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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

Fever spreads when spores ride on wind, lodge in lungs

Life cycles of valley fever graphic

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

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

Valley fever.

Live in the southern San Joaquin Valley long enough and you'll hear about it.

But everyone has a different story to tell.

"I didn't know too many people that had it that bad," said Russell Wissink, a Bakersfield construction worker who was out of work for six months due to the disease. "I was kinda ignorant to it."

Valley fever can be confusing because it makes a few people really sick, some people a little sick and it doesn't bother most people at all.

The disease is caused by a fungus called Coccidioides immitis that grows along the foothills of the valley and in other areas in the southwestern United States, Latin America and South America.

Coccidioides immitis, or cocci (KAHK-see) for short, grows in alkaline soils in hot, dry areas, particularly near fossil sites. Experts believe it flourishes with ample winter rainfall followed by long, dry periods. It reproduces by releasing its spores, which is where humans come in.

Winds pick up the microscopic spores from dry soil and they can be inhaled by humans and animals.

The spores can then lodge in the small bronchial tubes in the lungs, where they cause infection.

In about 60 percent of cases, the immune system fights it off.

However, the other 40 percent of valley fever patients can come down with a fever, cough and even pneumonia.

Even in most of these cases, people can fully recover without being diagnosed with having valley fever.

For a few unlucky people, about 10 percent of the population that's infected, valley fever can be devastating.

Cocci wreaks havoc by changing its form after it enters a host.

After it enters the lungs, cocci changes from a spore to a spherule, or a fungal ball. The spherule is filled with baby fungal balls, waiting to be released.

Once released, they grow into new spherules, ready to release more cocci balls.

The fungus sometimes travels to the lymph nodes, where it can move to other parts of the body and enter the circulatory system.

The skin, bones and brain lining are particularly susceptible to the fungus, although cocci has been known to spread to virtually every part of the human body.

An attack on the brain lining, or meninges, is by far the most dangerous. It causes meningitis, which is fatal without treatment.

Meningitis is the second most common way people die from valley fever; severe pulmonary disease is the first.

Fatalities are relatively rare.

During the previous epidemic, which started in early 1991 and lasted until 1994, there were more than 8,400 documented valley fever cases in Kern County and 55 deaths.

At the epidemic's height in 1992, there were 3,342 reported cases that resulted in 25 deaths, which is less than 1 percent.