Dust, Devil : The Rise of Valley Fever
January 13, 2014 1:48 PM   Subscribe

"All you have to do is take a breath at the wrong time. It will impact your lower lung, and the infection starts from there [...]. If you roll down the window driving from San Diego to Seattle, you could catch cocci while you're driving through, no question. That could happen, and it has happened." Valley Fever (coccidioidomycosis) is a fungal infection endemic to certain areas of the Southwest. The CDC has described it as a "silent epidemic"; between 1998 and 2011, reported cases increased tenfold. It's often misdiagnosed, but even when correctly-diagnosed, the prognosis can sometimes be grim: there is no vaccine, the price of the first-line drug has skyrocketed, and the treatments for more-severe cases often carry their own punishing side effects. While many groups (including NASA) seek to halt the spread, the disease continues to infect 20,000+ individuals each year. "It destroys lives,” said Dr. [Royce] Johnson [...]. Divorces, lost jobs and bankruptcy are incredibly common, not to mention psychological dislocation."
posted by julthumbscrew (30 comments total) 27 users marked this as a favorite
(Posted during a Santa Ana.)
posted by professor plum with a rope at 2:05 PM on January 13, 2014 [3 favorites]

Before everyone freaks out:

Most of the infected humans don't experience any symptoms or consequences
posted by empath at 2:19 PM on January 13, 2014 [6 favorites]

I remember running across references to this ailment in some old books by Edward Abbey, though I never experienced it myself, or knew of anybody who had.
posted by metagnathous at 2:19 PM on January 13, 2014

Most of the infected humans don't experience any symptoms or consequences

Actually, the mortality rate is 100%...eventually.
posted by yoink at 2:21 PM on January 13, 2014 [4 favorites]

Before everyone freaks out:

Most of the infected humans don't experience any symptoms or consequences

posted by empath at 2:19 PM on January 13

Ha, damnit- I was rollin' into this thread ready for a good ole fashioned freak...

Actually, the mortality rate is 100%...eventually.
posted by yoink at 2:21 PM on January 13

posted by stinkfoot at 2:26 PM on January 13, 2014 [2 favorites]

Hasn't everyone in the southwest already been wiped out by the hanta virus and killer bees?
posted by Sys Rq at 2:36 PM on January 13, 2014 [4 favorites]

Most of the infected humans don't experience any symptoms or consequences

But if you're already infected with Toxoplasma gondii you should definitely avoid eating any catnip.
posted by RonButNotStupid at 2:36 PM on January 13, 2014 [1 favorite]

Valley Fever plays a role in the YA novel "Esperanza Rising", where it is contracted by one of the important characters. It was the first place I had heard of that ailment, so I had to go and see if it was a real thing. It is, ave I was a bit surprised that it was known of back in the 1930s, the time of the novel.
posted by happyroach at 2:36 PM on January 13, 2014

Before everyone freaks out:

Most of the infected humans don't experience any symptoms or consequences

Perhaps, but my father died a very swift and unexpected death from it (probably; my stepmother did not have an autopsy done) after a visit to Southern California.
posted by dhens at 2:38 PM on January 13, 2014 [1 favorite]

Alright, after reading through some of the articles, I am a little freaked out, since my parents live in an effected area. Should I tell them to wear masks when it gets dusty?

Also, I looked up Santa Ana winds, and saw this in the wiki: "There is some belief the winds also create positive ions, which are believed to affect mood negatively. Many believe this to be the cause for the statistical increase in the number of suicides and homicides during these times"

Edit on preview: Sorry about your father dhens, I shouldn't have been so flippant with my initial comment.
posted by stinkfoot at 2:38 PM on January 13, 2014

I shouldn't have been flippant either. I'm sorry to hear about your loss. This is a very serious ailment that shouldn't be made light of.
posted by RonButNotStupid at 2:45 PM on January 13, 2014 [2 favorites]

posted by dhens at 2:46 PM on January 13, 2014 [1 favorite]

I spent a couple years living in New Mexico and had several bouts of pneumonia that responded very poorly to antibiotics. Never got tested, but must say, I've never gotten that sick since.

I think the big thing is making sure the testing gets done when you've been potentially exposed and go in for treatment for a respiratory infection. I was a very healthy person initially and have never been nearly so much so since, a lot of which I put down to the lingering effects of those illnesses. I thankfully never had to be hospitalized, but I did lose a job over it. Proper treatment from the beginning would have made a big difference.

Never going back there again. Have had a doctor since suggest that people who have other fungal allergies may be more susceptible, so that's just hearsay but it's something to watch out for.
posted by Sequence at 2:55 PM on January 13, 2014

I grew up in Phoenix in the 70's and 80's and it was common knowledge that if you lived there for more than seven year the odds of you contracting Valley Fever approached 100%. Most people assumed they had it and were asymptomatic.

My grandfather was misdiagnosed with tuberculosis and it delayed his entry into WWII for a year. Once his Valley Fever abated he was cleared for duty and entered the Army.
posted by djeo at 3:22 PM on January 13, 2014

I've looked but I can't find an innertube copy of the old "Distant, dry, dusty...dusty...dusty..." PSA that used to air on local Phoenix tv channels.
posted by djeo at 3:29 PM on January 13, 2014 [1 favorite]

A friend of mine used to travel regularly to Bakersfield, in order to provide medical care to inmates at one of the state prisons near there. Valley Fever can be very dangerous to incarcerated people, especially to incarcerated people with certain conditions. In June, state prisons were ordered by a judge to relocate 2000 inmates susceptible to infection.
posted by rtha at 3:31 PM on January 13, 2014 [2 favorites]

I was probably brain damaged by valley fever when I was a young child.

I had gone to Arizona to visit relatives. When when I got back to the UK I was taken ill with a strange disease the British doctors had never seen before. I had terrible fevers and strange 'absences', seizures with no loss of muscle tone. Nobody knew how to treat it, because nobody knew what it was. They kept me cool and kept me fed and hydrated, and eventually I recovered.

Years later, it became obvious that I had severe, but very specific, cognitive impairments (called 'learning disability' in North America, and 'dyslexia' in parts of the US and in the UK). I have memory problems, I have problems with fluid, fine motor control which prevents me from writing by hand easily, I am face blind (prosopagnosia).

Nobody can prove it, of course, but it seems likely that my mystery illness was valley fever, something the British doctors had no experience with. Nobody can know for sure, of course, but it seems very possible that my strange pattern of brain damage is related to those repeated fevers and seizures at such a young age.
posted by Dreadnought at 3:34 PM on January 13, 2014 [1 favorite]

California prisons are/were massively overcrowded (I think we've now moved to "regular overcrowded" at this point), and inmates have no control over their environment - they can't control the HVAC system or open and close windows and so on. Medical care is terrible. And apparently, some ethnic and racial groups seem to be more susceptible to it - and guess who makes up a lot of the inmate population? You're also more susceptible if you have other medical conditions, especially if those conditions are not well controlled, and....medical care in the state prison system is an abomination.
posted by rtha at 3:47 PM on January 13, 2014 [2 favorites]

more: "Rates of valley fever among prisoners at Pleasant Valley and Avenal state prisons have been substantially higher than among the rest of Californians: more than 1,000 times higher at Pleasant Valley and 189 times higher at Avenal."

> In June, state prisons were ordered by a judge to relocate 2000 inmates susceptible to infection.

[same article] "as those high-risk prisoners leave, the state is moving hundreds of new inmates, including Baca, into those two prisons."
posted by morganw at 4:09 PM on January 13, 2014 [1 favorite]

I think I remember reading somewhere that migrant workers are disproportionally affected by Valley Fever, either owing to genetics or lack of reliable insurance/medical care. Am I making that up?
posted by mudpuppie at 4:13 PM on January 13, 2014

Mudpuppie, my guess is that comes from agricultural work where you are around a lot of dust. I am sure I have been exposed and my brother missed almost his whole 8grade year because of valley fever amd subsequent opportunistic infections. Its a fact of life if you live in the desert southwest amd work or play in the dirt. The drought we have had has made the problem worse because more rain means less dust.
posted by nestor_makhno at 5:23 PM on January 13, 2014

I once visited Bakersfield, for fun. I was doing some work for the state, and I'm not from California. I'm pretty familiar with the Bay Area, and have some familiarity with Sac, San Diego and Los Angeles, but I'd never been to the San Joaquin Valley, so I thought it might be helpful. I took the train from Sacramento to Stockton, spent Friday night in Stockton, took a morning train to Fresno, spent the afternoon in Fresno, and then on to Bakersfield for the evening.

My visit to Bakersfield was marked by three things; the amazing Basque meal I had; the friendly folks at the Basque restaurant who were honestly baffled that a tourist from Canada would be in Bakersfield, and who were appalled and shocked that I planned to walk the entire mile back to my hotel at night; and the article in the Chamber of Commerce type magazine in my hotel room.

I only half remember it but it talked about this lady who was from somewhere else, England maybe, and had come to Bakersfield to visit someone, but had caught San Joaquin Valley Fever and wound up staying, and opening a hair salon or bakery or some other small business, and was now a fixture of the community. And when I read it, I swear that catching San Joaquin Valley Fever sounded at first like it was the local equivalent of leaving your heart in San Francisco or something like that; a civic boosterism. It wasn't until after I had finished that I realized something was up with San Joaquin Valley Fever, and, of course, a quick search revealed that it wasn't the heartfelt love of the area, or a local booster cliche, but a crippling fungal infection.
posted by Homeboy Trouble at 5:25 PM on January 13, 2014 [6 favorites]

I grew up in Tucson and Valley Fever was endemic to the area, but most people didn't have any lasting effects from it. One of my best friends in high school, however, lost a lung to it when she was 16 and she never did get completely well again; she died when she was about 20, just a year or two after we got out of high school.

I've heard that flares of the fungus have become more common in the last few years. When I was in Tucson in 1999 or 2000 the news was all about a severe outbreak of the disease, with warnings to stay in, wear a mask or cloth over your face when outdoors, don't dig in the dirt, etc. I wondered then why there was so much fuss over good-old Valley Fever, but I suppose the intervening 35 years had simply given the spores time to dense up and take over the Arizona-Sonora Desert.

"Crippling" is a good word for it. They say that even those who've only had a mild brush with it many years ago carry scars in their lungs.

Bad news.
posted by aryma at 7:11 PM on January 13, 2014

This whole thing sounds horrible..

However, in the last link I read this:

Once athletic, Deandre Zillendor, 38, dropped to 145 pounds from 220 in two weeks...

Is that a misprint? That doesn't seem physically possible to me.
posted by RedEmma at 8:17 PM on January 13, 2014

As a dirty-hippy newcomer to LA from the Bay Area, one who grew up in a house full of pet hair and a mandate that "all the kids have to shower at least every Sunday!" (I say that as my non-neat-freak bona fide) I have been appalled by the sheer quantity of dust and dirt that just ends up covering everything. Everything! Walls, handrails, window sills, tables, picture frames, everything. I wash our back patio, an otherwise dirt-free zone on the second floor of an apartment building, twice a month because it accumulates a thick layer of dust at a crazy rate. I had no idea this Valley Fever nonsense existed, but have decided it fits right in with my disgust for the freakish dust here.
posted by samthemander at 9:09 PM on January 13, 2014 [1 favorite]

Huh. I grew up in the Valley, but while I wasn't really that familiar with the fever, it's common knowledge that, and I quote, the San Joaquin Valley has some of the dirtiest air in the country and high rates of childhood asthma.

And when I read it, I swear that catching San Joaquin Valley Fever sounded at first like it was the local equivalent of leaving your heart in San Francisco or something like that...

This is hilars. And yes, Valley denizens have no illusions about the area's draw for tourists: rare and eccentric.
posted by psoas at 4:07 AM on January 14, 2014

Valley fever also affects pets. One of my dogs contracted it; he did recover. It took a long time. Had my registered nurse mother not been so strict in his compliance with his medication and blood tests, I'm sure he would have succumbed. This was in Bakersfield.

Strangely, I've never known a human to get it.

Hans Einstein, MD was and is the big name in valley fever research in Bakersfield. He was a very compassionate man who was really interested in eradicating valley fever and improving the quality of life for the residents of the San Joaquin valley.
posted by FergieBelle at 7:07 AM on January 14, 2014

Most of the infected humans don't experience any symptoms or consequences.

And some of us do.

I have it. I've lived in Stockton (San Juaquin Valley) and Phoenix. I came down with mono-like symptoms with the WORST respiratory infection when I was 11. I was out of school for two months. I had no energy, a horrible cough and I had to take inhaled steroids and the yukkiest cough syrup known to man.

It recurred annually for years, until I took two courses of anti-fungals. I have lung scarring and I am susceptable to respiratory infections, so I'm all up on my flu shots.

It was and is pretty terrible to live with. It saps your energy and when you have a respiratory infection, the cough is really painful.

They didn't know it was a fungus! In the DUST! PSA that ran all over Phoenix TV in the seventies, they talk about it being a spirochete! (I wish I could find it, it was actually pretty interesting in its day.)

Finding conclusive information about living with it, and long term effects has been really frustrating.
posted by Ruthless Bunny at 7:39 AM on January 14, 2014 [1 favorite]

dhens: "Thanks."

Thank you, dhens, for reminding us that the internet is actually describing real life here. Hard to remember sometimes, in our snarkquarters of comfort and distance.
posted by IAmBroom at 11:54 AM on January 14, 2014 [1 favorite]

I'd guess diabetics of all kinds are more likely to have serious problems with this stuff, and we have seen big run-ups, particularly of type 2.
posted by jamjam at 10:21 PM on January 14, 2014

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