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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

Education key to treatment

By MICHELLE TERWILLEGER Californian staff writer e-mail: mterwilleger@bakersfield.com

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

Dan Ocampo / The Californian Robert Brauer Jr. serves as executive director of the Valley Fever Center for Excellence at the Southern Arizona VA Health Care System in Tucson.

The San Joaquin Valley may not be California's main tourist attraction, but it gets its fair share of visitors.

And a small percentage of those passing through go home with a biological souvenir they never bargained for: valley fever.

In the past year alone, two Europeans who came to Lost Hills for a model airplane competition and a handful of out-of-town construction workers, here to build a power plant in McKittrick, were diagnosed with the fungal disease.

Without assistance from local medical experts, the patients probably never would have learned what was ailing them.

In the first situation, the U.S. Centers for Disease Control got involved, issuing a report that airplane competitors might want to talk to their physicians about whether they needed to get tested for the disease.

Those kinds of incidents are just one reason why people concerned about the disease have set up Web sites, brochures and toll-free numbers with plenty of information about valley fever.

The information is particularly helpful for people living outside the area but is used by locals as well.

Answers from Bakersfield

Dan Ocampo / The Californian Dr. Tom Larwood of Bakersfield spends several hours each week answering specific questions about valley fever via e-mail. The questions are forwarded from the Web site, www.valleyfever.com

Dr. Tom Larwood, a Bakersfield physician, spends about three hours a week on his home computer, answering questions and giving advice to people concerned about valley fever.

People from Arkansas to Australia write to the Valley Fever Vaccine Project of the Americas Web site or call the organization's hot line, desperate for answers.

Much of what they need to know is on the Web site at www.valleyfever.com, which includes basic information about the disease and ongoing research efforts.

People with more difficult or specific questions have their comments passed on to Larwood.

Larwood advised a woman from Canada to get tested for valley fever when she became ill after digging in the soils of Arizona.

"Her doctors in Canada weren't interested in listening to this," he said. "She needed help."

In addition to giving advice, Larwood sometimes can refer people to nearby physicians whom he knows are familiar with valley fever.

The public also can learn about valley fever from doctors like Dr. Hans Einstein, who occasionally give lectures on the disease.

Einstein, who has treated valley fever patients for decades, figures he has talked to nearly every Bakersfield service club as well as many businesses and organizations.

Despite all that, many doctors still don't think to test for the disease, he said.

"It still often gets overlooked," he said, "in the emergency rooms, too. Unless you have something in front of you, mentally speaking, at all times, you tend to fall into familiar patterns."

Like California, Arizona sees plenty of valley fever cases each year, particularly in the Phoenix and Tucson areas.

While hometown folks tend to know about the disease, many new arrivals don't.

Alerting snowbirds

Dan Ocampo / The Californian Dr. John Galgiani teaches physicians about valley fever and its symptoms.

Neither do the droves of tourists who travel through the Grand Canyon state each year and can pick up the fungal disease.

Like Bakersfield's Valley Fever Vaccine Project, Tucson's Valley Fever Center for Excellence is working to educate more people about it.

The Center for Excellence, which is housed in an office at the Southern Arizona VA Health Care System, has two full-time staff members and runs a Web site and a telephone hot line.

A sizable chunk of inquiries to the center come from Arizona, but it also has significant contact with people from California and around the world.

Part of the center's mission is to inform new residents, particularly the senior snowbird population that fills RV parks during the winter months.

"We're here to educate and help awareness grow," said Robert Brauer Jr., executive director of the Valley Fever Center for Excellence. "We're not here to scare you."

Brauer advises people to tell physicians their travel history when they feel ill.

Just like hiking in New England could increase exposure to Lyme disease, visiting parts of the southwestern United States could increase the chance of getting valley fever, he said.

"We're teaching people to be their own patient advocate," he said.

Some Arizona natives may remember hearing about valley fever on television, but now the disease is just occasionally covered by the local media.

Brauer is hoping to develop television public service announcements for the future, but he is still seeking funding for the project.

Dr. John Galgiani, an infectious disease specialist and researcher in Tucson, educates physicians about the disease and its symptoms.

"In Arizona, people are slow to look for cocci (valley fever)," he said.

Doctors are more likely to give a patient an anti-bacterial medicine for a fever and cough rather than testing for valley fever, he said.

Valley fever educational resources * Valley Fever Vaccine Project of the Americas at (800) 825-3387 or 832-1456 or on the Web at www.valleyfever.com * Valley Fever Center for Excellence at (520) 629-4777 or on the Web at www.arl.arizona.edu/vfce