An extremely deadly disease called Valley Fever has prompted a federal judge to order approximately 3,200 inmates out of two California prisons, by no later than Sept. 23.
Meantime, in a separate lawsuit, a group of inmates is suing the prison system for lifetime medication for Valley Fever they previously contracted.
Corrections department spokesman Jeffrey Callison declined comment on the lawsuit, but said the state is complying with the federal court order by moving about 2,600 of the 8,100 inmates housed at Avenal and Pleasant Valley state prisons; both located about 175 miles southeast of San Francisco.
Valley Fever is an infectious disease caused by inhaling a fungus that lives in the dry soil of low rainfall areas. It is spread through airborne spores when the dirt is disturbed by digging, construction, or strong winds.
There’s an increase risk to contract Valley Fever among African-Americans and Filipinos.
There is also a higher risk for people with weak immune systems, such as those with organ transplants or who have HIV/ AIDS, or have chronic illnesses such as diabetes, or chronic lung disease requiring oxygen, according to expert testimony in court papers.
Experts say there is no direct person-to-person transmission of infection and people with a prior history of the disease are immune to subsequent infection. However, a commercial test to determine immunity is not available, nor is there a vaccination to protect against infection.
The following California prisons have been termed environmentally friendly to the fungus:
Avenal State Prison, Pleasant Valley State Prison, California Correctional Institution, California State Prison Corcoran, Kern Valley State Prison, North Kern State Prison, Wasco State Prison, and The Substance Abuse Treatment Facility and State Prison at Corcoran.
Doctors say Avenal and Pleasant Valley have an unusually high rate of Valley Fever. A 2011 report shows 535 of the 640 reported cases within California prisons occurred at these two institutions.
The rate of sickness at Pleasant Valley was 38 times that of the residents of Coalinga, the city in which the prison is located, and 600 times the rate of Fresno County.
In 2005, the California Department of Public Health found 166 cases of Valley Fever at Pleasant Valley. Twenty-nine inmates required hospitalization and four deaths were reported.
Notably, although the state health department observed the increased risk for AfricanAmericans and Filipinos, Pleasant Valley did not transfer these inmates out, according to the court.
In addition, Pleasant Valley prison administrators did not implement recommendations made by the state health department to increase ground cover throughout prison property, which demonstrated to be an effective method at reducing airborne spores, the court papers show.
The Pleasant Valley warden described the health department recommendation as “not feasible” due to an initial cost that “could potentially exceed $750,000, in addition to signifi cant ongoing maintenance costs,” according to documents fi led in the court. “The warden proposed soil stabilization as an alternative solution; however, neither measure was implemented at that time,” the documents report.
A committee consisting of a court-appointed receiver and his staff, public health, academic, and clinical Valley Fever experts issued a report with 26 proposals to mitigate the sickness. However, prison offi cials and the receiver did not adopt all the recommendations but did respond by:
Implementing Valley Fever education programs for inmates and staff at state prisons
Canceling construction to expand Pleasant Valley
Relocating inmates with medical conditions designated by the multidisciplinary committee as being high-risk for Valley Fever from the eight institutions environmentally friendly to the fungus
Supporting the construction of a medical facility with dialysis beds in Stockton for the protection of patients with endstage renal disease
“Recommendations related to environmental mitigation that had been shown to be effective were judged to be too costly and were not implemented,” according to the court fi nding.
In December 2008, California prison offi cials asked a select subdivision of the federal Centers for Disease Control and Prevention (CDC) to examine Valley Fever cases among prison employees – not inmates – at Pleasant Valley and Avenal for a health hazard evaluation.
However, state offi cials unilaterally cancelled the planned site visit by the subdivision of CDC and “the agency subsequently closed out the request for a health hazard evaluation,” according to the court papers.
As the subdivision of CDC explained in a December 2009 letter to CDCR:
“We had planned a visit to both Pleasant Valley and Avenal for May 18-20, 2009. However, our trip was cancelled the week prior at your request. Shortly after we made plans for a site visit, a motion was made by California’s Offi ce of the Governor to have CDCR create an advisory group that would decide whether or not pursuing the health hazard evaluation further would be valuable to the State of California. In June 2009, we learned that your Offi ce of Risk Management, which had overseen occupational health issues for the prison system, was disbanded. You have since relocated to another position within CDCR. This development along with the lack of support from CDCR management precluded moving forward with the health hazard evaluation. We contacted the union leaders for the local California Correctional Peace Offi cers Associations (CCPOA), who did not support efforts to advance the health hazard evaluation. Since we do not have the support of either CDCR management or the local CCPOA unions, we are closing out your health hazard evaluation request.”
In April 2012, a report that examined Valley Fever 2006 and 2010 found:
Four institutions – Pleasant Valley, Avenal, Wasco State Prison, and North Kern State Prison – had Valley Fever rates higher than rates in the counties in which they are located, and none of these institutions “showed a consistent decrease in rates” despite implementation of the recommended measures, according to court documents.
Pleasant Valley had a Valley Fever rate 52 times higher, and Avenal had a Valley Fever rate nearly 10 times higher, than the county with the highest rate in California.
For fiscal years 2008-09 and 2009-10, 355 inmates required outside hospitalization because of Valley Fever, at a cost of $23.4 million per year.
Pleasant Valley and Avenal experienced the highest costs for Valley Fever in the system.
From 2006 to 2010, 27 inmates died from Valley Fever.
The receiver also conducted a study of 36 inmate deaths between 2006 and 2011 that were attributable to Valley Fever and found that 97 percent were in regions environmentally friendly to the fungus. Seventy percent were African-American, and 76 percent had a serious illness like HIV or diabetes.