Weakened valley fever bill heads to governor's desk

The California legislature approved a bill Wednesday that would require the state public health department to develop public outreach programs for valley fever, an insidious respiratory disease endemic to Kern County. It next heads to the governor.

But that bill, AB 1279, authored by Assemblyman Rudy Salas, D-Bakersfield, has been significantly stripped down by a committee from the version introduced last spring. In the legislative process, it lost millions of dollars in funding and robust elements that addressed flaws in disease reporting.

“Unfortunately, the Assembly Appropriations Committee removed the funding. The focus of the bill was narrowed to public awareness in order to keep this issue at the forefront and to persist in the fight against valley fever,” Salas said Wednesday.

Once a comprehensive bill promising  $2 million in funding and the formation of a workgroup of health professionals to address deep flaws in disease reporting protocols, the bill now proposes just one thing: to require that the California Department of Public Health create a public awareness campaign for valley fever.

Ironically, the California Department of Public Health opposed the legislation. The Department of Finance was the only other state agency to formally oppose it,  according to a Senate floor analysis published this month.

CDPH declined to explain why it opposed the bill, saying it doesn’t comment on pending legislation. CDPH also wouldn’t say how it would implement a public awareness campaign if the governor signs the bill into law.

Salas said the CDPH’s opposition stems from its claim that it needs extra money to implement the bill. He said his office has been in talks with the CDPH about reaching out to vulnerable populations for the awareness program.

Despite the setback, Salas said he considers any bill that requires public outreach, potentially saving lives, a success.

“It has been proven that public outreach and awareness is an effective tool in combating valley fever that saves lives and helps patients get diagnosed early and accurately,”  Salas said. “When you see the suffering that patients go through because they were inaccurately diagnosed or diagnosed too late and the infection was allowed to spread to the brain and spine—I think that if this legislation can prevent anyone from having to go through that, then I would consider it a success.”

Salas introduced legislation after USC’s Center for Health Journalism Collaborative, of which The Californian is a member, uncovered deep flaws in the way valley fever cases are reported by 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.

Salas’ initial proposal promised to fix those reporting flaws by creating a workgroup of public health officials from the five counties most impacted by valley fever.

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 and may draft more legislation.

“I will continue to fight in the next legislative cycle for more funding and resources to be dedicated toward research, tracking and reporting of valley fever. I am continuing to work and talk with advocates and experts to find the best way to address valley fever with legislation in the future,” Salas said. “This disease is not going away and has actually been increasing, so I am not going to give up trying to help the thousands of families that have already been affected by this disease and those who might be infected in the future.”

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.

Throughout 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, mostly through overseas travel, 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 provide any state funds for valley fever awareness, even though valley fever routinely is contributes to about 50 deaths per year, 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.