Deadly disease with no cure 

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It was the flu. Dave Congalton, radio talk-show host, has had it before. You know, the usual aches and pains around this time of year. That’s what his doctor thought, too. Here, take these, drink lots of water and get plenty of rest. But after a few days, Congalton wasn’t feeling any better. As a matter of fact, he was feeling worse.

“It was a gradual process. I knew I was sick right from the very beginning because I had a fever and my glands were swollen and you can just tell right away when you’re sick versus when you’re sick. I knew I had something very serious.�

Congalton was right … he did have something serious.

Upon returning to his doctor, blood tests were ordered. Then the doctor noticed something else. His patient had rashes on his feet and under his arms. This, along with complaints of fever, chills, swollen glands, cough, and fatigue, led to a new and startling diagnosis: Dave Congalton had Valley Fever.

What on earth is Valley Fever?

Simply put, Valley Fever, or San Joaquin Fever, is a fungus that grows in the soil and spreads by dust. Windborne spores are inhaled into the lungs, and that’s where the infection starts and usually remains. At this stage it resembles pneumonia, but the disease can spread beyond the lungs, through the bloodstream to the skin, bones, and membranes around the brain, causing meningitis. If your immune system is weak for whatever reason, you become an easier target.

Valley Fever is prevalent in the arid regions of California, Arizona, and other parts of the Southwest, as well as many parts of Mexico and Central and South America.

And north San Luis Obispo County.

SLO County health officials say this might be due to increased dust in the air, in addition to more people.

Congalton lives in Atascadero, which, along with Paso Robles, are two of the fastest-growing areas in San Luis Obispo County.

“It wasn’t anything that I did,� he said. “I could have gotten it from working in the garden or walking the dogs, but I got it. It’s a fungus. It’s more like it finds you.�

Valley fever more often than not finds those who work in the endemic dusty areas. Construction and agricultural workers, geologists, and sporting enthusiasts on bikes or in RVs are all prone. Travelers are susceptible. Even nursing-home patients with a window open can get it.

So can animals, except cats. In fact, one of the biggest killers of sea otters happens to be Valley Fever.

Valley Fever, it seems, is no longer just a valley problem.

Steve Grey, who owns a mini-storage outfit, contracted Valley Fever a year or so ago while he was living in Paso Robles.

“At first I thought I had pneumonia. This thing went right into my lungs. It went deep, deep into my lungs.�

Grey was given drugs and told to rest, and indeed he began to improve. His fever went away after three weeks. But he was far from out of the woods. His disease began to take on a different form, and it was almost a year before he realized it.

“What it finally ended up doing was moving to soft tissue, and it created an abscess which had to be surgically removed.�

It was at this point that Grey was diagnosed with Valley Fever. Grey’s doctor prescribed the drugs necessary to fight the disease. Antibiotics won’t do it; Valley Fever isn’t a virus. It’s a fungus, and it can only be controlled — not killed — by fungicides, which are extremely expensive.

Amphotericin is the most effective but the most costly to give. Nizoral given orally can cause liver damage. Diflucan can be taken orally or intravenously. Sporanox is one other medicine used. The side effects of these medications can be nil to gnarly.

But it’s the cost of treating Valley Fever that can be the most crippling. Not just the drugs or surgery, but the expenses incurred by employers and insurance companies.

Grey said he had to go to where drugs are cheaper.

“I was having to go to Mexico. My doctor just gave me a huge prescription of Diflucan. I went down to the border and got the stuff for about 25 percent of what I’d pay here; Diflucan was about $1,800 a month.�

But Diflucan was affecting Grey’s liver, so he changed to Sporanox. He went to Mexico for that, too. It was half the price of Diflucan.

Congalton said that without insurance, he’d be in bad shape.

“I’m thankful I have a great medical plan through Clear Channel. Doctors ran all these expensive blood tests on me. I got all this medicine. Clear Channel has been totally supportive of me. If I didn’t have medical coverage I’d be screwed right now.�

Congalton is taking fungicides to treat his symptoms.

“The main thing is that you want to keep it out of your lungs. It’s a disease of the lungs. Once they diagnosed it they gave me an antifungal. They gave it to me once a day, and that’s designed to keep my lungs clear. Most of the symptoms have gone away. It’s been three weeks now. I still have chills every week. My fever is gone, so that stuff is working. I plan for a long recovery period.�

Congalton added, “Since I’m over 50 there’s a possibility that I’ll always feel the side effects of Valley Fever because I’m at an older age.�

Congalton, who hosts a talk show on KVEC-AM from 3-7 p.m. every weekday, missed three weeks of working behind the mike, smack dab in the middle of the elections. He came back to work last Monday.

As for his future in broadcasting, “It’s too early to tell. It’s a very demanding job. I’ll be doing it while I have Valley Fever. It is going to be a big challenge.�

One of the worst effects of Valley Fever, even during recovery, is extreme fatigue. There’s a joke that a man with Valley Fever could have $10,000 if he could walk 10 feet to get it. He couldn’t.

So how many people in SLO County suffer from Valley Fever? Somewhere in the low hundreds, county health officials estimate, but it’s difficult to pin down because it is so often misdiagnosed.

If there is an upside in the fight against Valley Fever, it’s that it’s not contagious. And once you get it, you can’t get it again. But there is no cure. Not yet, anyway.

Researchers say they are close to creating a vaccine for Valley Fever, but still have a lot of work to do. The Valley Fever Project of the Americas, based in Bakersfield, is spearheading the effort to find a vaccine; other groups such as the Rotary Club have been instrumental in helping to raise funding as well. Creating a vaccine is a costly, time-consuming goal that a multimillion-dollar drug company would perhaps have an easier time attaining.

Although treatment for Valley Fever is good, it’s not like penicillin for strep throat, said Dr. Tom Larwood, who has worked on the campaign to find a vaccine for Valley Fever in Bakersfield and is a member of the Rotary Club. “Prevention is what we need, and that’s why we’re working on a vaccine.�

Valley Fever does not affect enough individuals to attract the attention of larger drug companies, said Larwood.

“Large drug companies are not interested because they would not be able to sell enough of it at enough of a mark-up to cover overhead costs for research,� said Larwood. “For a drug company to make a vaccine it takes them like $150 million, and they can’t spend that unless it’s a sure thing.�

According to the Valley Fever Vaccine Project of the Americas, there are approximately 7,500 new cases of Valley Fever each year in the United States. Although there are likely many more cases in Central and South America, drug companies are still not interested. So the Valley Fever Project of the Americas has taken up the task by raising money and gathering support from researchers who work pro-bono.

“Twenty years ago there was a vaccine. It worked, but humans couldn’t take it,� said Larwood. “[Now] with molecular chemistry they can pick the molecules they want.�

Currently the group is testing the vaccine on primates and is ready to start testing on humans, but more money is needed. According to the Valley Fever Vaccine web site, there are there three phases of research for the vaccine. The first phase, Research, is “well underway, and a candidate vaccine has been identified.� Engineering, Development/Manufacturing a Vaccine is phase two, and was initiated in 2002. The third and final phase, Clinical Testing, is next, and researchers expect it to take up to five years to complete. In this stage humans are given the vaccine.

The Valley Fever Vaccine Project has about five researchers and $15 million, said Larwood.

Local groups like the Rotary Club are active in helping raise money too.

“People who think that it’s not here are sadly mistaken,� said Bob Putney, a member of the Rotary Club and Cambria’s fire chief. “Everybody gets pretty much exposed to it, and a small percentage gets sick and an even smaller percentage gets very, very sick and some may die, and it’s very tough on pregnant women,� he said. “So we’re trying to raise awareness.�

Right now Putney and other Rotarians are raising money by selling pins. The colorful pins help raise awareness and money for the Valley Fever Vaccine Project. For a $20 donation, patrons receive a pin and information sheet on the virus.

Putney said his interest in Valley Fever grew after a fellow firefighter became ill with the virus. He started researching Valley Fever and met will fellow Rotarians to raise awareness. Putney said that it’s a common misconception that the virus only affects those in other countries and places like Bakersfield and not in SLO County.

“If it’s killing the sea otters in the ocean and we’re inland, we’re obviously just as exposed to the spores as they are,� he said.

Putney said the pins are selling like wildfire and he’s optimistic about raising the money needed to bring the candidate vaccine to trial.

“$2.5 million is not a lot for the western United States to come up with to hopefully eradicate the disease.�

Other researchers are looking for different ways to approach and mitigate the virus. Scientists are using climate data to draw relationships between Valley Fever rates and climate changes like rain and wind. Scientists hope that they will then be able to foresee broad impacts of Valley Fever based on climate trends.

In other parts of the state, like Kern County, education is a key strategy in fighting Valley Fever. According Emma Chaput, who works for the Kern County Public Health department, Kern County has one of the best labs for testing for Valley Fever. This, combined with a population aware of the disease, provides the county with ample records to learn more about the virus.

“Kern County routinely accounts for a large percentage of the cases in California,� said Chaput. “So nobody’s going to compare to Kern.�

However, Chaput does not attribute the high rates of Valley Fever in Kern County to ag land.

“We don’t know why there’s a lot of Valley Fever in Kern County. The only thing we know is that it’s hyper-endemic, which means there’s a high rate here routinely. So there’s just a lot of spores in the soil here.�

In 1992 there were more than 3,300 Valley Fever cases in Kern County. Since then there have been about 1,000 cases a year there. “It wouldn’t surprise me if the number of cases continued to go up,� she said. A growing population that has arrived in the area and has not been exposed to Valley Fever before is at a higher risk. There is also an increased risk if houses are built in places with high spore counts.

Chaput said that Valley Fever is one of Kern County’s most commonly reported diseases, and she too holds out hope for a vaccine.

“A vaccine would be years down the road,� she said. “They’re working on it, but don’t expect anything anytime soon.� ³

 

Managing Editor King Harris can be reached

at [email protected]. Staff Writer

John Peabody can be reached at

[email protected].