Valley Fever Kills Dozens in California Prisons

FRESNO, Calif. (CN) - Forty people have died of valley fever in the past seven years in two California prisons in the San Joaquin Valley, inmates say in a federal class action.

Valley fever, Coccidioidomycosis, is an incurable, debilitating, infectious lung disease caused by inhalation of an airborne fungus.

Seventy percent of the reported cases of valley fever in California from 1991 through 1993 arose in the San Joaquin Valley, according to a 1994 "Morbidity and Mortality Weekly Report" by the U.S. Centers for Disease Control and Prevention.

Seven inmates and former inmates who contracted the disease at either Avenal State Prison or Pleasant Valley State Prison filed the class action against Gov. Jerry Brown, the Department of Corrections and Rehabilitation, and prison officials.

Avenal State Prison (ASP) and Pleasant Valley State Prison (PVSP) are 10 miles away from each other in Avenal and Coalinga.

The plaintiffs claim that California has done nothing to prevent high-risk prisoners, including African Americans and people 55 and older, from contracting the disease.

The complaint states: "Coccidioidomycosis (commonly known as 'Valley Fever' or 'San Joaquin Valley Fever' or simply 'cocci') has long been known as a serious infectious disease which is contracted by the inhalation of an airborne fungus, 'Coccidioides Immitis.' Cocci is endemic in the soil of various areas of the Southwest. Nowhere is it more prevalent however, than in the San Joaquin Valley of California; i.e., Fresno and Kings Counties. ...

"It is well known that disseminated Coccidioidomycosis is progressive, painful, and debilitating, and that it is uniformly fatal once it progresses to meningitis, if left untreated."

The disease does not have a vaccine or an absolute cure. Treatments include surgical excision of tissue and bone, or taking the drug Fluconazole every day for life, plaintiffs say.

"Epidemiological studies have established that, for unknown reasons, African-Americans, persons over the age of 55, and those in an immune-compromised state are at higher risk for developing the disseminated form of Coccidioidomycosis. [In fact, for African-Americans, the risk is tenfold that of the general population.]," plaintiffs say in the complaint. (Brackets in complaint.)

Plaintiffs sued on behalf of three subclasses: African Americans, people 55 and older, and people who are immune-compromised who have been incarcerated at Pleasant Valley or Avenal prisons since July 8, 2009, and who have contracted Valley Fever.

The defendants have been aware since at least 2006 that Valley Fever attacks prison inmates within these subclasses, but have failed to take adequate steps to protect them from the disease, plaintiffs say.

"Approximately 40 inmates in the custody and control of defendants have died from cocci complications within the past seven years," according to the complaint.

A 2007 article in the Annals of the New York Academy of Sciences "pointed out that the construction of new prisons in affected areas has led to a marked increase in the number of cocci cases and identified the high infection rates at these facilities," the complaint states.

It continues: "In the previous year, 2006, the California State Public Health Department ('SPHD') published a formal study and report on cocci. Preventative measures were identified, however, the great majority of these measures were never implemented at any state prison facility, nor at either PSVP or ASP."

The state failed to screen for inmates who are at high risk for valley fever and place them at facilities other than Pleasant Valley and Avenal prisons, the plaintiffs say.

Without keeping high-risk individuals out of these prisons or taking measures to prevent their exposure to the disease, "the incarceration of the subclasses at PVSP and ASP was the equivalent of conducting a human medical experiment on the inmates, without their consent. While the great percentage of inmates might be expected to survive the disease, for an unacceptable percentage of inmates, including the plaintiff subclasses identified here, assignment to these facilities was a potential death sentence," plaintiffs say in the complaint.

Once infected people are released from the prison system, they are on their own, without any compensation for the "additional punishment that has been unfairly added to their sentences," plaintiffs say.

"Moreover, once released from defendants' custody, no health care system or assistance is provided by defendants to assist the plaintiff subclasses with the overwhelming cost and hazards associated with their illness. The defendants simply absolve themselves of all responsibility, leaving these former inmates who are African-Americans, over-55, and/or immune-compromised to fend for themselves in their attempt to obtain health-care for an illness that - if left untreated - is uniformly fatal," plaintiffs say in the complaint.

Two weeks ago, U.S. District Judge Thelton Henderson ordered state corrections officials to move 2,600 high-risk inmates out of Avenal and Pleasant Valley prisons in an attempt to deal with the Valley Fever problem. The state has 90 days from the date of the order to move the prisoners.

It is unclear whether this development will have any affect on plaintiffs' lawsuit.

Named as defendants are the State of California, Gov. Edmund Brown, the California Department of Corrections and Rehabilitation (CDCR), CDCR Secretary Matthew Cate, CDCR Secretary Jeffrey Beard, PVSP Warden P.D. Brazelton, AVSP Warden James Hartley, and California Correctional Health Care Services.

Plaintiffs seek punitive damages and a comprehensive, court-supervised medical monitoring program for the subclasses.

They are represented by Mike Arias with Arias, Ozzello & Gignac in Los Angeles.

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