Monday, January 28, 2013

Got Cocci?

Coccidioidomycosis aka Valley Fever, California Fever, Desert Rheumatism, or San Joaquin Valley Fever is a fungal disease endemic to Arizona, California, Nevada, New Mexico, Texas, Utah, and northern Mexico. The fungus resides in the soil, it develops as a mold and breaks off into airborne spores when the ground is disturbed. Infection is caused by inhaling the particles. It is not transmitted from person to person. The infection however leaves the person with a specific immunity to re-infection. (why some archaeological company’s only hire crew who have had it.)

The spores can be easily inhaled without the person knowing. It arrives in the alveoli (the branches in your lungs) and then enlarge and internal septations develop. This structure is called spherule. The septations develop to form endospores. The spherules rupture and release the endospores. Nodules can form in the lungs surrounding these spherules. When they rupture, they release the endospores into the bronchus, forming thin-walled cavities. These cavities can result in symptoms like chest pain, hemoptysis (coughing up blood), and persistent cough.

Other more common symptoms include flu-like symptoms such as fever, cough, headache, rash, myalgia (muscle pain), and arthralgia (joint pain). Some people fail to recover and develop chronic pulmonary infection or widespread disseminated infection (affecting meninges [membranes that cover the nervous system], soft tissues, joints, and bone). Those with HIV can develop severe pulmonary disease.

The majority of people that have this, have had it since childhood. They don’t even know it. They get it as children and the parents see it as just another flu. This is especially true for those who were raised or live in the Central Valley of California, and those who have immigrated here legally or otherwise from Mexico.

Now that I have scared you to death, I have this lovely fungus among-us. I, along with several others were excavating in the deadly heatwave of the summer of 2006 just east of Bakersfield. I say deadly heatwave because some old people had died, and many a cows. I didn’t notice anything at the time. It takes a while to incubate, so to speak.

The following week we were to go up to the sierra’s to survey and record/update some sites, and a large sawmill site. The day we were to leave I woke up early with chest pains. I sat up and saw stars. I sat there and thought, “I’m having a heart attack”. I walked, slowly to my parents room and said, “I have chest pains, I think I’m having a heart attack.” They didn’t have the response I thought they’d have. My dad said, “are you dizzy, light headed?”, I said, “yes”. He said, “you probably have that bad flu thing with the inner ear thing. I had that last week.”

I turned around and went back to bed. “I guess I’m not having a heart attack”. I called the office and told them that I wasn’t feeling well and that I’d try and come out the following day. I drove out the next day, I still felt pretty bad. Still had the chest pains, and was getting weak. Day, three, started work with the crew out at the sawmill. I was tasked with documenting a trash deposit. I sat down on a tree stump and didn’t get up for two hours. I knew something was up. I was lethargic all that day and “out of it”. That night I got a fever. I still had the fever the next morning, and was even weaker. I walked out to the truck, and told my boss I now had a fever and said I should probably go home, so that I don’t infect everyone.

I rested up a bit, and then drove home. I didn’t leave my house for two weeks. I found out later that the day I left, the others started getting symptoms. In fact the day after, someone else went home. And by the end of the rotation, they were taking two hour naps under trees. After about 5 days or so, my chest pains went away. My other symptoms were fever, headache, cough, and muscle and joint weakness. I was out of work for about a month and it took about a year to get my lungs back to health. For many years, I had a hard time breathing at higher altitudes (above 7000 feet).

I never got tested. By the time everyone who got infected figured out what to test for, my symptoms were over. My boss got misdiagnosed with pneumonia and was eventually hospitalized for several days. She ended up taking anti-fungal medication for over a year to get rid of the spores in her lungs. She was out of work for over 4 months! Another comrade got chest x-rays taken and can see the scaring and nodules (looks like smokers lung). Another comrade had a cough for almost a year due to his complications with diabetes. We all inhaled the same spores but we all had a variety of different symptoms. I didn’t really know what Valley Fever was until we all came down with it.

For years after, I blamed my heavy breathing at high altitudes and when climbing/hiking up mountains on Valley Fever. And for awhile it was true. But now that I am in decent shape, I know that after the first couple years after infection, my heavy breathing was because I was out of shape. My lungs are now as strong as they ever were prior to infection. I still have nodules and probably scars, but they are healthy and strong now. The last time I was above 6000 feet, my lungs were fine, it was my legs that were sore. I had never fully recovered until now. Just like you can train your lungs to hold your breath for minutes, you can train them to better use oxygen. I figured they would recuperate on their own, and they did, but I had to train and exercise a lot to get them to be strong and function optimally.

So when I mentioned in my second post about Taft that some of my minions thought they had Valley Fever because they had heat rash, and I dismissed it? Now you know why I thought they were full of shit and overreacting. If your only symptom is a rash, count yourself lucky.

1 comment:

oneiromorphe said...

So glad I've not contracted disease while on survey. I've worn buffs, filter masks, and respirators (depending on how hot it is) when digging in areas where its supposed to be prevalent.