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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

Doctor has battled fever for 50 years

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

Saturday June 22, 2002, 12:00:00 AM

Dan Ocampo / The Californian Dr. Hans Einstein, 79, looks over a valley fever patient's chest X-rays. Einstein has devoted much of his career to studying valley fever.

Dr. Hans Einstein is a gentle, grandfatherly man with a brilliant mind.

And his name is practically synonymous with a terrible, fungal disease.

Almost 50 years ago, he performed clinical trials on the first effective -- and still most effective -- drug for the disease.

Over the last half-century, he's treated thousands of valley fever patients in Kern County.

He's traveled worldwide to give his expert opinions to thousands of physicians, scientists and students.

He's written some of the most important papers on the subject.

And he embraces his identity, driving a silver PT Cruiser with the license plate, COCCI, a nickname for the disease.

Einstein said he has broad interests and isn't obsessed with any one subject. But he admits, "Cocci comes closer than anything else."

Despite the almost universal admiration Einstein has earned, the 79-year-old doctor remains self-effacing with a sense of humor.

"All my friends laugh at your jokes," his adopted daughter, Jessica Sowers, told him.

"That's a good sign that you have very intelligent friends," he responded.

Despite his vast knowledge, Einstein speaks in a simple and direct manner, looking people in the eye while sharing his wisdom in plain language.

And as much time as he spends on his favorite subject, he leads a balanced life.

In fact, his current goal isn't scientific. He wants to live long enough to see 15-year-old Jessica finish high school.

"I can promise you high school, but college ... hmmm," Einstein said, quoting his cardiologist. His "ticker has been acting up here lately," he said, referring to a heart attack he suffered and the bypass surgery he had last year.

But Einstein has too many people depending on him to leave anytime soon.

Passing on wisdom

Dan Ocampo / The Californian Dr. Hans Einstein volunteers at the weekly valley fever clinic at Kern Medical Center.

In a small staff room in Kern Medical Center's clinic recently, Einstein listened to internal medicine residents describe valley fever patients and how they think they should be treated.

Einstein and his protege, Dr. Royce Johnson, chairman of KMC's department of medicine, responded with comments based on their long experience with the disease.

Einstein has volunteered for years at the weekly clinic, seeing patients and working side by side with Johnson.

"I'm very glad he's here," Einstein said of Johnson, who has seen valley fever patients and conducted research for decades. "I've never really been that successful in getting anyone that turned on to cocci."

Johnson joined Kern Medical Center in the 1970s and quickly got to know Einstein.

"He's a lovely man and he's a lovely human being," Johnson said. "Everybody loves Hans."

The long path to Bakersfield

Einstein spent his childhood in Germany as the Nazi Party was gaining power.

His parents were Quakers, but of Jewish origin, and his mother believed they had reason to fear Adolf Hitler.

A year after Hitler took power, 10-year-old Einstein moved with his mother and sisters to the Netherlands, but his father stayed behind. Later, his father moved to New York, where he practiced medicine.

At age 16, Einstein finished high school in the Netherlands and, with World War II still under way, moved to the United States as an exchange student.

Einstein attended Furman University in South Carolina where he earned degrees in biology and English with a minor in zoology.

One of the first things Einstein did when he moved to Greenville was to look up his last name in the phone book. There was one Einstein listed and he turned out to be a relative.

He also turned out to be Albert Einstein's son.

"We became friends," Einstein said. "Whenever Albert came down, they would invite me over."

After graduation, Einstein went to New York Medical College and then became a medical officer in the U.S. Army.

He revisited his homeland while helping with the Berlin airlifts after the war.

"It was very interesting," he said. "I looked at everything through American eyes."

After his stint in the military, Einstein longed for sunny California.

He drove across the country in an old Ford to get to Kern General Hospital in Bakersfield.

"I made it to Boron and the car broke down," he said.

He spent days in the summer heat scavenging through Boron junkyards for car parts. Finally, he got the car's engine patched up enough to make it to Bakersfield.

Becoming Dr. Valley Fever

After finishing his residency at Kern General -- now Kern Medical Center -- Einstein became the assistant medical director of the Kern County tuberculosis sanitarium in Keene.

Soon after he started, he realized some of the patients actually had a different pulmonary problem: valley fever.

"That's when I really started to get seriously interested in valley fever," he said.

Although he could diagnose the disease, there appeared to be little he could do for the patients.

"We were trying all kinds of medications," he said.

Then, in 1954, Einstein was asked by the Scribb Lung Association to oversee a drug study on a new anti-fungal drug. Kern Medical Center gave him his own ward to carry out the drug trial.

Four years later, the drug -- amphotericin B -- was approved by the U.S. Food and Drug Administration.

"It still is the most effective," he said.

Einstein made a major mark in valley fever history then, but he was already looking ahead.

In the 1960s, Einstein was ready to work on a vaccine, but his research methods were not approved.

He wanted to try out an experimental valley fever vaccine on a group of state workers who were coming from outside the San Joaquin Valley to build an aqueduct.

"It was an ideal time, but the government wouldn't let us," he said.

Einstein finally got his chance in 1977 when the government approved a valley fever vaccine trial for humans.

But by the time the study was under way, Einstein had moved to Los Angeles, where he served as a medical school professor at the University of Southern California.

Johnson took over the local vaccine trials, which ended up causing too many negative side effects.

At USC, Einstein changed his focus from valley fever to AIDS, which was just getting noticed.

He set up an AIDS hospice and spent his time both teaching students and treating patients.

"I learned a lot about politics and the politics of disease," he said. "The politics of getting funding -- I learned that from AIDS."

Einstein returned to Bakersfield in 1988 and served as medical director at Bakersfield Memorial Hospital until 1999.

Back in the fever

Even during his tenure at Bakersfield Memorial, Einstein kept his hand in valley fever, volunteering his time at the KMC valley fever clinics.

So when valley fever cases started piling up during the epidemic of the early 1990s, Einstein was there to help.

"It can be a real zoo," Johnson said of the valley fever clinic. "I need him there to help me with the work."

Einstein also helped develop valley fever vaccine nonprofits and supported scientific and political efforts to get a new vaccine project off the ground.

"He provides continuity. He provides understanding of the science. And he provides an appreciation of the politics," said Stanley Clark, a professor at Cal State Bakersfield who is involved in the Valley Fever Vaccine Project.

Assemblyman Roy Ashburn, R-Bakersfield, who has helped secure funding for valley fever research, said Einstein has been a driving force in understanding and treating the disease.

"On valley fever, he's never given up," Ashburn said.

Dr. Hans Erasmus Einstein Age: 79. Born in Germany. Profession: Doctor of internal medicine with a specialty in pulmonology. Former medical director at Bakersfield Memorial Hospital. Professor emeritus at the University of Southern California. Family: Widower. Three grown daughters, one grown stepdaughter and one adopted daughter, Jessica Sowers, 15. Currently reading: "John Adams" by David McCullough; "Level 4: Virus Hunters of the CDC" by Joseph McCormick; "Founding Brothers: The Revolutionary Generation" by Joseph Ellis; and "The Spirit Catches You and You Fall Down" by Anne Fadmian. Favorite magazines: The New Yorker, The Atlantic Monthly, Newsweek and five medical journals. What he watches on television: News and "Jeopardy." Most frequently asked question: Are you related to Albert Einstein? Answer: Yes. Hans Einstein's grandfather and Albert Einstein were first cousins. Favorite answer: "When I was younger, I used to tell people I was his illegitimate son."