Calif. lawmaker seeks valley fever funding, overhaul of reporting guidelines

Responding to a surge in cases and inconsistent reporting practices, Assemblyman Rudy Salas (D-Bakersfield) introduced legislation Tuesday that would allocate millions of dollars to valley fever vaccine research and streamline information sharing.

Assembly Bill 1279 would bring $2 million to an already-established state fund for valley fever vaccine research and create guidelines for how local, state and federal agencies report cases.

“Valley fever has been reported from almost every county in California, but 75 percent of cases have been found in people who live in the Central Valley and that is alarming,” Salas said in a news release. 

“The responsibility for identifying and warning the public of widespread diseases falls on local public health agencies, some of which have no set guidelines for defining epidemics. AB 1279 will invest in research and help health officials more accurately understand the disease.”

The bill’s introduction comes in response to the Center for Health Journalism Collaborative's years-long reporting series “Just One Breath,” which has exposed inconsistencies in how valley fever cases are tallied among local, state and federal health care agencies and highlighted the lack of attention and funding the disease receives compared to others. 

“The Collaborative’s work has been one of many sources that will guide this legislation and I look forward to working with stakeholders and researcher’s like the Collaborative as this legislation advances,” Salas said.

The reporting group has found that California lacks an official statewide method of tracking valley fever infections. Last year, for example, the California Department of Public Health reported that Kern County logged 455 cases through June. Kern County Public Health Services officials, however, reported 890 cases during the same time period.

Additionally, the Centers for Disease Control and Prevention has never logged more than 23,000 cases nationally in a given year, despite expert estimates that the disease infects more than 150,000 across the Southwest alone annually.

Lag times and disparities in reporting are so great that the CDC, the nation’s lead agency for protecting the public from serious diseases, would not know the full extent of a valley fever outbreak until months after it has occurred.

“We have seen inconsistencies in the reporting of valley fever cases at the county, state, and federal levels. AB 1279 intends to create clear guidelines for the reporting of infections so that health professionals can have a clear understanding of how many people are actually being affected. This will help us wisely target resources at the federal, state and local levels to address valley fever,” Salas said.

Despite experts theorizing for years that weather patterns play a role in valley fever epidemics, the Collaborative couldn't find any public health agencies with policies or procedures to warn the public about the possibility of a surge in cases based on those patterns. There has been no definitive study in California proving that weather alone predicts epidemics.

Salas’ bill seeks to address most of those things, although it does not specify how guidelines should be revamped. It's also unclear whether the $2 million could be spent on the development of treatments as well as vaccine projects, or if the funding could cross state lines.

Nikkomycin Z, for example, has shown promise in treating lab mice with valley fever, but has not attracted funding for human trials. The delta-CPS1 vaccine project is being developed for dogs and could lead to a human vaccine. Both are being developed in Arizona, another endemic region.

“I’m happy to hear that legislation is moving forward,” Rob Purdie, a board member for the Kern County-based Valley Fever Americas Foundation, said. “When we can track and streamline the tracking process, it is going to be a big step.”

Valley fever is an infectious respiratory disease caused by the coccidioidal fungus that predominately grows in the Southwestern United States, including Kern County. 

When the soil is disturbed, fungal spores are swept into the air, and if inhaled can lead to valley fever. Most who are infected don’t present symptoms, however others become severely ill, developing flu-like conditions and extreme fatigue. In rare cases it’s fatal.

That was the case for two San Luis Obispo residents who died of valley fever in the first months of 2017. Cases in Kern County from 2016 are still being tallied, but public health officials said in November they were expecting more than 1,500.

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