When Nora Bruhn bought admission to the Lightning in a Bottle art and music festival on the shores of Kern County’s Buena Vista Lake earlier this spring, her ticket never mentioned that she might develop fungus in her lungs. Is.
After several weeks of night sweats, “heaviness and heat” in her left lung, a cough that wouldn’t stop, and a painful rash on her legs, her physician brother said she might have valley fever, which There is a potentially fatal disease caused by dust. -loving fungus that lives in the soil of the San Joaquin Valley.
Bruhn said he was not warned in advance that Kern County and Lake Buena Vista are endemic for Coccidioides – the fungus that causes the disease.
“If there had been any warning that there was a potentially deadly fungal entity in the soil, there was no way I would have gone,” said the San Francisco-based artist. “Honestly, the whole time I was there, I would go crazy for breath.”
The incidence and extent of valley fever has increased dramatically over the past two decades, and some experts warn that the fungus is growing increasingly resistant to drugs—they say this phenomenon may be due to the increased use of antifungal agents on field crops. Due to spraying.
As annual cases rise, local health officials have sought to increase awareness of the disease its symptomsWhich are often misdiagnosed. However, this messaging is focused only on Kern County and other Central Valley locations and rarely reaches people who live outside of Kern County, or other high-risk areas.
in the matter of lightning in a bottle festBruhn said he was not given any information about the risks on his ticket, or in the materials provided to him by event organisers. As far as he remembers, there were no signs or warnings at the place where he ate, slept, danced and breathed dust for six consecutive days.
And she was not the only one infected. According to state health officials, 19 other people were diagnosed with coccidioidomycosis in the weeks and months following the incident. Five were admitted to hospital.
According to a statement from the California Department of Public Health, officials have been in communication with organizers and provided them “with recommendations to inform attendees about Valley Fever and how to contact healthcare providers if attendees become ill.” “Encouraged” to do so.
Do LaB, the company that organizes the festival, said through a spokesperson that it follows health and safety guidance provided by federal, state and local officials. “Health and safety are always the primary concern,” he said.
The company’s website warns festival-goers about the prevalence of dust – but makes no mention of fungus or disease.
“Some campgrounds and stage areas will be in dusty areas,” the website says. “We strongly recommend that everyone bring a scarf, bandana, or dust mask in case it is windy! We also recommend goggles and sunglasses.”
Bruhn said that’s not enough.
“I think it’s really irresponsible to celebrate the festival in a place where breathing is potentially life threatening,” he said.
The Kern County Health Department is also in discussions with the production company.
Kern County’s Buena Vista Lake was the site of the Lightning in a Bottle festival this spring.
(Nora Bruhn)
In California, the number of valley fever cases has increased by more than 600% since 2000. In 2001, fewer than 1,500 Californians were diagnosed. Last year this number was more than 9,000.
Most people who are infected will not experience symptoms, and their body will fight the infection naturally. However, people who do suffer symptoms often have difficulty recognizing them, as they resemble the onset of COVID or flu. This makes efforts to combat the disease even more complicated.
Take the case of Kern County Public Health Director Brian Carrigan, for example.
In April, Carrigan began experiencing severe headaches. Not exactly a “headache person,” she chalked it up to the stress she faced: managing a high-profile public health job while parenting two teenagers. But as the days and weeks passed, the headaches became more frequent, longer lasting, and more painful. He also developed painful sensitivity to light.
“I had never experienced such sensitivity to light before… I had to close all the curtains in my house. I was wearing sunglasses inside — because even my microwave and my oven’s clock, and the cable box… Oh my God, it hurt excruciatingly,” she said. To leave the house he had to put a blanket over his head because the pain caused by the sun was unbearable.
She also started feeling nauseated and vomiting, due to which she lost a lot of weight. Soon she became so tired that she could not bathe without lying down and then sleeping.
Her doctors ordered blood tests and a CT scan. He told her to get a massage, saying that her symptoms were the result of stress. Another speculated that his symptoms were the result of dehydration.
Eventually, the condition became so bad that he had to be admitted to the hospital.
When the test results came back, her doctors told Carrigan that she had a case of disseminated valley fever, a rare but very serious form of the disease that affects the brain and spine rather than the lungs. Looking back he said that perhaps he had had this disease for several months.
Valley fever, a fungal infection, is spread by dust.
(Jason Armand/Los Angeles Times)
And yet, here she was, possibly the most high-profile public health official in a county that was identified as a hot spot for the fungus and the disease, before anyone finally decided to test her for the fungus. Was repeatedly misdiagnosed by myself and other health professionals.
She will now have to take expensive antifungal medications for the rest of her life—medications that have resulted in her hair falling out, including her eyelashes, as well as her skin and mouth becoming increasingly dry.
As a result of Carrigan’s experience, his agency has been running public service announcements on TV, radio and movie theaters. She holds news conferences, talks to journalists and runs presentations to outdoor workforces — solar farms, agriculture and construction — to educate those “individuals who have nothing else to do except be outside and actually disturb the soil.” Not an option.” She is also hoping to get admission in schools.
But he realizes that his influence is limited geographically. She can really only talk to the people who live there.
People who come to Kern County to visit — like Bruhn and the 20,000 other concertgoers who attended this year’s Lightning in a Bottle — once they leave, they’re on their own. .
A truck kicks up dust on a dirt road in Bakersfield in March 2022.
(Jason Armand/Los Angeles Times)
Outside California, Valley Fever is also prevalent in Arizona and Nevada, New Mexico, Utah, and some areas of Texas, as well as Mexico and parts of Central and South America.
Experts worry that as the range of valley fever spreads – whether due to a changing climate, changing demographics, or increased construction in areas left to coyotes, desert rodents and cacti – more and more serious cases will emerge.
They are also concerned that the fungus is developing resistance to drugs used to fight it.
Antje Lauer, a professor of microbiology at Cal State Bakersfield and a “cocci” fungus expert, said he and his students have found increasing drug resistance in the fungus, which is a result of agricultural fungicide use on crops.
He said the drug fluconazole – the fungicide doctors prescribe off-label to treat the disease – is almost identical in molecular structure to the antifungal agents “being sprayed against plant pathogens.” …So when a pathogen is exposed through those pesticides, the Valley Fever fungus is also in those soils. “It gets exposed and is building immunity.”
This is the kind of thing that really worries GR Thompson, professor of medicine at UC Davis and an expert in the treatment of valley fever and other fungal diseases.
“If you ask me, what keeps you up at night about valley fever or fungal infections?, it’s what we do to the environment,” he said. “We learned that giving antibiotics to chickens and cattle was bad, because even though they grew faster, it created antibiotic resistance. At the moment, we are thinking our way through fungal infections in the environment. We’ve been putting antifungals on our crops, and now our fungus has become resistant to the treatments our patients have already had.
He said he and other health and environmental professionals are working with various local, state and federal agencies “to make sure everyone is talking to each other.” “You know what we’re putting on our crops is not going to cause problems in our hospitals.”
Because at the same time, he said, there is growing concern that the fungus has become more serious in terms of clinical consequences.
“We’re seeing more patients in the hospital this year than ever before, which makes us wonder… has the fungus changed?” He immediately said that health experts are actively investigating the question and do not have an answer.
John Galgiani, who runs the Valley Fever Center for Excellence out of the University of Arizona in Tucson, remains hopeful that a vaccine may be on the way.
He said a Long Beach-based medical startup called Anivive Got a contract to take a vaccine that’s being developed for dogs – outdoor-loving creatures that have their noses to the ground and a tendency to dig, and are therefore vulnerable to the disease – and put it into human clinical trials. It is reformulated to make it suitable for tests.
He said prison populations, construction workers, farm workers, firefighters, archaeologists — anyone who digs soil, breathes in it or spends time outside in these areas — would be suitable populations for such vaccinations.
But like others the Times spoke to, he believes education and outreach are the most important tools in the fight against the disease.
As with any other risky activity, he said, if people are aware, such knowledge empowers them to make choices — and in this case, the tools they need to help themselves if they fall ill. it occurs.
