ARI SHAPIRO, HOST:
California's been experiencing a record number of cases of Valley Fever. It's a fungal infection caused by breathing in spores that live in soil. Its most severe form can be deadly or require lifelong treatment. The illness is most common in California and Arizona. Jerimiah Oetting takes us to California's Salinas Valley, an area that's seeing one of the largest increases.
JERIMIAH OETTING, BYLINE: It's a hot, dry day in the Salinas Valley. Fields of leafy greens and vegetables stretch in every direction. Clouds of dust rise up behind trucks and tractors in the fields and sweep across Highway 101 in the wind. These are the perfect conditions to spread spores of the fungus that causes Valley Fever and why people who work outside, like farm and construction workers, are especially at risk.
JESSICA BADER: I got asked a lot if I was working in fields or gardening.
OETTING: Jessica Bader doesn't work outside. She and her husband, Brian Bader, live with their two children in Paso Robles, on the southern end of the Salinas Valley. Late last year, Jessica started feeling sick with symptoms similar to the flu or COVID-19, but she tested negative. Her doctor gave her antibiotics for pneumonia, but she kept getting worse.
J BADER: My neck was incredibly stiff. I felt like I couldn't stand up. I had incredibly bad headaches.
OETTING: That's when Brian rushed Jessica to the emergency room. She was seven months pregnant, and it was New Year's Eve.
J BADER: Worst New Year's ever - was just feeling absolutely awful.
OETTING: By the time she was diagnosed with Valley Fever, the infection had spread to her spinal cord and brain, a form of the illness called cocci meningitis. Her husband Brian says the diagnosis was scary.
BRIAN BADER: You know, the first things you look up with meningitis is it's fatal.
OETTING: Jessica and her baby survived the ordeal, but she now takes a powerful antifungal every day to keep the disease at bay.
B BADER: This will never go away. It's lifetime. She'll always have to take medicine.
ALLEN RADNER: It's really dramatic the number of cases that we've seen.
OETTING: Dr. Allen Radner has worked as an infectious disease expert in the Salinas Valley for 30 years. He says a decade ago, Valley Fever was a rarity.
RADNER: Historically, we might have 40 or 50 cases in a year, and now we're approaching 4- or 500 cases in a year.
OETTING: Valley Fever is not contagious. Most cases are so mild, they don't require any treatment at all, but anyone who inhales the spores can get a severe infection. Gail Sondermeyer Cooksey is an epidemiologist at the California Department of Public Health. She says they're not sure why there's a spike in California, but she says it might be due to a few factors. Like, doctors could be testing for it more. More construction in new places could be disturbing the soil. The series of wet years California has recently seen may also play a role.
GAIL SONDERMEYER COOKSEY: When we see prolonged drought followed by heavy winter rains, we see these surges in Valley Fever in the years that follow.
OETTING: She says the fungus thrives in the soil during wet winters, and its spores spread in the hot dry months of late summer and fall when cases are often highest in California. These so-called grow and blow cycles might intensify with more extreme weather due to climate change.
SONDERMEYER COOKSEY: There is a lot of concern that changes in climate and environment are going to lead to these diseases occurring more in the state of California, but also elsewhere in the United States.
OETTING: Arizona, where cases are historically higher than in California, is also seeing a spike, though it's not record-breaking. In general, cases have gone up across the West. And in the past few years, more cases have been reported outside of Valley Fever's typical range, even as far north as Washington state. With the disease becoming more widespread, Sondermeyer Cooksey says doctors and patients should learn more about it.
SONDERMEYER COOKSEY: Awareness of Valley Fever is low among the public and health care providers. So we want there to be more awareness.
OETTING: Jessica Bader says if she had more information...
J BADER: I'd be in a much, much better place now.
OETTING: She could have gotten tested earlier before her illness became so severe. For NPR News, I'm Jerimiah Oetting in Paso Robles, California.
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