CDC Says Calif. Inmates Should Be Tested for Valley Fever Immunity

California should test inmates for immunity to valley fever as part of efforts to reduce outbreaks of the illness in state prisons, according to a CDC report obtained Friday by the Associated Press, the AP/Sacramento Bee reports (AP/Sacramento Bee, 7/25).

Background

Researchers estimate that each year more than 150,000 people nationwide contract an airborne fungus known as valley fever, or coccidioidomycosis. People can contract valley fever by breathing in cocci fungal spores.

The fungus typically causes mild to severe influenza-like symptoms. However, the infection also can spread from the lungs to other parts of the body and cause symptoms such as skin abscesses, blindness and death.

In early May 2013, CDC began investigating the deaths of more than three dozen California inmates who had contracted the fungus at Avenal and Pleasant Valley state prisons in San Joaquin Valley.

In June 2013, U.S. District Judge Thelton Henderson ordered California to move inmates at risk of contracting valley fever out of the two prisons (California Healthline, 9/25/13).

Details of Recommendations

In the report, CDC recommended that the state begin using hypersensitivity skin tests to detect inmates who previously were exposed to valley fever, making them largely immune to the illness.

The skin tests -- recently approved by FDA -- involve an injection of a noninfectious strain of the illness and then a follow-up screening 48 hours later.

Inmates found to be previously exposed to the condition could be safely housed at Avenal and Pleasant Valley state prisons, according to the report.

Joyce Hayhoe, spokesperson for a court-appointed overseer of the state prison system, said inmates would be able to refuse the screening.

CDC experts predicted that system-wide testing would determine that 13% of the prison inmate population is immune to valley fever. In addition, the report projected that the skin tests would decrease the rate of infected inmates to 2% annually. The experts also said that about 5% of inmates at the two San Joaquin Valley prisons would be infected each year if preventive measures are not taken.

Don Specter, director of the not-for-profit Prison Law Office, said the skin test should be implemented as soon as possible (AP/Sacramento Bee, 7/25).

Lawsuit Filed Over Valley Fever

In related news, a lawsuit filed earlier this month on behalf of 58 current and former state prisoners alleges that the state knew inmates were at risk of contracting valley fever at the Avenal and Pleasant Valley  facilities and did not take preventive steps, the Sacramento Bee reports.

The suit states that inmates who were affected by the illness now face a "lifelong, crippling and sometimes fatal disease in addition to their lawfully determined sentences." The lawsuit seeks punitive damages, as well as monetary damages of:

• $5,000 annually per inmate for antifungal medication;
• $1,000 annually per inmate for testing; and
• $25,000 for the hospital expenses of those with the worst infections.

The action is the latest in a series of lawsuits against the state related to valley fever, according to the Bee.

The California Department of Corrections and Rehabilitation did not comment on the lawsuit, but a spokesperson said the agency has "been working to mitigate valley fever for years" (Stanton/Walsh, Sacramento Bee, 7/28).