Brynn Carrigan’s headaches started in April 2024. In a few weeks, she was weakened.
His vomiting exacerbated excruciating pain in his skull. She spent almost every hour in bed with the blankets pulled on her head, blocking any ribbon of light. Even the clock on its microwave was too much.
“I went from training to a marathon, raising two teenagers and having a job to be essentially bedridden,” said Carrigan, 41, from Bakersfield, California, who works for public health of Kern.
Her condition continued to get worse and the doctors could not provide answers – until his third visit to the hospital, when a doctor asked her if she had had respiratory symptoms before the start of the headache.
She had. About a month before the start of the headache, Carrigan had what she thought was a typical cold – although she remembered that her cough lingered a little longer than normal and she continued to develop a rash on her thighs. Both symptoms have improved without treatment.
These have proven to be key information. A biopsy of its medullary fluid revealed that Carrigan had coccidioidal meningitis, a rare complication of fungal infection called fever valley.
“I knew that something was wrong, but never in a million years I thought it would be something so serious,” said Carrigan.
The valley fever, or coccidiodomycosis, is caused by inhalation coccidioides Spores, a type of endemic mushrooms in the warm and dry climate in the southwest of the United States. Climate change creates drier soils that go up further east, expanding the range of mushrooms. The valley fever is increasingly diagnosed outside its usual territory and the cases have increased in the west of the United States while Arizona still sees as many people as possible each year, California fills the gap.
From 2000 to 2016, California had 1,500 to 5,500 cases per year. From 2017 to 2023, these figures increased to 7,700 to 9,000 annual cases. Preliminary data for 2024 put the count to more than 12,600 – plus the state has ever experienced and around 3,000 cases more than the previous file, in 2023.
The first data show that California is on the right track for another record year. Already, the State recorded more than 3,000 confirmed cases of fever from the valley to the scale of the State, more than there was at the same time last year and almost double of cases at that time in 2023.
“There is no doubt that the number of coccidiodomycosis cases is extremely higher than before,” said Dr. Royce Johnson, head of the infectious disease division and director of Valley Fever Institute in Kern Medical in California. “If you want to see me right now, you should wait until July, and this is also going for my colleagues.”
Drought cycles leading to propagation
Carrigan lives in the county of Kern, a dry and sprawling region which is between two mountain ranges at the southern end of the Central California valley.
The county has already recorded at least 900 cases of valley fever so far this year and has been zero for the fungal infection of the State in the past three years.
But the cases still raised in places like Kern County do not lead the upward trend in California, said Gail Sondermeyer Cooksey, epidemiologist at California Department of Public Health.
Instead, new hot spots emerge along the edges of the central valley – in the counties of Monterey and San Luis Obispo, along the central coast of California. The cases of Contra Costa County, just east of Berkeley, have hitherto tripled this year compared to the same period in 2023.
“He seems to propagate,” said Soundmeyer Cooksey.
Many factors probably influence how coccidioides Spores are multiplying and spreading, “but something we have identified as a great driver of these peaks and decreases is drought,” she said.
A study in 2022 in the Lancet Planetary Health revealed that the years of drought suppress cases of fever in the valley, but several years of drought followed by a humid winter causes a strong rebound. This change in weather conditions, which is motivated by climate change, seems to be largely influenced by the hot spots of the valley of the valley emerge. Longer, dried summers can also change the transmission season, when the spores have spread, from the end of summer and early winter to earlier from the year.
“We see more humid pounds and drier dryers across the Southwest, but California sees it in a higher degree,” said Jennifer Head, assistant professor of epidemiology at the University of Michigan, who studies valley fever and climate change.
In Arizona, new hot spots appear in state places that have a climate more similar to that of California than in Arizona.
“The highest increases in Arizona can be found in the Northern Plateau regions, which, similar to California, have always been colder and wet,” said Head.
Next closely Los Angeles
The widen climatic models The range of valley fever in California are the same ones that drive increasingly intense forest fires. Scientists are still trying to understand how fires can worsen the risk of valley fever, but some research has shown a link between forest smoke and higher diagnostic rates.
Sounding Cooksey said that the State Health Department had warned the first stakeholders in the devastating fires in January in the County of Los Angeles, the potentially increased risk of the valley in the region due to fires. There have been epidemics spent among forest firefighters.
There are limited evidence that forest fires can spread the coccidioides Spores. In a study in 2023, the researchers examined 19 fires across California and observed higher rates of valley fever after three of these fires. These fires tended to be larger, located near population centers and burned areas which had a high transmission of the valley fever before the fire.
“It is not entirely clear if there is a link between forest fires and the valley fever, but what is important to know is that coccidioides Living in dirt and anything that disrupts dirt can exacerbate the valley fever, “said Soundmeyer Cooksey.” The fires do this, so we have all the reconstruction projects that also disturb the soil. “”
The Peak Valley Fever season has not yet occurred this year. Because reconstruction efforts are disturbing the soil in the burn scar, surveymeyer Cooksey said that public health and local services “follow the figures closely” in the zones affected by the fires of January.
Case after lightning in a bottle festival
The diagnosis of the valley fever is delicate, mainly because its symptoms overlap with other respiratory diseases, including flu, cocoat and pneumonia. If someone experiences these symptoms, it is important for him to let his doctor know if he has been around the ground or disturbed dust – in a construction area, campsite, hiking, outdoor work or in a festival – or in an area known to have a valley fever, said Sounding Cooksey.
Symptoms generally appear one to three weeks after exposure, but it can take up to eight weeks, so people may not establish an immediate link, the head of the University of Michigan.
Last year, at least 19 people attended the Lightning in A Bottle Music Festival – which takes place again in Kern County this month – were diagnosed with the fever of the valley later in summer. At least eight have been hospitalized.
“Lightning in a bottle is in the middle of the endemic region, it is one of the hot spots of the disease,” said Dr. George Thompson, director of the Center for Valley Fever at the University of California, Davis, adding that the vast majority of people who are attending there will not get an infection, but people who are not an endemic area may be at higher risks.
Thompson said he is clear that he and his colleagues through the state treat more patients for infection. Only approximately 1% of cases lead to fatal meningitis or other complications, as Carrigan did, but once a person is infected, he never releases the fungus from her body.
“There is no drug that kills Cocci, so what prevents you from being sick is your immune response,” said Johnson, from Kern Medical. To treat the infection, people receive antifungals “long enough for a person’s immune system to determine how to control it. If you do something to disrupt this immunity, it can start developing again, and this can surface years later, “he said.
Carrigan has spent the last year on an intense antifungal treatments. During the first months, she lost most of her hair and eyelashes and barely recognized herself in the mirror.
She has now recovered completely and even ran a marathon this spring, but she still takes antifungal medicines. Carrigan said that she wanted more people to understand both the warning signs of the valley fever and the importance of telling their doctor if they were somewhere with cases, which could help people get faster diagnosis.
“Even if it is only 1% of cases, as we see increasing, the number of people who undergo complications will also increase,” she said.
