Hoping to Beat a Pernicious Disease

BAKERSFIELD —  For decades, little-known microscopic spores have blown through Kern County, causing flu-like symptoms in most people, leaving others fighting for their lives.

After a failed attempt to create a vaccine for valley fever in the 1980s, researchers say they are on the verge of testing a new vaccine for the disease known for its prevalence in the Central Valley. Their hope is to make a vaccine available to the public in five years.

“It’s not a high-profile disease that is going to get a lot of attention,” said Michael Cooper, president of the Valley Fever Americas Foundation. “It’s not like cancer, where everyone has been touched by it. Valley fever is on a much smaller scale than that.”

Still, the illness can have devastating effects, though fatal cases are rare. An epidemic, like one in 1992 that affected more than 3,000 people in Kern County, has the ability to hurt local businesses.

“It can cost a company half a million dollars in workers’ comp costs and medical costs,” Cooper said.

Kern County, with an estimated 713,087 people, is the hub for valley fever in the state, with more than 60% of cases in the past 15 years.

Last year, California had 2,638 cases, with 1,524 in Kern County.

Officials say the numbers can be deceiving. Though more people are becoming infected, more cases are being reported and doctors are getting better at diagnosing the illness.

Emily Arellano’s fight with valley fever began in 2001, when she started coughing up blood. After five months of hoping it would go away, Arellano went to a doctor, who immediately diagnosed valley fever. Her X-rays showed that, at age 22, she had a cavity in her right lung.

“I heard about valley fever growing up, but I never really thought it would happen to me,” the Bakersfield native said. “I always thought it was more common for people to get it who come from out of town.”

After four years of taking oral anti-fungal medication without results, Arellano was referred to a pulmonary specialist. One month later, in February, one of her lungs collapsed and the damaged portion had to be removed.

“It’s a scary thing,” Arellano said. “I never knew it was that bad, but it is.”

In the three months since her surgery, Arellano has been receiving four-hour treatments three times a week that leave her with chills, migraine headaches and muscle cramps.

At a clinic, in a room full of reclining chairs, Arellano and other valley fever victims receive intravenous doses of amphotericin-B, a drug that has been used to treat fungus infections since the 1950s.

“We call it ampho-terrible because it makes you feel really bad,” she said.

The experience has left her scarred -- physically and emotionally -- and worried about her family. She doesn’t let her 5-year-old son go outside on windy days, which she calls “valley fever weather.”

The disease, known to science for more than a century, is caused by the Coccidioides immitis fungus, which dwells in uncultivated soil until its spores are stirred up by the wind or activity and are inhaled by a host.

“We are a dead-end for the fungus,” said Tom Larwood, a physician long involved with valley fever research. “It isn’t looking for us, but when it gets in us, it does us harm.”

Most people who test positive for valley fever never knew they had it because they never developed symptoms. Others assume they have the flu. In the most severe cases, the disease can lead to a deadly form of meningitis.

People with compromised immune systems are more susceptible than others, and for unknown reasons, blacks, Filipinos and other dark-skinned people are more likely to experience severe symptoms.

In 2001, the same year Arellano was diagnosed, Jennifer Youngblood lost her 49-year-old father, Michael, to spinal meningitis, the most lethal complication of valley fever.

Youngblood tearfully held up two pictures of her father. One showed a healthy, full-faced man at her wedding in 1996, one year before he was diagnosed. The other was of a hollow-cheeked man at her older sister’s wedding in 1999, when it was obvious that valley fever was taking its toll.

“I had friends in high school who got it and then one month later they’d be better,” Youngblood said. “I never knew people died from the disease at all.”

Her father’s death, she said, could have been prevented if a test vaccine he received in the 1980s during its trials had worked. Now she wants to get involved in fundraising for a new vaccine.

“A vaccine is the only thing that can prevent people from going through what I’ve gone through, what my family has gone through,” she said. “I feel bad for my [other] sister because he’ll never get to walk her down the aisle when she gets married.”

A grass-roots effort to fund the creation of a vaccine was started by the Rotary Club of Bakersfield East, which is trying to raise money in other areas where the disease is endemic. Valley fever spores are found in Arizona, mainly in three counties, two of which include Phoenix and Tucson.

But leaders of the Bakersfield effort complain that financial assistance from Arizona has been sparse.

“That has been a thorn in everybody’s side,” said Hans Einstein, a Bakersfield physician working with the Valley Fever Vaccine Project. “Arizona has been lagging, to put it mildly.”

The University of Arizona Valley Fever Center for Excellence has contributed manpower, brain-power and leadership, but that’s not enough coming from a state that has more cases of valley fever than California, Einstein said.

The director of the Arizona center, John Galgiani, said the state’s government might be willing to contribute to vaccine research once Arizona officials realize the potential impact of the disease on the state’s nearly 6 million people.

The center, meanwhile, will focus on discovering more about the biology of the fungus and finding new drugs to treat patients infected with the disease.

“Rather than putting all our eggs in one basket, there are other ways to help people other than the development of a vaccine,” Galgiani said.

Bakersfield leaders will continue to be persistent.

“We definitely want them to do more, and we are lobbying for them to do more,” said Stanley Clark, a political science professor at Cal State Bakersfield who is coordinating funds, contracts and legislation related to the vaccine project.

In California, $14 million from state and private sources has gone into the development of the vaccine. Last month, the Valley Fever Americas Foundation started a corporate fundraising drive to raise $2.5 million needed to take the new vaccine to human trials.

“We’re not looking for donations so much as for people to make investments in this vaccine,” Cooper said.

It’s not unreasonable to ask a company for a $100,000 donation, Larwood said, if the vaccine will potentially save it $500,000 in lost employee time.

Because dogs are susceptible to the disease, an animal vaccine is also in the works. That, researchers think, may be a possible source of income for research on a human vaccine.

But officials are wary of going down that road because the development of a canine vaccine could delay work on the human vaccine.

After the money is raised, the next hurdle would be to get members of the community to stick out their arms like Youngblood’s father did in the 1980s.

The last big step would be to find a pharmaceutical company willing to invest in the manufacturing of the vaccine.

“It’s not like a Viagra,” Cooper said. “It’s not going to be a big money-maker.”