Brynn Carrigan’s headaches began in April 2024. In a couple of weeks, it was weakened.
His vomit exacerbated unbearable pain in his skull. He spent almost every hour in bed with the sheets on his head, blocking any light splinters. Even the clock on his microwave was too much.
«I went from training for a marathon, raising two teenagers and having a job to be prostrated in bed,» said Carrigan, 41, from Bakersfield, California, who works for the public health of Kern County.
His condition continued to get worse and doctors could not provide answers, until his third visit to the hospital, when a doctor asked him if he had had any respiratory symptom before headaches began.
She had done it. Approximately a month before the headaches began, Carrigan had what he thought it was a typical cold, although he recalled that his cough remained a little more than normal and continued to develop an eruption in his thighs. Both symptoms improved without treatment.
These turned out to be key pieces of information. A biopsy of its spinal fluid revealed that Carrigan had coccididal meningitis, a rare complication of a fungal infection called Valley Fever.
«I knew something was wrong, but never in a million years I thought it would be something so serious,» Carrigan said.
Valley fever, or coccidioidomycosis, is caused by inhalation Coccidoidoides Spores, a type of endemic fungi of the warm and dry climate of the southwest of the United States. Climate change is creating drier soils that advance more east, expanding the range of fungi. The valley fever is increasingly diagnosed outside its usual territory and the cases have increased in the west of the United States, while Arizona still sees the highest number every year, California is closing the gap.
From 2000 to 2016, California had 1,500 to 5,500 cases a year. From 2017 to 2023, these numbers increased to 7,700 to 9,000 cases per year. Preliminary data by 2024 count in more than 12,600, the top that the State has seen and about 3,000 cases more than the previous registration, in 2023.
Early data show that California is on the way to another record year. The State has already registered more than 3,000 confirmed cases of fever of the Valley throughout the state, more than there was at the same time last year and almost double what they were currently in 2023.
«There is no doubt that the number of cases of coccidioidomicosis is enormously higher than before,» said Dr. Royce Johnson, head of the Division of Infectious Diseases and director of the Valley Fever Institute of Kern Medical in California. «If you want to see me, right now you would have to wait until July, and that also applies to my colleagues.»
Driving Spred Drought Cycles
Carrigan lives in Kern County, a dry and extensive region that is between two mountain range at the southern end of the Central Valley of California.
The county has already registered at least 900 cases of fever of the valley so far this year and has been the zero zero for fungal infection in the state during the last three years.
But consistently high cases in places like Kern County are not conducting the upward trend in California, said Gail Sondermeyer Cooksey, an epidemiologist of the Department of Public Health of California.
Instead, new hot points are emerging along the edges of the Central Valley, in the counties of Monterey and San Luis Obispo, along the central coast of California. The cases in the counter against Costa, east of Berkeley, have tripled so far this year compared to the same time in 2023.
«It seems that it is spreading,» Sondermeyer Cooksey said.
It is likely that many factors influence good Coccidoidoides The spores multiply and spread: «But one thing we have identified as a great driver of those peaks and sauces is drought,» he said.
A study of 2022 in the planetary health of Lancet found that the years of drought suppress cases of fever of the valley, but several years of drought followed by a wet winter make the cases recover abruptly. This change in meteorological patterns, driven by climate change, seems to greatly influence the new hot fever points of the valley. The driest and fastest summers can also change the transmission season, when the spores extend, from the end of summer and early winter until the beginning of the year.
«We are seeing the most humid margins and the dryers throughout the southwest, but California is seeing that to a greater extent,» said Jennifer Head, an assistant professor of epidemiology at the University of Michigan, who studies fever of the valley and climate change.
In Arizona, new hot points appear in places of the state that have a climate more similar to that of California than in other parts of Arizona.
«The highest increases in Arizona are found in the northern plateau regions, which, similar to California, have been historically colder and more humid,» Head said.
Los Angeles closely tracking
The climatic patterns that expand the valley fever range in California are the same that drive increasingly intense forest fires. Scientists are still trying to understand how fires can make the risk of valley fever worse, but some research has shown a link between the smoke of forest fires and the highest diagnostic rates.
Sondermeyer Cooksey said the State Health Department warned the first to respond to the devastating January fires in Los Angeles County about the greatest risk of fever of the valley in the area due to the fires. There have been previous outbreaks among forest firefighters.
There is some limited evidence that forest fires can spread the Coccidoidoides spores In a 2023 study, the researchers analyzed 19 fires in California and observed higher valley fever rates after three of those fires. These fires tended to be larger, located near the population centers and the burned areas that had a fever transmission of the high valley before the fire.
«It is not entirely clear if there is a link between forest fires and the valley fever, but what is important to know is that it is that Coccidoidoides He lives on Earth and anything that disturbs dirt can exacerbate valley fever, «Sondermeyer Cooksey said.» The fires do that, so we have all the reconstruction projects that also disturb the ground. «
The Peak Valley Fever season has not yet happened this year. Because reconstruction efforts disturb the soil in the burning scar, Sondermeyer Cooksey said the state public and local health departments «are closely tracking the numbers» in areas reached by January fires.
Cases after lightning at a bottle festival
The diagnosis of valley fever is complicated, mainly because its symptoms overlap with other respiratory diseases that include flu, covid and pneumonia. If someone experiences those symptoms, it is important for them to inform their doctor if they have been on their disturbed ground or dust, in an area of construction, camping, walking, working outside or in a festival, or in an area that is known to have a valley fever, said Edertermeyer Cooksey.
The symptoms usually appear one or three weeks after the exhibition, but it can take up to eight weeks, so people may not establish an immediate connection, Head said, from the University of Michigan.
Last year, at least 19 people who attended the Lightning Music Festival in A Bottle, which is held again in Kern County this month, were diagnosed with a valley fever later in the summer. At least eight were hospitalized.
«Lightning in A Bottle is right in the middle of the endemic region, that is one of the hot points for the disease,» said Dr. George Thompson, director of the fever of the Valley of the University of California, Davis, and added that the vast majority of people who attend will not obtain an infection, but people who are not of an endemic area can be a higher risk.
Thompson said it is clear that he and his colleagues throughout the state are treating more patients for infection. Only about 1% of cases result in potentially deadly meningitis or other complications, as Carrigan did, but once a person is infected, he never eliminates the fungus from his body.
«There are no drugs that kill Cocci, so what prevents him from being sick is his immune response,» said Johnson, Kern Medical. To treat infection, people receive antifungals «enough time for the immune system of a person to discover how to control it. If you then do something to interrupt that immunity, you can start growing again, and that may arise years later,» he said.
Carrigan spent the last year in an intense regime of antifungal treatments. During the first months, he lost most of his hair and eyelashes and barely recognized himself in the mirror.
Now he has recovered completely and even a marathon ran this spring, but he still takes antifungal medications. Carrigan said he wants more people to understand both the warning signals of the valley fever and the importance of telling their doctor if they have been somewhere with cases, which could help people get a faster diagnosis.
«Even if it is only 1% of cases, as we see that cases increase, the number of people who experience complications will also increase,» he said.
