Despite opposition from health officers, the State Assembly unanimously passed two bills Thursday authored by Assemblyman Rudy Salas, D-Bakersfield, that could streamline and standardize case reporting of valley fever, a respiratory disease endemic to Kern County and the southwestern United States.
The bills, AB 1787 and AB 1788, are part of a robust four-bill legislative package Salas introduced this year to combat the little-known fungal disease that gets scant funding for research and public awareness efforts.
AB 1787 would require an annual deadline of March 31 for local health officers to report all cases of valley fever for the previous year to the state. AB 1788 would allow health departments to report cases of valley fever based solely upon laboratory data, and not a clinical confirmation — which has been standard practice in Arizona for years.
Both measures could streamline reporting, Salas said.
“The record numbers of cases that we see occurring with valley fever means that more and more families are being affected by this disease,” Salas said in an emailed statement. “It is critical that we have the right mechanisms in place for local and state officials to most effectively help the thousands of victims of valley fever.”
Valley fever is caused by the Coccidioides fungus, which grows in the loamy soil of the southwestern United States. When disturbed, often through agricultural tilling, construction and high wind, microscopic fungal spores can become airborne and, once inhaled, cause valley fever. Most people are asymptomatic, but others develop flu-like symptoms, including fever, cough, headaches and chills. In some cases, when left untreated, the fungal spore can spread throughout the body and cause a lifetime of health issues, and in rare cases, death.
Salas’ legislation received criticism from The Health Officers Association of California, which is comprised of local health officers who oversee disease control. HOAC leaders said that an annual reporting deadline wouldn’t provide the needed flexibility to accommodate changing circumstances, and that progress has already been made with ongoing Valley Fever Workgroup discussions being had statewide.
The organization also asserted that the bill was “premature,” and could disrupt overall consistency of disease reporting timelines.
HOAC officials said that AB 1788, which would do away with clinical confirmation requirements, would result in “inaccurate, overinflated case counts.” That’s because the clinical confirmation process affords health agencies an extra step to ensure cases are genuine.
Disease experts at the Council and State of Territorial Epidemiologists said earlier this year that the bill would trade accuracy for speed and the result could be “chaos.” Meanwhile, Dr. John Galgiani, executive director of the Valley Fever Center for Excellence at University of Arizona, said that the margin of error by not conducting clinical confirmations is slim — less than 3 percent.
The legislation comes as cases of valley fever rise statewide for the third straight year and the disease spreads beyond its traditional boundaries. The Kern County Public Health Services Department reported valley fever infected more than 2,900 and killed nine people in 2017, making it the second worst year for the disease since the county began recording cases in 1992.