H5N1

MMWR: Coccidioidomycosis outbreak among workers constructing a solar power farm — Monterey County, California, 2016–2017

Via MMWR: Coccidioidomycosis Outbreak Among Workers Constructing a Solar Power Farm — Monterey County, California, 2016–2017. The summary:

What is already known about this topic?  

Workers performing soil-disturbing activities are at risk for coccidioidomycosis, an infection caused by inhaling the soil-dwelling fungus Coccidioides. 

What is added by this report?  

Nine confirmed coccidioidomycosis cases were identified among 2,410 solar farm workers in California. The incidence among workers (1,095 per 100,000 persons/year) was 4.4 to 210.6 times higher than background county rates, providing evidence that illness was work-related.  

What are the implications for public health practice? 

Employers should take measures to protect workers from dust exposure in areas where Coccidioides is endemic, involvement of public health practitioners is needed in the review of proposed construction that might expose workers to coccidioidomycosis, and clinicians should suspect coccidioidomycosis in patients with a clinically compatible illness who work outdoors.

Canada BC wildfire: Health authorities dealing with ‘surge’ in smoke-related cases

Here in Vancouver we've been living for five days under an overcast of smoke, with the sun a bright-orange disc. So this Globalnews.ca report is no surprise: B.C. wildfire: Health authorities dealing with ‘surge’ in smoke-related cases. Excerpt and then a comment:

B.C. health workers are dealing with a “surge” in cases related to smoke from the province’s wildfires. 

The spike is related to the combination of heat and poor air quality, according to deputy provincial health officer Dr. Bonnie Henry.  

“We monitor the number of people who are getting Ventolin, which is a prescription rescue medication for asthma, and we monitor ambulance calls for respiratory issues, and we have some monitoring in some emergency departments, and yes, we’ve been seeing an increase in all of those.”  

Much of B.C.’s Interior, along with Whistler, Howe Sound, Vancouver Island, and the Central Coast are under a smoky skies advisory, while Metro Vancouver is under an air quality advisory due to fine particulate matter.  

Henry said the increase in cases is particularly acute in the heavily populated Lower Mainland area, which is also in the midst of a heat wave.  

“We’ve seen an increase in some areas, depending on the day and the time of day, the increase can be from 20 per cent to 50 per cent more than we’ve seen in the past 10 years in the same area.”

 Earlier this week, paramedics also reported a two per cent jump in 911 calls related to breathing issues.

As SF author William Gibson famously observed, "The future is here, but it isn't very evenly distributed." In British Columbia, the future is distributed all too generously.

US: California jury awards $12 million in valley fever suit against Caltrans

Via The Los Angeles Times: Jury awards $12 million in valley fever suit against Caltrans. Excerpt:

A Northern California jury awarded five construction company workers nearly $12 million in damages in a lawsuit alleging the California Department of Transportation did not warn them about the risks of being exposed to a dangerous fungus at a work site.  

The Solano County jury on Thursday found that Caltrans knew the risks of the fungus and concealed its presence. The crew was excavating and expanding a culvert in Kern County in 2008, according to the complaint. 

During the trial, jurors learned Caltrans employees not only knew the Kern County project was in a high-risk area, but had a map from the county health department showing places where the fungus previously had been in the soil.  

The fungus causes a potentially deadly respiratory disease commonly known as valley fever. 

Peter Alfert, lead attorney on the case, said Caltrans warned all of its employees in Kern County by email about the risk of the fungus and told them how to prevent exposure. That warning, however, was not given to independent contractors and their employees, he said.   

"They weren't advising people of the risk that they would get an incurable disease," he told The Times. "On a real, common-sense level, the case came down to the fact that it was clear that Caltrans knew about the risk. They warned their own people about the risk. It would be so easy to warn the plaintiffs about this."  

US: Five cases of valley fever reported in Washoe County, Nevada

Via the Reno Gazette-Journal: 5 cases of valley fever reported in Washoe County. Excerpt:

Health officials are blaming the four-year drought after five cases of valley fever were recently reported in Washoe County—an illness that is common in southwestern states, but rare in Northern Nevada. 

Since 2008, a yearly average of two to three cases of valley fever have been reported in the region, said Randall Todd, Washoe County Health District director of epidemiology and public health preparedness. Most of those individuals become infected while traveling to other neighboring states, he said. 

This year, infected individuals in two of the five cases said they haven’t traveled out of the county, Todd said. Although concerning, it doesn’t prove anything, he said. 

“When we identify a case, (infected individuals) almost always report traveling to areas that have more cases than we do like in California or Arizona,” Todd said. “So having a couple of people with confirmed valley fever, but have reportedly not traveled outside the area, it’s interesting.” 

Valley fever, also known as coccidioidomycosis, is soil-borne fungus that causes lung infection, according to the Center for Disease Control and Prevention. People become infected when they breathe in the spores. 

Although 60 percent of infected people don’t show symptoms, about 5 to 10 percent may have long-term breathing problems, Todd said. 

The illness could also spread to other areas outside the lungs and cause meningitis in about 1 percent of infected people. The fungus might also affect the nervous system and spinal cord and cause bone and joint problems in others. 

Valley fever is common in southern Nevada, Arizona, New Mexico and in the San Joaquin Valley in California. It’s also found in Texas, Mexico and most recently in south central Washington. It’s considered highly endemic in southern Arizona and central California. 

“It kind of just stops shy of us here,” Todd said. “The Las Vegas area sees more cases than we do up here. Every time we get one of these cases (in Washoe County), my question to staff is, ‘Where have they have been?’ ”

US: Valley fever as a human-rights issue

I think this must be my first post from the American Civil Liberties Union: Exposing Immigrants to Death Dust? No Thanks. Excerpt:

Immigration detention centers are notorious for extreme isolation and inhumane conditions, especially detention centers run by private corporations. So we were more than concerned when we learned a few weeks ago that Immigration and Customs Enforcement (ICE) is planning to send immigrants to a new GEO-run detention facility in the Bakersfield area—known as Mesa Verde. 

Not only will the transfer have serious consequences for immigrants fighting to stay in the country, but also for their health and wellbeing.  

A logistical nightmare 

Why should Bay Area advocates be concerned? Because ICE is planning to transfer immigrants that fall within the San Francisco immigration court’s jurisdiction to this new facility, even though Mesa Verde is nearly three hundred miles away from the court and most immigration lawyers’ offices. 

Being detained in northern California is already an extremely isolating experience, but ICE is taking the isolation to a new level. Immigrants will no longer be able to appear in front of judges in person, but will be forced to appear via grainy videoconference. These virtual immigration hearings will create an unnecessary burden for people fighting to stay in the U.S. and avoid being separated from their loved ones. 

In fact, a videoconferencing pilot program in the San Francisco immigration court from ICE’s Sacramento field office has made it next-to-impossible for immigrants to understand what is happening in their own court hearings. 

And although detained immigrants already struggle to communicate with their lawyers (when they have them) from current facilities in Yuba, Sacramento and Contra Costa Counties, good attorneys can and do visit their clients. 

But being five hours away from San Francisco will make attorney-client in person meetings a logistical nightmare for attorneys and clients held at Mesa Verde. All this will have serious and very real consequences for immigrants fighting their cases in court. 

Valley fever 

To make matters worse, transferring immigrants to the new facility in Mesa Verde represents a big health risk to the people ICE plans to detain there. 

Mesa Verde is located in the heart of a region that has high rates of coccidioidomycosis cases, a disease also known as “cocci,” valley fever, or death dust. For most, valley fever is a momentary illness, but for some people, it can be life-threatening, requiring hospitalization or a lifetime of medical treatment. 

It’s enough of a public health concern for the California Department of Corrections and Rehabilitation (CDCR) to spend $5 million to screen inmates held in prisons in the Central Valley in response to federal court supervision. The CDCR also moved more than 2,000 California inmates from Central Valley prisons earlier this year because of the health risks associated with valley fever. 

Those at high risk for severe cases of valley fever include Black, Hispanic, and Asian people--who, due to the systemic racism and inequities in our criminal justice and immigration enforcement systems, are also the ones most likely to be detained at Mesa Verde. 

The situation is particularly troubling considering that many of the future Mesa Verde detainees face deportation to countries where valley fever does not exist or with medical systems that are ill-equipped to treat it. 

For all these reasons, the ACLU Foundation of Northern California, the Asian Law Caucus, and several other partner organizations sent a letter to the San Francisco ICE office, urging them to pause all immigration detention at the facility until a study is carried out to determine whether appropriate safety measures can be adopted and such measures are put in place.

US: Drought conditions, travelers can spread Valley fever into California’s northern counties

Via The Sacramento Bee: Drought conditions, travelers can spread Valley fever into California’s northern counties. Excerpt:

Don Hopkins, a former Davis police officer and professional ballroom dancer, is having some trouble staying on his feet. 

Hopkins, 67, is still physically drained from an early May trip to Mercy Hospital at Folsom, where doctors pumped him with pneumonia antibiotics for more than a week before accurately diagnosing his Valley fever. 

As Hopkins’ temperature soared and he began to hallucinate, his wife, Lizette, insisted the doctors test for the disease, which is historically more prevalent in the southern Central Valley. Though Hopkins’ test results would surprise many in the Sacramento region, experts say the fever is not constrained to the south state and can be carried to other regions via travelers and drought conditions. 

“When doctors see somebody with what they think is pneumonia, they immediately give them antibiotic,” said Hopkins, who lives in the El Dorado County foothills. “Often the patient gets worse and the doctors don’t think about Valley fever. It can basically disable a person for the rest of their life.” 

Valley fever is caused by a species of fungus called coccidioides, which lives in the soil in Southern California, Arizona, Mexico and parts of Central America and can be brought to the surface by construction, agricultural work and other activities that disrupt the terrain, said Dr. George Thompson, director of the Coccidioidomycosis Serology Lab at the UC Davis Medical Center. 

Once airborne, the spores can travel beyond these endemic regions on a mere gust of wind. Thompson called the assumption that the disease is only a Southern California problem a “total misconception.” 

“The maps of where it is are well done, but those were in the ’40s,” Thompson said. “I think we’re going to see it all the way up through Oregon into Washington, maybe into Idaho and Nevada ... I think the region of it being endemic is going to expand a few hundred miles.”

US: A Valley fever death in New Mexico

Via the Carlsbad Current-Argus: Valley fever claims life of Carlsbad man. Excerpt:

A Carlsbad man is dead after a recent battle with valley fever. 

The fever is relatively rare for New Mexico, and deaths even more so, according to a state health official. It's more commonly found in areas of Arizona and California. 

Cases of the fever are now on the rise, largely in Arizona and California, the Health Department said. There have been 336 cases of valley fever in New Mexico reported since 2006. None of those have resulted in deaths, according to the health department. Four cases have been reported so far this year. 

Paul Jeffery Moore, 60, died on May 19. The Current-Argus was unable to talk with Moore's family members about the circumstances of his death, but according to a spokeswoman at the Office of the Medical Examiner, in Albuquerque, the manner of Moore's death was natural. The cause was "sepsis due to coccidioides immitis pneumonia." 

What that means in plain English, according to the Centers for Disease Control, is that valley fever is an infection caused by the fungus Coccidioides. The fungus lives in the soil in the southwestern United States and parts of Mexico and Central and South America. The fungus was also recently found in south-central Washington.

US: Doctoral candidate presents research on racial disparities in Valley fever

Via the Merced Sun-Star: Doctoral candidate presents research on racial disparities in Valley fever. But it really sounds like class disparities. Excerpt:

Latino and black men are more likely to acquire and die from Valley fever than other groups, research shows, but very little is known about why that occurs. 

According to Sarah Rios, a doctoral candidate in the sociology department at the University of California, Santa Barbara, a possible explanation as to why these groups are especially vulnerable could be because of the environments they are exposed to. 

During a lecture at UC Merced on Wednesday, Rios presented research that examines how race, gender and geography shape the environmental health risk of Valley fever for certain nonwhite groups in the Central Valley. The lecture is part of a Valley Fever Seminar Series hosted by UC Merced’s Health Sciences Research Institute. Valley fever is a fungal infection of the lungs. 

Rios, who comes from a family of farmworkers in the Salinas-Watsonville area, completed her undergraduate studies at Fresno State. After college, Rios joined the United Farm Workers, where she started developing the foundation for her work. 

Rios currently collects interviews from Valley fever patients in Kern County, where there is a large population of farmworkers. Because Valley fever is prevalent in areas where dirt and soil are disturbed, farmworkers are at greater risk. Rios recruits subjects mostly at health fairs, swap meets and bus stations in Bakersfield, Wasco and Taft. 

These patients, who are in large part Spanish speakers, share with Rios their experiences in dealing with the disease as well as their access to health care. 

Rios noted that because a large number of these people are undocumented, they do not have access to proper medical care. 

“Most of the affected people have worked in the fields,” Rios said. “They become sick, but they never know if it’s Valley fever, pesticide poisoning or exhaustion, because some of the symptoms are very similar. And without visiting a doctor, there’s no way to know for sure.” 

“I’ve heard cases of people who work until they collapse,” she continued. “Their knees just give out.” It is not until these workers are taken to a hospital that they learn about the possibility of Valley fever, Rios explained. 

Although there is still no cure for Valley fever, antifungal medications can be used to treat more severe cases. However, Rios said, the costs of these medications are too high for most farmworkers. 

“Medicine is very expensive. While speaking with these people, I’ve found that many feel the financial burden that they are placing on their families is not worth it,” she said. “As horrible as it might sound, some people feel it’s easier to just die.”

US: Valley fever found in Washington state

Via MyNorthwest.com: For the first time, fatal fungus found in Washington state. 

A fungus that can launch a fatal illness has been found for the first time in the soil of Washington. 

Officials for Washington State University say the fungus can cause valley fever, an illness that presents symptoms ranging from flu- to pneumonia-like. 

Valley fever occurs when the soil-dwelling fungus becomes airborne, releasing spores that get lodged in the lungs of humans and certain animals, especially dogs. 

The fungus is normally found in semiarid parts of the Southwest. 

Three unrelated cases were diagnosed in Eastern Washington in 2010-11. 

Scientists for Washington State say that soil samples taken recently from the vicinity tested positive for the fungus, proving it can survive here. 

All three people who got sick in Eastern Washington survived. 

According to WSU, in the fungus' most severe form, spores break from the lungs and cycle through the bloodstream, setting up infections that destroy bones, cause skin abscesses and inflame the brain. 

The Centers for Disease Control estimates it kills 160 people a year. 

WSU Regents Professor Emeritus Jack D. Rogers, an international expert on fungi, said the appearance of valley fever is not a one-time fluke. 

"Do I think it just showed up and made three people sick? No," Rogers said. "I think it has probably been in the soil for some time."

US: Valley fever confirmed in cast, crew of outdoor filming event

Via Healio.com: Valley fever confirmed in cast, crew of outdoor filming event. Excerpt:

An investigation by the California Department of Health identified five laboratory-confirmed cases and five probable cases of coccidioidomycosis, or valley fever, among cast and crew members filming at an outdoor set in Ventura County, Calif., according to an MMWR report. 

“Public health professionals, clinicians and the television and film industry should be aware that employees working outdoors in areas where Coccidioides is endemic (eg, central and southern California), even those not engaged in soil-disruptive work, might be at risk for coccidioidomycosis,” the investigators wrote. 

The first patient identified was an actor who presented to the ED on Feb. 28, 2012, after a 2-week history of fever and cough. The second patient identified was a camera operator who sought treatment in the ED on Feb. 24, 2012, after a 2-week history of cough, joint aches and muscle pain. Both patients had worked at the same outdoor filming event that took place Jan. 17 to 19 in Ventura County. 

A subsequent review of information from the California Department of Industrial Relations found six more workers with the same employer, who had also participated in the filming event and were evaluated for possible work-related valley fever. Two other cases were identified: one by review of social media in which one patient posted about his hospitalization, and one by a relative. 

Only two of the patients reported soil-disrupting activities, including digging and moving dirt. However, substantial soil-disruptive work, including grading and digging and filling a mud pit, occurred on the site shortly before filming.