State senators will vote this week on a bill that would enhance valley fever reporting guidelines and mandate public outreach. The aim: to raise public awareness of valley fever, an insidious respiratory disease endemic to the southwestern United States.
“We can save lives by making sure people are informed about valley fever,” State Assemblymember Rudy Salas Jr. said in a statement. “Without a cure or vaccine, right now we need to educate the public about the signs and symptoms of this disease to prevent infections and ensure early and accurate diagnosis.”
Salas introduced legislation after USC’s Center for Health Journalism Collaborative, of which The Sentinel is a member, uncovered deep flaws in the way valley fever cases are reported among local, state and federal public health agencies. Without properly tracking the disease, experts cannot determine whether an epidemic is occurring, sometimes until months after it takes place, The Collaborative found. Experts recommended better sharing of lab reporting among public health agencies and more public awareness, both elements of the proposed legislation.
Initially, Salas was attempting to bring $2 million in funding to public awareness, but that money was lost during the appropriations process. His office is now researching valley fever awareness among physicians, potentially planning to draft more legislation.
Even without the funding, AB 1279 would address some deficiencies by creating a coalition of experts from various county public health agencies to improve accurate and timely reporting while developing public outreach programs.
Valley fever, or coccidioidomycosis, is caused when fungal spores endemic to the southwestern United States get kicked into the air and inhaled. Most people don't develop symptoms, but others come down with a fever, cough, extreme fatigue and a rash, among other symptoms. In rare cases, the fungal spore can spread to the bloodstream and cause cocci meningitis, leading to a lifetime of health issues, and potentially death.
Valley fever cases have spiked recently, adding urgency to the need for a policy response.
Statewide, in California, cases rose from about 3,000 in 2015 to more than 5,700 in 2016, according to the California Department of Public Health. Kern County reported the most cases with 2,310 infections and six deaths that year.
Despite that, valley fever receives no state awareness funding. Zika virus, which has so far infected about 23 people statewide, received $27,000 in awareness funds in Kern County alone last year.
Meanwhile, in Arizona, another state where valley fever is epidemic, the state does not give any of its own money to valley fever awareness, even though valley fever routinely is a contributor to about 50 deaths per year in Arizona, state health data show. There were 6,101 cases reported to the state in 2016.
The Arizona Department of Health Services relies on a $96,868 Centers for Disease Control and Prevention grant for surveillance and education. Since 2008, the program's budget has never exceeded $100,000 per year.
“To my knowledge in Arizona there is no legislation anything like what they are doing in California,” said Dr. John Galgiani, director of the University of Arizona’s Valley Fever Center for Excellence, which is entirely grant-funded. “I don’t recall a valley fever legislative initiative in Arizona, ever. I think it would make perfect sense for Arizona to be addressing this issue like California is. The California legislation is a great first step.”