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Valley fever hit epidemic proportions last year and experts are wondering if 2002 will be a repeat.

If the disease infects anywhere near the same number of Kern County residents as it did in the early 1990s, the cost could be staggering. During the epidemic years of 1991-93, valley fever costs mounted to more than $56 million. A similar outbreak now could mean even greater costs.

Researchers are making progress toward a vaccine, but the going has been slow. The Californian examines the impact of the disease and the efforts of those ìFighting the Fever.î

Treatment costs could skyrocket if last yearís epidemic continues

The Bakersfield Californian

Sunday June 23, 2002, 12:00:00 AM

Valley fever cost Kern County more than $56 million during the last epidemic in the early 1990s.

While staggering, that figure still probably understates the true costs, said one of the local experts who helped calculate how much money valley fever sucked out of Kern in terms of lost wages, hospital stays and drug costs for the years 1991 to 1993, when the epidemic was raging.

The costs were meticulously broken down in a 1996 paper written by doctors Royce Johnson, Hans Einstein, John Caldwell and epidemiologist Gavin Welch, included in the book "Coccidioidomycosis."

In 2001, doctors saw another epidemic caseload of valley fever patients. And experts now are waiting nervously to see if 2002 matches or exceeds that pace. If so, costs could soar far beyond those of the 1990s epidemic.

"How we treat patients - hospital costs, drug treatments - have all changed," Johnson said. Hospital stays are shorter but much more expensive now. And while more people are treated on an outpatient basis, drugs used now that weren't available back then are extremely pricey, he said.

"Drug treatment, even for mild cases, is much higher," Johnson said.

Valley fever afflicts many more people than reported because most fight it off without treatment.

The costs pile up with the cases that require a doctor's care.

Since the 1940s, when U.S. Army air cadets were brought to Kern airfields to train, experts have studied the effects of valley fever. Large numbers of those cadets fell ill, costing valuable training time.

Using figures from the 1940s through the 1990s, experts determined valley fever costs an average of 33 lost working days and put people in the hospital for an average of 11.5 days.

The total yearly cost per case using those averages was calculated at $8,096 in the 1996 paper.

That cost was broken down as 63 percent for hospital stays; 18 percent for clinic visits; 12 percent for lost wages; and 7 percent for drug costs. Uncomplicated cases averaged $5,400 per year while more severe cases averaged $48,000 a year.

Johnson expected those figures would be much higher if a similar epidemic hit now.