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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

Robbed of strength

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

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

Dan Ocampo / The Californian Holly Wiswell holds her 10-month-old son, Aaron, who suffers from valley fever. Aaron woke up coughing, wheezing and crying at night until he was diagnosed at four months and received medication.

Valley fever doesn't discriminate when picking victims. The fungal spores don't care if they attack a grandmother trying to finish a quilt, a baby still adjusting to the world or someone just trying to make a living.

Although most people get valley fever without even knowing it, the disease wreaks serious havoc for an unlucky few.

Their recovery can take weeks or, sometimes, years.

A "happy wheezer"

Ashley Wiswell, 3, starts most of her sentences with, "Hey, hey, hey!"

Sometimes it takes serious effort for her to nudge her way into a conversation, but Ashley is persistent.

Staying the center of attention isn't easy even for a cute, little girl when she has a chubby-cheeked baby brother who goes to the doctor a lot.

Aaron, at 10 months, is all smiles, clapping as he says his favorite word, "Da-Da."

His happy countenance masks the fact that he has been sick with valley fever for eight months. His doctor calls him "a happy wheezer."

While babies have been known to get the disease, it is rather unusual.

Aaron's parents took him to the hospital with a 105-degree fever when he was just a couple of months old. Soon after, he was diagnosed with pneumonia, which commonly occurs in valley fever.

But it took several hospital visits and physician consultations before anyone tested him for the fungal disease. At four months, he began treatment.

His parents mix an orange-flavored, anti-fungal powder with water each night and feed it to him with a plastic syringe.

When Aaron isn't taking his medicine, Ashley likes to play with the syringe.

During his first few months on medicine, Aaron would wake up in the middle of the night and cough, wheeze and cry.

But now Aaron's condition has improved. His parents hope that will continue, but doctors aren't making any promises.

The Wiswells' medicine cabinet is now well stocked. Aaron has had to take steroids, allergy medicine, asthma inhaler treatments and nebulizer treatments through a face mask.

His parents even moved from their home around Edison Ranch to a place near Meadows Field in Oildale to get away from the dust.

They believe Aaron got the disease at their old house, where the fungus probably came in through a swamp cooler.

Aaron has become so used to doctors and various treatments that he doesn't cry anymore when his blood is drawn.

"They all know him," his mother said.

In spite of the disease, Aaron appears to be developing normally: growing, gaining weight and sticking anything he can find in his mouth.

Still, the disease has caused its share of financial and emotional difficulties.

"I worry about him every day going to work," said Aaron's father, James Wiswell, who is the sole breadwinner. "I know my wife is pretty strong. She's been going through a lot with him."

Both parents check on Aaron frequently at night.

Aaron's father had to take a week off work in the oil fields when his son was at a Los Angeles hospital, which meant losing a week's pay.

The family has insurance through Kaiser Permanente but keeping up with the co-payments has taken its toll.

The family members are now fully aware of the dangers of the disease, and they don't want to catch it themselves.

"I have to shut the windows," Aaron's mother, Holly Wiswell, said. "If it gets really windy outside, we keep him in the house."

Ashley, for her part, likes to help her brother.

"I get him to the doctor," she said.

Taking life as it comes

Dan Ocampo / The Californian Jackie Brown spends time working in her garden at her Bakersfield home. Extreme fatigue from valley fever has limited her activities.

The joys of Jackie Brown's life come in varied forms: a cross-stitch pattern, a large pot of flowers, old friends and her precious grandchildren.

When Brown was diagnosed with breast cancer in 2000, she remained positive, believing everything would be OK.

But she hated being tired and was disappointed when her doctor told her last year that it was a normal part of recovering from cancer treatments and growing older.

However, Brown, 69, knew it must be something more when she struggled to walk to her car after a Fresno State football game late last summer.

Soon after that game, her doctor diagnosed her with valley fever, a disease that kept her stuck in bed for at least six weeks, at times with a high fever.

Brown didn't always sleep, but she also didn't have the energy to read, watch television or do anything else.

"I just kinda laid in bed and looked out the window," she said. "If I got up and took a shower, I would have to go back to bed before I got dressed."

For a woman who was used to keeping a clean house, cooking, and playing bridge with friends, the lifestyle change was difficult.

"I was going to make my grandchildren quilts for (last) Christmas," she said. "They're still not made. I still don't have the concentration."

Because of her experiences with breast cancer and valley fever, Brown has learned to become more laid back.

She no longer winds up the hose when she is done watering the plants in the back yard. If she gets tired while vacuuming, the vacuum stays in the middle of the room and she goes to bed.

"I just don't let anything bother me," Brown said. "There's more important things to be concerned about."

While Brown says she feels "a thousand times better," she still has the disease and her energy level is not high.

She gets up every morning for breakfast with her husband, Michael Brown, and will clean a little, do a crossword or garden, by far her favorite activity.

"That's the most important thing," she said. "I just pull up a chair and I kind of putter. I kinda play in the dirt."

But by the time she and her husband finish lunch, she is ready to go upstairs to rest.

Occasionally, she will play bridge or make a quick trip to a sewing shop in the afternoons, but then she has to take it easy the next day.

While Brown has experienced some other valley fever symptoms, such as loss of balance, the most annoying one has been her constant need for rest.

"It just seems like a gross waste of time," she said. "I feel like I don't accomplish anything."

Struggling for a future

Dan Ocampo / The Californian Marta Chavez of Bakersfield has had valley fever for six years. The disease has prevented her from keeping a steady job.

Marta Chavez is 26 years old.

By this time in life, she expected to have a college degree and a full-time job working with children.

Instead, she's sitting at home with no money in her pockets, trying to recover from valley fever.

For the past six years, the West High School graduate has held various jobs for short stints before quitting due to sickness and fatigue.

It started just a year after high school.

She was attending Bakersfield College and working at a dental office.

Between filing papers, she would rest her head on her hand and wonder, "Why am I so tired?"

One Sunday evening, she hyperventilated at church and was taken to the hospital. Doctors found an inch-long cavity in her lung and guessed it was valley fever.

They were right.

Chavez, who also suffers from diabetes and asthma, eventually had to quit her job and school.

"I haven't been to school since 1999 because I would feel so tired," she said. "I'm in class and I'm tired and I'm sleeping."

In addition to fatigue, Chavez felt hot all the time. On the coldest winter nights, Chavez slept with her windows open and had a fan blowing on her.

Still, over the years, she worked at several places as much as possible. Her last job was as a clerk at Kern Medical Center last year.

"I felt good working," she said. "I started feeling like pressure in my lungs. I'd say, 'Man, something's wrong with me,' but I loved my job and I kept working."

But when her physician found cavities in both of her lungs from the fungus, it looked as if Chavez might need surgery. She feared dying on the surgery table.

Instead, she ended up going on amphotericin B intravenous treatments. Amphotericin B is the most effective treatment for valley fever, but also the most brutal.

It's similar to undergoing chemotherapy.

Chavez went from working at KMC to reporting there three times a week for four-hour treatments. She would use the days in between to recuperate.

"This past year was the worst of everything I had to go through," she said. "It's a good medicine, that amphotericin, but I wouldn't wish anyone to go through that."

She traded in her night sweats for cold chills, regularly coughed up blood and found it difficult to get out of bed.

At her weakest moments, she couldn't even dress herself or shave her legs.

"It makes you feel like your whole body is hurting, the amphotericin," Chavez said. "I used to call it ampho-terrible."

After nine months on amphotericin B, Chavez is back on oral medicine, which doesn't cause her problems.

Her strength is slowly coming back and she can spend more time up and around, even visiting her young nephews and nieces.

Last month, she went to Pismo Beach, Cambria and Morro Bay -- her first out-of-town trip in several years.

"It just felt good to go out and get some fresh air," she said.

Chavez doesn't have the energy yet to do everything she wants, but she hopes before too long, she can get on with her life.

"I would like to go back to work at the hospital," she said. "Get my degree, go to Cal State."

Eventually, she would like to work with children in a school, hospital or day care setting.

"I'm tired of being home. I'm used to having money in my pocket," Chavez said. "If I can go back to work, I'd be more than glad to."

Shooting for normal

Dan Ocampo / The Californian Russell Wissink, a Bakersfield construction worker, was out of work for six months due to valley fever.

Russell Wissink's days are filled with physical exertion and he likes it that way.

For work, the 25-year-old sets up wood and steel at construction sites to support concrete formations.

For play, he works on his Harley-Davidson, takes it for rides, skateboards and builds skateboard ramps.

So in 1999, when Wissink dropped from a muscular 180 pounds to a skinny 140 while lying in bed with valley fever, he lost his ability to do most of the things he loves.

"I just woke up one morning at 4 and had my parents take me to the hospital because I couldn't breathe," he said.

For weeks he slept 22 hours a day.

He felt he was making progress when he finally managed to get out of bed and walk to another room.

But then, after a few minutes, he would have to hit the sack again.

One day, Wissink felt good enough to walk out to the mailbox.

"I remember that was a big step," he said.

Visits from friends made the time bearable and as he got stronger, he could stay awake for several hours to watch videos or work on photo albums with a friend.

But he missed his normal life.

"I couldn't get up and do what I usually do," he said. "I missed snowboarding season."

By January 2000, Wissink felt good enough to try going back to work.

"I worked my eight hours, I went home and went straight to bed," he said.

In time, his strength improved and he continued working as well as getting back to working on his bike.

However, two years later, Wissink believes his bout of valley fever still has lingering effects.

"I think I'm just now beginning to get back the same stamina I used to have," he said. "I might not still be 100 percent."

Limited life

Dan Ocampo / The Californian Leonard Donald, 31, has struggled with valley fever, which has kept him from working.

Leonard Donald loves to work.

Whether it's delivering water to oil fields or driving a tank for the National Guard, Donald is willing to put in 12-hour days.

But for the past eight months, Donald wasn't able to work. And that bothered him at least as much as the reason for his hiatus: valley fever.

The 31-year-old was hospitalized with pneumonia last fall, but was not tested for valley fever.

A week later, he was back at work and developed painful lumps on his left thigh and forearm.

Donald went to an urgent care center, but the doctor just asked if he'd been in a fight or was using drugs.

The doctor prescribed painkillers, but ran no tests.

Swelling in Donald's arm and leg increased so much that he started to limp and his supervisor insisted he see a doctor.

"They took one look at me and then they admitted me to the hospital," Donald said.

Hospital staff drained fluid from his arm and leg and diagnosed him with valley fever. They also put him on intravenous anti-fungal drugs.

"They said they pretty much caught it in time," he said.

Donald's physician, Dr. Navin Amin, said Donald would have died if the disease had spread any further.

After diagnosis, Donald's leg and arm continued to hurt and drain fluid for several months.

"It was stinging. I didn't even sleep," Donald said.

Over time, Donald went from using a walker to crutches and now walks on his own.

Not being able to work made Donald bored and stir-crazy. He missed his job at Kern Vacuum Service, where he would deliver water to the oil fields in Belridge.

He couldn't stand to think how the disease had limited him.

"I get pretty bad headaches," he said last month, grimacing with tears running down his face. "I can't -- I can't really -- I get tired quick. I never got tired before."

Just recently, however, Amin had some good news for Donald: He can go back to work.

And this month, that's what he did.

"I feel pretty good," Donald said. "I'm ready to go back. I've been ready."