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The following article was posted on December 6th, 2017, in the Santa Maria Sun - Volume 18, Issue 40 [ Submit a Story ]
The following articles were printed from Santa Maria Sun [santamariasun.com] - Volume 18, Issue 40

Greater number of valley fever cases reported on the Central Coast

By KASEY BUBNASH

It was 2006 when the Perkins wildfire devastated parts of the Cuyuma Valley. As captain of the Santa Barbara County Fire Department’s hand crew, Rob Hazard spent more than a week installing hand and bulldozer lines to help suppress the fire.

The crew used several bulldozers, and Hazard said he remembers fighting various spot fires that ignited in large dry fields. At some moments, he said his crew was almost completely enveloped in black dust and smoke.

When Hazard came down with a cough and fever about a week later, he called in sick with the flu. But as weeks passed, his symptoms worsened.

“I was extremely tired. I had no energy,” said Hazard, now a battalion chief with the fire department. “I had a really gnarly cough. I would lose my breath just getting up and walking.”

Hazard said he eventually remembered an announcement given by a fire department medical unit leader during the Perkins fire about valley fever. The medical unit leader told the firefighters that valley fever was commonly contracted in the Cuyuma Valley, and that anyone feeling sick should get tested.

It took months for Hazard to be properly diagnosed with valley fever, he said, despite several blood tests and various treatment attempts. His acute symptoms eventually manifested in extreme respiratory issues and joint pain, which caused him to be off duty from mid June until Labor Day that September.

Reports of valley fever cases like Hazard’s are on the rise across California.

From Jan. 1 to Oct. 31 in 2017, Californians reported 5,121 total cases of valley fever, according to data collected by the California Department of Public Health (CDPH), a 25 percent increase from the 3,827 cases reported in the same time period in 2016. This year’s numbers are an even higher leap from the 2,343 cases of valley fever reported in 2015.

But the reason for the spike in valley fever cases is relatively unknown, according to the CDPH.

 

Symptoms and soil

Valley fever, also known to many health care providers as coccidioidomycosis, is an illness that can lead to chest pain, tiredness, fever, coughing, muscle and joint aches, rash, unexplained weight loss, and difficulty breathing—all symptoms that can last more than a month. Although nearly 60 percent of individuals infected with valley fever never get sick, if left untreated, it can infect the brain, joints, bones, skin, and organs, and can cause serious, sometimes fatal illnesses.

African-Americans, pregnant women, elderly, and Fillipino and Hispanic individuals have a higher risk of valley fever manifesting into severe illness, according to the CDPH.

In Hazard’s case, valley fever led to a constant fever, extreme lethargy, and pain in his wrists and ankles. Breathing became so difficult that doctors eventually wanted to test Hazard for lung cancer. He was seeing a doctor nearly every week, but his original blood test for valley fever was negative. False negatives, he said, are common in the first few tests for valley fever. His doctor didn’t know that at the time.

“Literally I would try to walk around the block with my wife and couldn’t do it,” Hazard said. “One morning I woke up and that joint pain had gone all the way up to my knees and elbows and I could barely walk.”

He was admitted to Cottage Hospital and eventually tested positive for valley fever. Hazard said he was prescribed fluconazole, a basic antifungal medicine, and felt better after a week. Since then, Hazard said the fire department’s protocol regarding valley fever has improved.

“They know to get us tested and tested every few weeks,” he said. “And the firefighters union has collected a lot of information about it for our employees.”

Valley fever is caused by breathing in the spores of a fungus of the genus coccidioides, according to the CDPH, which is found in soil and dirt located in some areas of the southwestern United States and parts of Mexico and Central and South America. When soil where the fungus grows is disturbed, its spores are released in dust and can be easily breathed in.

Workers—including wildland firefighters like Hazard, construction workers, archaeologists, military personnel, and workers with mining, gas, or oil extraction jobs—who work near soil have a high risk of exposure to valley fever, according to the CDPH. Valley fever prevention can be difficult, but the CDPH encourages frequently exposed workers to wear respirators and wet soil before digging.

Santa Barbara County Fire Department wildland firefighters don’t wear respirators, according to Public Information Officer David Zaniboni, and it can be difficult to effectively to wet the soil during a fire. But Zaniboni said the fire department has become increasingly aware of valley fever exposure since Hazard’s incident in 2006, which was followed by a few other cases within the department.

“There is a lot of it, mostly in the Santa Maria and Cuyama valleys,” Zaniboni said.

While the increase appears to be a statewide trend, the CDPH said valley fever is most commonly reported from Californians living in the San Joaquin Valley and on the Central Coast, where the right soil and climate conditions allow the fungus that causes the illness to abundantly grow.

Santa Barbara County has seen its own major increase in reported cases of valley fever, according to data collected by the Santa Barbara County Public Health Department. In 2016, 53 residents reported having been infected with valley fever, which accounts for a nearly 60 percent increase from the 23 cases reported in 2015 and 21 cases in 2014. There were 51 cases reported in Santa Barbara County this year as of Oct. 31, according to the CDPH.

The spike in valley fever could be attributed to a variety of factors, according to the CDPH, including increased testing and reporting, and weather conditions. Some studies suggest rainfall after several years of drought allows the fungus that causes valley fever to grow more copiously, but the CDPH said that information is not well understood. 

Prevention and intervention

“The issue isn’t going away, it’s only increasing,” according to Jordan Cunningham (R-Templeton), assemblyman for California’s 35th Assembly District.

Cunningham, whose district includes much of the Central Coast, recently co-authored Assembly Bill 1279, legislation that would have required local public health departments to devote resources to valley fever research and awareness.

The bill, Cunningham said, would have improved valley fever awareness and diagnosis, which can be a difficult process because its symptoms are so similar to those of cold and flu illnesses. It would have also funded local research into possible valley fever treatment options and vaccines. The goal of the bill was to prevent situations like Hazard’s.

“If we could get some preventative investment at the state level, that could be helpful,” Cunningham said.

The bill originally included $2 million of funding that would have been appropriated to Santa Barbara and San Luis Obispo counties, Cunningham said, which have both seen dramatic increases in valley fever cases. An appropriations committee eventually removed that funding from the bill, and the policy alone was passed by the state Assembly and Senate but eventually vetoed by Gov. Jerry Brown on Oct. 3.

In the veto message, Cunningham said the governor suggested the bill be addressed during budgeting. Cunningham said he and other representatives supporting the bill plan to reintroduce it, or one like it, in the future. Valley fever is a growing issue, he said, and it can be devastating to the people who contract it.

For now, the best-known way to prevent valley fever is to avoid exposure to dust and soil in areas where it is most common, according to the CDPH.

“An ounce of prevention could be worth a pound of cure,” Cunningham said. “I knew someone who had it actually, and it lingers a long time. It can be fatal and can really pile on medical costs.”

Staff Writer Kasey Bubnash can be reached by email at kbubnash@santamariasun.com.




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