Coccidioides immitis twarts development in California

As in everything, California is a generation ahead of the rest of the world. Now they have discovered that a native fungus produces a sometimes deadly illness called valley fever, a problem that has to be taken into account in development. An outbreak at a Central Valley prison last year has state and county health officials worried that a planned expansion of area prisons will lead to additional sickness, death and financial cost. Construction kicks up dirt and increases the risk of infection. I am in this development business already fifty years but never heard of fungus problems in construction. But if California gets flu, I bet we all here in Israel shall soon in bed with meningitis.

At the Pleasant Valley State Prison in Coalinga, California, the infection rate skyrocketed last year after construction of a psychiatric hospital nearby released clouds of dust. More than 500 inmates, or about 10 percent of the prison population, showed symptoms of valley fever. Thirty-seven guards and prison staff also fell ill. Among them was Owen Kimberling, a 29-year-old guard who spent the summer of 2003 overseeing inmate crews working outside as the construction was going on. He woke up one morning with flu-like symptoms and a temperature of 104 degrees Fahrenheit (40 Celsius). Over the next five months, he was rushed to the emergency room twice and missed nearly 40 days of work. ``There wasn't a day that went by when I didn't feel absolutely miserable,'' Kimberling said. Powerful antibiotics finally eased the symptoms, though they have recurred, he said. At its worst, the fungus can cause severe pneumonia or meningitis, sometimes leading to death, according to the U.S. Centers for Disease Control and Prevention in Atlanta. At least nine prisoners and one staff member have died of valley fever- related ailments, the Department of Corrections said. Everyone who lives in the Central Valley inhales Coccidioides Immitis spores, experts say. Lifelong valley residents tend to develop immunity and usually don't get sick. Transplants -- such as inmates, prison staff and others new to the area -- are more vulnerable.

Coccidioides immitis/posadasii is the causative agent of coccidioidomycosis in humans. This fungus thrives in the dry dusty desert environment (it was discovered by Argentine Dr. Posadas - see pic) and most probably is present in Israel's Negev. Coccidioidomycosis is one of the true systemic (endemic) mycoses. It is acquired by inhalation and initially presents with a pulmonary infection which may later disseminate to other organs and systems. Airway coccidioidomycosis involving the endotracheal and endobronchial tissues may develop. Inhalation of the dry arthroconidia of Coccidioides immitis/posadasii, which are carried by dust storms, initiates the infection. Afterwards, hematogenous spread of the organism results in infection of skin, bones, joints, lymph nodes, adrenal glands, and central nervous system. The clinical picture has a remarkably wide spectrum. The infection remains as an acute and self-limited respiratory infection in most exposed hosts, but it progresses to a chronic and sometimes fatal disease in others. Spontaneous healing is observed in as high as 95% of the otherwise healthy hosts. Dissemination may occur particularly during pregnany and carries a high risk of mortality. Activities and professions related to tillage of the soil, such as agricultural work, telephone post digging, archeology, or simply playing with soil appear to be associated with development of coccidioidomycosis [531].