When Nora Bruhn purchased her ticket to the Lightning in a Bottle art and music festival on the shores of Lake Buena Vista in Kern County earlier this spring, her ticket never mentioned that she might attend. ending up with a fungus growing in his lungs.
After weeks of night sweats, “heaviness and heat” in her left lung, a persistent cough and a painful rash on her legs, her doctor brother said she might have Valley fever, a potentially serious illness. deadly caused by dust. -loving mushroom that lives in the soils of the San Joaquin Valley.
Bruhn said she was not warned beforehand that Kern County and Lake Buena Vista are endemic for coccidioides, the fungus that causes the disease.
“If there had been a warning that there was a potentially deadly fungal entity in the soil, I absolutely would not have gone there,” the San Francisco-based artist said. “Honestly, I would have been paranoid about breathing the entire time I was there.”
The incidence and scope of valley fever has increased significantly over the past two decades, and some experts warn that the fungus is becoming increasingly resistant to drugs – a phenomenon they say is due to spraying of antifungal agents on crops in the region.
As annual cases continue to rise, local health workers have sought to increase awareness of the disease and its symptoms, which are often misdiagnosed. However, these messages focus only on Kern County and other Central Valley locations and rarely reach those who live outside of Kern County or other high-risk areas.
In the case of the Lightning in a Bottle festival, Bruhn said she did not receive any information about the risk on her ticket, nor in the materials provided to her by the event organizers. As far as she remembers, there were no signs or warnings at the site where she ate, slept, danced and inhaled dust for six consecutive days.
And she wasn’t the only one infected. According to state health officials, 19 other people were diagnosed with coccidioidomycosis in the weeks and months following the event. Five were hospitalized.
According to a statement provided by the California Department of Public Health, officials have been in communication with organizers and “encouraged” them to inform “participants about Valley Fever and to provide participants with recommendations for making a follow-up with health care providers if they develop illness.”
Do LaB, the company that puts on the festival, said through a spokesperson that it is adhering to health and safety guidelines provided by federal, state and local authorities. “Health and safety is always the primary concern,” they said.
The company’s website warns festival-goers about the prevalence of dust, but does not mention fungus or disease.
“Some campgrounds and stage areas will be located on dusty grounds,” the website states. “We highly recommend everyone bring a scarf, bandana or dust mask in case the wind picks up! We also recommend glasses and sunglasses.
Bruhn said that wasn’t enough.
“I think it’s really irresponsible to have a festival in a place where breathing can be a potentially fatal act,” she said.
The Kern County Health Department is also in discussions with the production company.
Lake Buena Vista in Kern County was the site of the Lightning in a Bottle festival this spring.
(Nora Bruhn)
In California, the number of cases of valley fever has increased by more than 600% since 2000. In 2001, fewer than 1,500 Californians were diagnosed. Last year, that number was over 9,000.
Most infected people will not have any symptoms and their body will fight the infection naturally. However, those who experience symptoms often have difficulty recognizing them because they resemble the onset of COVID or the flu. This further complicates efforts to combat the disease.
Take for example the case of Brynn Carrigan, Kern County Public Health Director.
In April, Carrigan started having a lot of headaches. Not much of a “headache person,” she attributed them to stress: managing a high-level public health job while also being a parent to two teenagers. But as the days and weeks went by, the headaches became more frequent, longer and more painful. She also developed a distressing sensitivity to light.
“I have never felt such sensitivity to light…all the curtains in my house had to be closed. I wore sunglasses indoors – because even the clock on my microwave and my oven, and the cable box… oh, my God, it caused excruciating pain,” she said . To leave the house, she had to put a blanket over her head because the pain caused by the sun was unbearable.
She also developed nausea and began vomiting, which led to significant weight loss. Soon she became so exhausted that she could no longer shower without needing to lie down and sleep afterwards.
His doctors ordered blood tests and a CT scan. They told her to get a massage, suggesting her symptoms were the result of tension. Another assumed her symptoms were the result of dehydration.
Eventually, the situation got so bad that she was hospitalized.
When the test results came in, Carrigan was told by her doctors that she had a case of disseminated valley fever, a rare but very serious form of the disease that affects the brain and spine rather than the lungs. . Looking back, she said she had probably been suffering from the illness for months.
Valley fever, a fungal infection, is spread through dust.
(Jason Armond/Los Angeles Times)
And yet, there she was, arguably the most high-profile public health official in a county recognized as a hot spot for the fungus and disease, misdiagnosed by herself and other health professionals several times before someone finally decided to test her for the fungus.
She will now have to take expensive antifungal medications for the rest of her life – medications that have caused her to lose her hair, including her eyelashes, and have left her skin and mouth constantly dry.
Because of Carrigan’s experience, his agency broadcasts public service announcements on television, radio and in movie theaters. She gives press conferences, speaks to reporters and hosts presentations for outdoor workers – solar farms, agriculture and construction – to educate these “individuals who have no choice but to be out and really disrupt the ground”. She also hopes to enter schools.
But she realizes that her influence is geographically limited. She can only really talk to the people who live there.
For people who come to visit Kern County — like Bruhn and the 20,000 other spectators who attended Lightning in a Bottle this year — once they leave, they find themselves alone.
A truck kicks up dust on a dirt road in Bakersfield in March 2022.
(Jason Armond/Los Angeles Times)
Outside of California, Valley Fever is also prevalent in Arizona and parts of Nevada, New Mexico, Utah, and Texas, as well as parts of Mexico and Central and American America. South.
Experts fear that as Valley Fever spreads — whether due to climate change, shifting demographics or increased construction in areas once left to coyotes, desert rodents and cacti – more and more serious cases are appearing.
They also fear that the fungus will develop resistance to the drugs used to combat it.
Antje Lauer, a professor of microbiology at Cal State Bakersfield and an expert on “cocci” fungi, said she and her students have discovered increasing pharmaceutical resistance in the fungus, a result of the use of agricultural fungicides on crops.
She said the drug fluconazole – the fungicide that doctors prescribe off-label to treat the disease – is almost identical in molecular structure to antifungal agents “sprayed against plant pathogens”. … So when a pathogen is exposed via these pesticides, the valley fever fungus is also found in these soils. It is exposed and builds immunity.
That’s the kind of thing that really concerns GR Thompson, a professor of medicine at UC Davis and an expert in treating valley fever and other fungal diseases.
“If you ask me, what keeps you up at night because of valley fever or fungal infections? This is what we do to the environment,” he said. “We learned that giving antibiotics to chickens and cattle was bad, because even though they grew faster, it led to antibiotic resistance. Right now, we kind of have to do our own reckoning with fungal infections in the environment. We apply antifungals to our crops, and now our fungi have become resistant before our patients have even been treated.
He said he and other health and environmental professionals are working with various local, state and federal agencies “to make sure everyone is talking to each other.” You know that what we put on our crops will not cause problems in our hospitals.
Because at the same time, he said, there is growing concern that the fungus has become more serious in terms of clinical outcomes.
“We’re seeing more patients in the hospital this year than ever before, which makes us wonder… has the fungus changed?” he said, quickly adding that health experts were actively studying this question and did not have an answer.
John Galgiani, who directs the Valley Fever Center for Excellence at the University of Arizona in Tucson, hopes a vaccine will be available soon.
He said a Long Beach-based medical startup called Anivive was awarded a contract to take a vaccine being developed for dogs — outdoor-loving creatures with noses to the ground and a penchant for digging, and therefore susceptible to disease – and reformulate it to make it suitable for clinical trials on humans.
He said prison populations, construction workers, farm workers, firefighters, archaeologists – anyone who digs the ground, breathes it or spends time outdoors in these areas – would be suitable populations for such inoculations.
But he, like everyone the Times spoke with, believes that education and awareness are the most important tools in the fight against the disease.
As with any other risky activity, he said, if people are aware of it, that knowledge gives them choices — and in this case, the tools they need to help themselves. -even if they get sick.
