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Updated Sep 24, 2013 - 6:05 pm

Feds announce clinical trial for valley fever

SAN FRANCISCO — California prison officials said Tuesday they have met a
federal judge’s order to transfer nearly 2,000 prisoners prone to valley fever
from two Central Valley prisons in areas particularly hard-hit by the
potentially deadly fungal infection.

The California Department of Corrections and Rehabilitation said it met the
judge’s goal a day after federal government scientists announced they were
launching a major medical experiment in search of a treatment for valley fever,
which is prevalent in California and Arizona.

The fever swept through two Central California prisons over the past six years,
killing 36 and hospitalizing hundreds more.

A federal judge on June 24 gave prison officials 90 days to complete the
transfer of prisoners prone to the fever to other prisons outside the region.

A prison spokesman said Tuesday 750 inmates prone to the illness remain at the
prisons. Several declined transfers. Others just recently qualified for
transfer, and corrections spokesman Jeffrey Allison said officials are working
to transfer those prisoners.

Blacks, Filipinos and inmates suffering from diabetes and HIV are among those
thought to be prone to valley fever, and the judge ordered transferred from
Avenal and Pleasant Valley prisons.

Officials with the Centers for Disease Control and Prevention and the National
Institutes of Health made the announcement about of the clinical trial Monday at
a symposium about the infection in Bakersfield, according to newspaper reports.

“We don’t exactly know what the best treatment is for valley fever, and this
is why we need a clinical trial,” said Dr. Thomas Frieden, director of the CDC.

The clinical trial will involve about 1,000 patients diagnosed with
community-acquired pneumonia, the most common presentation of valley fever. Half
the group will be randomly chosen to receive a placebo and an antibiotic used to
treat bacterial pneumonia. The other half will get the antibiotic plus an
antifungal medication frequently used to treat valley fever.

Officials say the goal is to determine whether patients on the antifungal
medication do better.

The study is not expected to get underway for at least another year, NIH
Director Francis Collins said. Results are not expected for several years.

“We all recognize that there’s more that needs to be done. There’s so many
unknowns,” Collins said. “We don’t know exactly what the right treatment is
for people who become infected with this fungus.”

The fungus that causes valley fever is found in soil and can be contracted by
breathing in the spores from dust disturbed by wind or other activity. In most
cases, the fever results in no symptoms, but in about 40 percent of the cases it
causes mild to severe flu-like symptoms or more serious infections. In can also
spread to the brain, bones, skin and eyes, leading to blindness, skin abscesses,
lung failure, even death.

The fever is prevalent in arid regions of the U.S., especially in California
and Arizona, as well as in Mexico, Central and South America. In California,
rates of reported fever cases increased by more than six-fold over the past
decade. Fever cases rose from about 700 in 1998 to more than 5,500 cases
reported in 2011, according to the CDC.

Royce Johnson, professor of medicine at the University of California, Los
Angeles and Kern Medical Center’s chief of infectious disease, welcomed news of
the clinical trial.

“There is a real difference of opinion about who should be treated, when they
should be treated and how much they should be treated with,” Johnson told the
Bakersfield Californian. “It would answer some of those questions.”

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