Trying Not to Catch the Fever—Valley Fever—in California

What’s native to dry southwest US soils, causes a flu-like illness that can turn deadly, and can get you cited by Cal/OSHA for letting workers be exposed? It’s Valley Fever—a disease caused by inhaling fungal spores—and California is reporting an uptick in both cases of Valley Fever and Cal/OSHA citations arising from it.

The California Department of Public Health (CDPH) has taken the unusual step of releasing provisional data—data showing suspect, probable, and confirmed cases of Valley Fever infection—because they are seeing a striking increase in the number of new Valley Fever cases reported in California through October 31, 2017. From January 1 through October 31, 2017, 5,121 provisional cases of Valley Fever were reported in California—an increase of 1,294 provisional cases over 2016. According to CDPH, although suspect and probable cases may or may not be confirmed, the provisional data does provide an early indication of the potential risk of Valley Fever in the current season.

Cal/OSHA is seeing an uptick, too—the agency has cited six employers and proposed total fines of $241,950 for workplace safety and health violations after reports that workers contracted Valley Fever on a solar project construction site in Monterey County. The employers at the California Flats Solar Project in Cholame Hills were cited for serious violations that included failure to control employee exposure to contaminated dust at the worksite, and failure to provide and ensure use of appropriate respiratory protection.

It is unknown why there has been an apparent increase in provisional Valley Fever cases in California in 2017, but both Cal/OSHA and CDPH are warning people who live, work, and travel in California, to take appropriate precautions and learn to recognize symptoms of the disease.

The microscopic fungus that causes Valley Fever, Coccidioides immitis, lives in the top two to 12 inches of soil in many parts of the state. When soil is disturbed by digging, driving, or high winds, fungal spores can become airborne and may be inhaled by workers. While the fungal spores are more likely to be present in the soils of the Central Valley, they may also be present in other areas of California.

Cal/OSHA and CDPH offer these tips for employers and workers to reduce the risk of Valley Fever exposure:

• Determine if a worksite is in an area where fungal spores are likely to be present. In these areas, when it is windy outside and the air is dusty warn workers to stay inside whenever possible, and keep windows and doors closed. While driving, they should keep car windows closed and use recirculating air conditioning, if available.
• Adopt site plans and work practices that minimize the disturbance of soil and maximize ground cover.
• Use water, appropriate soil stabilizers, and/or re-vegetation to reduce airborne dust.
• Limit workers’ exposure to outdoor dust in disease-endemic areas by
• Providing air-conditioned cabs for vehicles that generate dust and making sure workers keep windows and vents closed,
• Suspending work during heavy winds, and
• Providing sleeping quarters, if applicable, away from sources of dust.
• When exposure to dust is unavoidable, provide approved respiratory protection (such as an N95 respirator mask) to filter particles.
• Train supervisors and workers in how to recognize symptoms of Valley Fever and minimize exposure. Most infected people will not show signs of illness. Those who do become ill with Valley Fever may have symptoms similar to other illnesses, including influenza or bacterial or viral pneumonia, so Valley Fever is not always recognized.

While most people recover fully, some people are at risk for more severe disease or complications of Valley Fever such as pneumonia, infection of the brain, joints, bone, skin or other organs. People with an increased risk for severe disease include those 60 years or older, pregnant women, and people with diabetes or conditions that weaken their immune system. Additionally, African-Americans and Filipinos are at increased risk for severe disease, but the reason is unknown. Workers who show symptoms of Valley Fever, such as cough, fever, or difficulty breathing lasting two weeks or more, should see a health care professional.