost of these might be up to about $10 a day. For patients who have a worse condition and need a stronger drug, there’s Amphotericin B (generic name), brand named Abelcet or Amphotec, which is known in the medical profession for its many unpleasant side effects. This must be taken intravenously daily, and the cost can run up to more than $2,000 per month.

Months ago, lawyers for the CDCR wanted to postpone the transfers until the CDC and the National Institute for Occupational Safety and Health conduct a study. The CDC says the study should be completed by December. Henderson’s order and the CDCR’s compliance agreement would probably void that request. Governor Jerry Brown has said it would be “impractical” to move about 3,000 men. Others say it’s “inhumane” not to transfer them away from the killer fungus that has already claimed too many lives.

It’s going to take a lot of work to transfer about 2,600 prisoners out of various facilities in order to transfer 2,600 others in. But it can be done. I recall a few years ago when I visited Angola, Louisiana’s Level Four men’s state prison. Everyone was still talking about the recent flood. There had been hurricanes, and the Mississippi River, which forms one “wall” of the prison, flowed over into Angola. It also flooded nearby men’s and women’s prisons.

It didn’t take long for Angola inmates and staff, working together, filling sandbags, and opening up some old buildings in a relatively dry area of the large facility, to make the yards habitable. Within hours, they managed to bring in hundreds of inmates from two other prisons, put the women into a safe area and put everyone to work. And they did this with no fights, no rapes, no escapes, just people helping each other to survive. We can do that here, too, if necessary.

I wouldn’t wish valley fever on my worst enemy. About a dozen years ago, my brother was gardening on a windy day. A few days later, neighbors found him on the ground, barely breathing, and rushed him to the hospital. He was on life support, a machine breathing for him through a tube, for several weeks. Doctors told us he would probably die, but miraculously, he survived. He had aspergillus pneumonia. The fungus in his small home garden got into his lungs and caused the infection. It took months before he could resume normal activities, and he still suffers from ongoing respiratory problems.

My turn came about five years ago. I was having terrible headaches, pains in my eyeballs and couldn’t breathe through my nose; I breathed only through the mouth. I was diagnosed with aspergillus sinusitis, a dangerous infection caused by the microorganism. I had to undergo sinus surgery to “roto-root” out the nasty fungus from my sinuses. The doctors told me that sometimes the fungus gets “aggressive” and wiggles its way through the extremely thin bones between the sinuses and the brain, then attacks the brain, causing death.

Here in the Valley we definitely have the fungus among us. So why do the powers-that-be drag their feet, dawdling about getting those at-risk prisoners somewhere else, out of harm’s way, to prevent God-only-knows how many more deaths or hospitalizations? We can pack up and leave, go to a safer location; they can’t.

When we don’t get an acceptable answer, or can’t figure one out, it’s easy for prisoners, and those of us who advocate for them, to hurriedly blame “The Department.” But the CDCR is people who, like most of us, are just trying to do their jobs. The men and women who constitute the CDCR are powerless to act if the politicians and bureaucrats in the ivory towers refuse to acknowledge a problem exists, thereby withholding the funds and authority needed to fix it. Those two prisons definitely have a problem that needs fixing.

Our national culture has popularized a false concept that prisoners—one percent of our total national population—are subhuman critters who don’t deserve even the minimum of anything. Every day letters to the editor are full of comments like “So let them die, they don’t deserve medical care” or “Let them starve to death.” We are better than that. We need to follow up on this problem and be ready to deal with the politicians and bureaucrats if they don’t do what’s right to save the lives of these prisoners. Stealing a car or robbing a bank does not warrant a death penalty.

*****

Maria Telesco is a retired registered nurse who has volunteered in various aspects of prison ministry for more than 25 years. Contact her at maria.telesco@sbcglobal.net.
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Serious medical crisis is looming in two California prisons. Valley fever a sometimes lethal fungus (Original Post) annm4peace Aug 2013 OP
Maria Telesco needs to use Google a little more. Valley Fever is kestrel91316 Aug 2013 #1
she is a nurse and has seen many with Valley Fever annm4peace Aug 2013 #2
You may well trust her, but she's still wrong. n/t Egalitarian Thug Aug 2013 #4
I disagree with you annm4peace Aug 2013 #5
Fine, as my father used to say no skin off my nose, but that just makes both of you wrong. n/t Egalitarian Thug Aug 2013 #6
The treatment used to be bed rest. Downwinder Aug 2013 #3
 

kestrel91316

(51,666 posts)
1. Maria Telesco needs to use Google a little more. Valley Fever is
Wed Aug 7, 2013, 12:32 AM
Aug 2013

caused by one organism and ONLY one organism: Coccidioides immitis.

No Aspergillus species has anything to do with Valley Fever. Aspergillus causes aspergillosis, a completely different fungal infection.

I know that this might seem like hair splitting to some, but words do have meanings and that's especially true in science and medicine.

Valley Fever is never contagious from person to person - it is an opportunistic infection and the organism is harbored in the soil. I don't think aspergillosis is contagious either, but I am only 90% certain of that. If a person is immunosuppressed, they might be able to catch if from someone who has it, but I have always considered it another opportunistic infection.

They are both very costly to treat. If prisoners catch either one, I assume it's a death sentence because our prisons don't provide anything resembling adequate healthcare.

annm4peace

(6,119 posts)
2. she is a nurse and has seen many with Valley Fever
Wed Aug 7, 2013, 12:48 AM
Aug 2013

I doubt she used "Google" for her research of Valley Fever or the article. I trust her.


"Aspergillus is only one of several organisms that can cause the disease, but it has been identified specifically as responsible for multiple California prison deaths."

I did "google" it and this site popped up first

http://aspergillusblog.blogspot.com/2013/07/valley-fever-another-inhaled-fungal.html

my best friend's husband almost died from Valley Fever.. it took awhile for the Doctors to realize what he had.

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