Kern County Public Health has seen a 22 percent increase so far this year in the number of serological lab tests performed for valley fever, an indication that cases could top last year’s figures, which were the worst recorded since the 2011 epidemic.
The public health lab performed 15,058 tests for coccidioidomycosis, or cocci for short, through September — almost 3,300 more than the same time last year. When lower figures came in for September 2016, the Kern County Public Health Services Department seized the opportunity to warn the public of a potential increase in cases.
By the end of last year, 2,310 people had been infected and six had died.
It’s unclear, however, how many of the lab tests run this year are positive for the infection, and the data doesn’t account for serological tests run through commercial laboratories, such as Physicians Automated Laboratory, QuestDiagnostics or Lab Corp. It also doesn’t account for whether there’s been a general increase in lab testing at the Kern Public Health lab, or for patients who have developed valley fever and are getting routine monthly tests.
The department does not have up-to-date numbers of confirmed valley fever cases this year.
Between the lab data and what public health officials have heard anecdotally, however, they suspect cases could be on par with last year — but won’t say definitively.
“It does seem similar to what we saw last year,” Kern County Department of Public Health Services Senior Epidemiologist Kim Hernandez said, making no predictions, however, whether cases would eclipse what was recorded last year.
“I wish I could predict how bad it could be so we could tell people beforehand. It’s always been a struggle to warn people. If we say it’s going to be a bad year and nobody gets valley fever, is it because everybody’s taking precautions, or did we miss the mark?” Hernandez said.
An insidious respiratory disease, valley fever starts with breathing. When the Coccidioides fungus that grows throughout the southwestern United States gets disturbed in the soil, microscopic particles are swept into the air. On dry, dusty days, those fungal spores can be inhaled and become lodged in the lungs. Some people develop no symptoms — the case for most. But for others, the fungus leads to flu-like symptoms, including cough, fever, extreme fatigue and night sweats. In the rarest cases, the fungus can spread throughout the body and cause a lifetime of health complications, and even death.
While lab tests have increased across the year, the greatest spikes have come in winter months — an unusual occurrence since the disease typically peaks during the late summer and early fall.
More than 2,000 lab tests were requested in January, a 35 percent spike over 2016, according to Public Health data. February saw a 24 percent increase, and March a 34 percent surge. Combined, the three months of testing total 5,207 — almost 40 percent of the year’s requested labs.
Hernandez said that could be chalked up to a delay in testing. People could be getting infected during peak months, but develop symptoms weeks later. By the time a doctor thinks to test for valley fever, it could be winter, she said.
While Hernandez said the lab tests aren’t always an indicator of higher cases, valley fever advocates say they’ve been hearing of increased cases throughout the community.
Sandra Larson, a longtime member of the Bakersfield-based Valley Fever Americas Foundation, said she met a doctor recently who just learned about cocci while working in Taft, where she practices.
“She’s appalled by the number of cases she’s getting diagnosed every week,” Larson said. “She’s getting three or four cases a week out there. That’s a lot.”
Fellow VFAF member Rob Purdie suggested another possibility: that consistent messaging about valley fever through media and public awareness campaigns are paying off and leading to the surge in testing.
"I wonder if it's a sign of effectively communicating the message," Purdie said. "That would be the best-case scenario."