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Blowing in the Wind

May 6, 2013 – From the Little Known Facts File: a disease called Valley Fever.  Until quite recently it was endemic in the arid farm regions of California and Arizona, but nowhere else in the United States.  Now, because of ongoing drought in other areas of the country, awareness of this disease needs to increase.  For while half of those exposed to the fungus spores that carry the disease show no symptoms, the numbers of those who die – yes, die! – is on the upswing each year.  One of the reasons is the lack of familiarity with this malady on the part of doctors.  Another reason is climate change.
Other areas of the world that already know about Valley Fever (VF) include Mexico, Central, and South America.   Once soil has become so dry it has the consistency of dust, it is easily transported by the wind.  Human and animal activities increase its transportability.   VF can be contracted simply by breathing in the fungus spores that make up a portion of the dust.   Members of certain ethnic groups, those with weakened immune systems, and newcomers or visitors to a place where VF is prevalent are the most susceptible to infection.  Sadly, over 150,000 VF cases go undiagnosed every year, according to the Center for Disease Control and Prevention.  The symptoms are similar to influenza – it seems like that’s the case with a number of dangerous infections – and in a small percentage of cases the infection can spread from the lungs to the brain, bones, skin, and even the eyes.  Individuals who do not receive treatment can go blind, have skin abscesses, lung failure, or even die.

Federal health officials have ordered 3,000 highly susceptible inmates from two San Joaquin Valley (CA) prisons to be moved, because several dozen prisoners have died in recent years of Valley Fever.  Between the years 2001 and 2008, 265 Californian’s died of VF.   Farm workers and those who labor in construction can be especially hard hit by VF.  Twenty-eight construction workers became ill in February in San Luis Obispo County, again in California.  In 2011 there were nearly 22,000 cases of VF found almost entirely in California and Arizona.  The fact is that cases in California increased from about 700 in 1998 to more than 5,500 in 2011. Needless to say, some of the escalation in numbers is due to a better understanding and awareness of the disease.
Do not be fooled into thinking that VF continues to occur only in the southwest U.S.  Cases of VF  increased nationwide by 850 percent between 1998 and 2011.  Periods of dramatic increase have been observed when drought is followed by prolonged  episodes of rain.  This kind of “random” weather appears to characterize climate change in the United States.   For instance, the nearly unnavigable Mississippi River, for reasons having to do with the lack of rain, has now flooded. Not only does the weather vary a good deal from one year to the next, it can vary within a season.

Certainly one location that may be ripe for an increase in the number of cases would be Texas.  Anyone who has observed drought maps over the past two years knows how severely Texas farmers and communities have been affected.  There has been some minor easing so far this year; whether that will continue and whether that can be regarded as good news on the Valley Fever front remain to be seen.  It would make an enormous amount of sense for Texas doctors to familiarize themselves with Valley Fever now, rather than wait for a possible outbreak.
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