Disease rides the dust of American Southwest

December 23, 1992|By Los Angeles Times

BAKERSFIELD, Calif. -- For the past 16 months, a strange dust-borne disease endemic to the American Southwest has blown rampant through Kern County, infecting more than 4,000 people and killing 34, according to state and local health officials.

The incidence of valley fever here has exploded tenfold since the summer of 1991 and shows no signs of abating.

"The numbers are astounding," said Ronald Talbot, director of the Kern County health department lab. "Any other disease with this abnormal number of infections and deaths would be grabbing national attention."

While Kern County rates as the hotbed of valley fever, accounting for two-thirds of the cases and deaths statewide, the disease is also afflicting record numbers in Los Angeles, Ventura, Santa Barbara, Tulare and San Luis Obispo counties.

Health officials say that in this siege at least 6,000 people statewide have been infected with the fungus found in the arid soils of Central and Southern California, Arizona, New Mexico and Texas. About 50 Californians have died since August 1991. A typical year sees 441 cases and six deaths statewide.

Most who take ill suffer from flu-like symptoms. But for some, the disease spreads beyond the lungs and can lead to a deadly form of meningitis. A pregnant woman dying of valley fever in Los Angeles was kept alive on a ventilator until doctors could deliver her baby. A doctor at the University of California, Davis, Veterinary Hospital succumbed after performing an autopsy on a horse that carried valley fever.

"There have been epidemics of valley fever in the past, most recently 1978, but none that comes close to these numbers," said Dr. Demosthenes Pappagianis, a UC Davis medical professor who has tracked the disease for 41 years.

The fungus that causes valley fever is known by the name Coccidioides immitis -- or cocci (pronounced "coxy") for short.

Of those exposed to the spores, only 30 percent become sick enough to call a doctor. A smaller portion is actually diagnosed with the disease.

"Only 10 percent of those exposed require medication and most of them get well," said Dr. Hans Einstein, a Bakersfield physician and noted cocci authority. "But for some, the disease spreads beyond the lungs and attacks the skin, bones and brain. That's when it's nasty. That's when it can become a killer."

Several factors may be behind the big numbers here. Six years of drought have baked the San Joaquin Valley soil to a chalky dust easily scattered by winds that blow late summer through winter. Much of last year's rain came in spring -- too little to offset drought but right on time to send the spores abloom.

Also, the growth boom transforming this region acts like one big spade, working the fungus to the surface where it can become airborne. And with the new houses and shopping centers has come a surge of new residents who lack the immunity afforded by exposure to the fungus. They are easy targets.

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