Valley fever rate stays high in Ventura County, sparks debate about fire, global warming

Only six California counties reported more possible cases of valley fever than Ventura County through the first 10 months of the year, according to new state data.

Cases of the difficult-to-diagnose infection surged locally two years ago in a rise that sparks debate about possible causes ranging from massive wildfires to global warming.

Preliminary disease counts from the California Department of Public Health suggest the fungal infection that one patient described as "hell," has continued in the county at an elevated rate.

Breaking down the numbers

Through Oct. 31, 260 Ventura County residents were identified with confirmed or suspected cases of an infection caused by breathing icoccidioides fungus spores lifted from the soil into the air by wind, construction, farming or other activities.

Many people escape infection with few if any symptoms. Others develop severe pneumonia and sometimes nodules in their lungs. In rare cases, valley fever can spread to the brain and spinal cord, bringing potentially fatal conditions like meningitis.

Of 58 California counties, only Kern, Los Angeles, Fresno, Riverside, Tulare and San Diego reported more possible cases than Ventura. Kern was, as usual, the state's hotspot with 2,487 possible cases over 10 months.

More:The Woolsey Fire has sparked valley fever fears, but how high is the risk?

Ventura County's 260 tally is on a rate that, depending on how many of the suspected cases are confirmed, could be the highest in at least two decades, rivaling the 249 cases in 2017.

The numbers don't surprise Dr. Glen Abergel, an Oxnard lung and infectious disease specialist. As of Tuesday, he had seen three patients with symptoms of valley fever in one week.

"They almost always have the same story," he said, noting they're diagnosed with pneumonia or bronchitis and given antibiotics that have little or no effect on the symptoms.

What are doctors saying?

The cases come frequently enough that Abergel usually starts treatment with antifungal medication even before tests from specialized labs confirm the diagnosis.

Abergel believes the recent surge of patients may be linked to the massive Maria and Easy fires in Santa Paula and Simi Valley. He and other area lung specialists contend the Thomas Fire in 2017 and last year's Woolsey Fire also spawned cases of valley fever.

"Absolutely, there is a correlation," he said, contending fires and wind unleash spores into the air from coccidioides fungus that lives in the soil. "In two to three weeks after the fire, we see cases."

More:Conditions improve for Cave Fire in Santa Barbara County; some evacuations to be lifted

Dr. Robert Levin, Ventura County public health officer, challenges the connection between the infection and fire. He noted the county once saw only dozens of valley fever a year before a surge of cases in 2017 that began several months before the  December Thomas Fire.

The peak didn't last but subsided into a new baseline of more than 200 cases a year —far higher than what the county once saw.

Levin argues global warming is a more likely contributor than fire, contending slightly higher soil temperatures could provide better incubation for the fungal spores that cause valley fever.

"Cocci is our canary in the (coal) mine," he said, contending the infection is one of many things impacted by climate change.

Dr. Ramesh Nathan, an infectious disease specialist in Thousand Oaks and Simi Valley, said he's seen an increase in severe complications of valley fever. In one case, a patient contracted the condition during pregnancy and developed meningitis. The baby was delivered and, after initial illness, appears to be doing well.

Some are at a higher risk

People at higher risk of severe complications include those with HIV or AIDS, transplant recipients, pregnant women, diabetics, African-Americans and Filipinos. Nathan said other questions remain.

"I don't think we have a great understanding of some people do really poorly and some don't," he said.

California Department of Public Health officials said the number of cases in California have risen steadily over the past five years. They said the rise has brought action, including a coming awareness campaign and a new law that requires construction employers in many counties, including Ventura, conduct training to make sure workers understand the risks of valley fever.

State officials suggest people in areas where the disease is common stay inside during windy conditions, keep car windows closed and use recirculated air conditioning when driving.

Lynn Silveira, 69, of Oxnard, takes the precautions seriously. During the recent fires in Santa Paula and Simi Valley, she wore a surgeon's mask outdoors.

"The fires scare me," she said. "The winds scare me."

Her fear comes from experience. She was diagnosed with pneumonia in 2017 and given medication that didn't alleviate her symptoms before her husband suggested maybe the culprit was valley fever.

It was.

It took a year for her to recover. She lost 50 pounds. Constant fatigue meant all she wanted to do was nap. The fungal medication made her hair fall out.

"I went through what I considered hell," she said, adding that a year later she feels much better. "Fantastic. I had a very good doctor. I got on the right medication."

Valley fever symptoms

Officials from the U.S. Centers for Disease Control and Prevention say people should contact a doctor if symptoms last for more than a week. They can include:

• Fatigue
• Cough
• Fever
• Shortness of breath
• Headache
• Night sweats
• Muscle aches or joint pain
• Rash on upper body or legs

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.