Nearly one-third of nation’s Valley Fever cases are in the Central Valley. What you should know about the fungal disease, and how to stay safe.

August 4, 2021 | 6:00 am


About 10,000 cases of Valley Fever are reported every year nationwide, according to the Centers for Disease Control, with about 30% of cases occurring in the Central Valley.

So it’s no wonder that Kern County has been at the forefront of treatment, research, and prevention efforts of Valley Fever over the years. And it’s the reason Assemblyman Vince Fong of Bakersfield has introduced a resolution declaring August 2021 as Valley Fever Awareness Month. The resolution is co-authored with Assemblyman Rudy Salas (Bakersfield), Senator Melissa Hurtado (Sanger), and Senator Shannon Grove (Bakersfield).

Chain | Cohn | Stiles, too, would like to warn local residents about Valley Fever, a respiratory disease caused by breathing in a desert fungus that grows in soil and spreads airborne from soil disruption or wind. Here’s what you need to know about Valley Fever, whose most at risk, what you can do to prevent the spread, and what to do if you or your loved ones are affected, especially while working.

 

WHAT IS VALLEY FEVER?

Valley Fever, or coccidioidomycosis, is caused by a fungal spore that is found in soils in the southwest United States, and in some areas of Central and South America. People get infected by breathing in spores contained in dust that gets into the air when it’s windy or when the soil is disturbed during activities such as digging, gardening and construction.

In many cases, Valley Fever does not make people ill, but some get flu-like symptoms that can last a month or more. Most who have flu symptoms recover fully, but others can develop severe disease, including pneumonia and infection of the brain, joints, bone, skin and other organs. Anyone who thinks they might have Valley Fever should see a doctor. A blood test can determine the disease, and doctors should be suspicious of Valley Fever in patients who live in the valley or have traveled through the area who have a cough that doesn’t go away after more than several weeks.

Valley Fever does not spread from person to person, and many people who are exposed to the fungus never have symptoms. Other people may have flu-like symptoms, including fatigue, cough, fever, shortness of breath, headache, night sweats, muscle aches or joint pain, and rashes on the upper body or legs. Serious illness can occur, resulting in hospitalization, long-term disability, or even death.

Healthcare providers prescribe antifungal medication for some people to try to reduce symptoms or prevent the infection from getting worse. People who have severe lung infections or infections that have spread to other parts of the body always need antifungal treatment and may need to stay in the hospital.

 

KERN COUNTY AT RISK

Anyone who lives in or travels to an area where the fungus lives in the environment can get Valley Fever, and it can affect people of any age, but it’s most common in adults age 60 and older. Additionally, certain groups of people may be at higher risk for developing the severe forms of Valley Fever, such as people who have weakened immune systems, as well as pregnant women, people who have diabetes, and people who are black or Filipino. Central Valley prison inmates have also been infected by Valley Fever at epidemic rates, contributing significantly to the state’s prison healthcare costs, and resulting in inmate deaths.

The best way to reduce the risk of Valley fever is to avoid breathing dust by:

  • Minimize soil disturbance.
  • Stay indoors on dusty days.
  • Roll up windows in cars and use recirculating air conditioning when driving through dusty areas.
  • If outdoors in dusty areas, consider wearing a mask or respirator.

In areas where Valley Fever is common, like Kern County, it’s difficult to completely avoid exposure to the fungus because it is in the environment. And there is no vaccine to prevent infection. That’s why knowing about Valley Fever is one of the most important ways to avoid delays in diagnosis and treatment. People who have Valley Fever symptoms and live in or have visited an area where the fungus is common should ask their doctor to test them for Valley Fever. Healthcare providers should be aware that Valley Fever symptoms are similar to those of other respiratory illnesses and should consider testing in patients with flu-like symptoms who live in or have traveled to an area where Coccidioides lives.

Recently, health officials said one way to protect yourself against Valley Fever is by wearing something that most people are accustomed to wearing during the COVID-19 pandemic — a mask, particularly an N95 mask.

 

WORK SAFETY

Employers in affected areas can take steps to protect workers from breathing in the fungal spores that cause Valley Fever. These include controlling dust, providing worker training, and suspending outdoor work during heavy winds.

It’s important for employers of outdoor workers to post resources for preventing work-related Valley Fever. Each year, more than 1,000 Californians receive hospital treatment for Valley Fever, and about eight of every 100 people hospitalized die from the infection annually.

Workers who dig or otherwise disturb soil containing the fungus are at risk for getting the illness. The fungus lives in the soil in parts of California, particularly the Central Valley. When people inhale the fungal spores released when the soil is disturbed, they may get Valley Fever.

Some workers at higher risk for Valley Fever include wildland firefighters, construction workers, archaeologists, military personnel, and workers in mining, gas, and oil extraction jobs.

Here are some steps employers and employees can take to prevent the spread of Valley Fever:

  • Determine if your worksite is in an endemic area.
  • Adopt site plans and work practices that reduce workers’ exposure, which may include minimizing the area of soil disturbed; using water, appropriate soil stabilizers, and/or re-vegetation to reduce airborne dust; stabilizing all spoils piles by tarping or other methods; providing air conditioned cabs for vehicles that generate heavy dust and make sure workers keep windows and vents closed; suspending work during heavy winds; placing any onsite sleeping quarters, if provided, away from sources of dust.
  • Employers must develop and implement a respiratory protection program in accordance with Cal/OSHA’s Respiratory Protection standard.
  • Take measures to reduce transporting spores offsite, such as cleaning tools, equipment, and vehicles before transporting offsite; providing coveralls and change rooms, and showers where possible if workers’ clothing is likely to be heavily contaminated with dust.
  • Train workers and supervisors about the risk of Valley Fever, the work activities that may increase the risk, and the measures used onsite to reduce exposure. Also train on how to recognize Valley Fever symptoms.
  • Encourage workers to report Valley Fever symptoms promptly to a supervisor.

 

HELP AVAILABLE

Valley Fever Institute at Kern Medical aims is to increase education and awareness for the public, patients and health care providers, and provide the patient care and promote research that includes epidemiology, clinical drug development, prevention, immunology and immunizations. Chain | Cohn | Stiles in years past has joined the Valley Fever Institute at the annual Valley Fever Walk aimed at raising awareness of Valley Fever.

The Valley Fever Americas Foundation aims to promote awareness and raise funds to support promising academic and medical research on the fungus which causes Valley Fever, in efforts to produce a vaccine or a cure. There is currently no cure for the disease.

“Understanding the conditions in which Valley Fever is most likely to be contracted can prevent further suffering and loss throughout our community, and being familiar with its symptoms empowers victims of this disease to be diagnosed early and increase their chances of making a full recovery,” according to the foundation.

More resources on Valley Fever can be found at the Valley Fever Institute and Valley Fever Americas Foundation.

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If you or someone you know is injured in an accident at the fault of someone else, or injured on the job no matter whose fault it is, contact the attorneys at Chain | Cohn | Stiles by calling (661) 323-4000, or fill out a free consultation form, text, or chat with us at chainlaw.com.

And if you or someone you know contracts Valley Fever at work, contact the Certified Workers’ Compensation Specialists at Chain | Cohn | Stiles.

Feeling the Kern County heat? Here’s a safety guide to avoid heat-related illnesses.

June 17, 2020 | 6:00 am


The heat has arrived in Kern County, and the extreme triple digit weather is not going anywhere any time soon.

As the temperatures rise above 100 degrees, Chain | Cohn | Stiles reminds local residents to take extra care to avoid heat-related illnesses, such as heat stroke and heat exhaustion. In fact, more than 600 people in the United States are killed by extreme heat each year, and countless others are hospitalized, according to Centers for Disease Control and Prevention.

Those at highest risk for heatstroke or heat exhaustion include infants and children up to 4 years old, people 65 and older, people who are overweight, and who are working or exercising outdoors. Pet owners, too, should be careful.

“Tragedy from extreme heat can happen quickly and without warning,” said David Cohn, managing partner and personal injury lawyer at Chain | Cohn | Stiles. “As we move into the tough summer days, it is important for parents, seniors, workers, employers, and everyone else to minimize the chances of heat-induced illnesses, to recognize the signs of heat stress, and take proper precautions.”

 

PREVENTION

Here are some tips to avoid heat-related health problems.

  • If available, stay in an air-conditioned area during the hottest hours of the day.
  • Drink plenty of water and don’t wait until you are thirsty. Schedule hydration breaks throughout the day.
  • Avoid alcohol and sugary drinks.
  • Take cool showers.
  • Never leave a child, elderly person, or pet unattended in a car.
  • Keep pets cool in hot weather.
  • Avoid unnecessary hard work or activities outside during the hottest part of the day. It’s recommended that you perform outdoor or strenuous activities during the early morning or at night when the temperature are cooler.
  • If you must be outside, be sure to wear sunscreen and wear lightweight, light-colored and loose-fitting clothing, as these reflect the heat and sunlight.
  • If outside, seek shade, wear a hat, or carry an umbrella. Place a cold towel around your neck and behind your knees, run your wrists under cold water, sit in front of a fan, or take a cool bath or shower.
  • Avoid using the oven to cook.
  • Do not use electric fans when the temperature outside is more than 95 degrees, as it could increase the risk of heat-related illness. Fans create air flow and a false sense of comfort, but do not reduce body temperature.
  • Some medications may cause you to be more susceptible to the heat. Listen to your body and don’t push yourself.

 

HEAT DISORDERS

There are four types of heat disorders to watch out for: sunburns, heat cramps, heat exhaustion, and heat stroke. In general, signs of these ailments include extremely high body temperature (103 or higher), dizziness, nausea, confusion, and headache. If someone shows these signs, call 9-1-1 and begin cooling the individual.

Here’s how to identify and treat these illnesses specifically:

  • Heat Cramps: Signs include muscle pains or spasms in the stomach, arms or legs. Take action by going to a cooler location, remove excess clothing, take sips of cool sports drinks with salt and sugar, and get medical help if cramps last more than an hour.
  • Heat Exhaustion: Signs include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, fainting, nausea, and vomiting. Take action by going to an air-conditioned place and lying down, loosen or remove clothing, take a cool bath, take sips of cool sports drinks with salt and sugar, and get medical help if symptoms get worse or last more than an hour.
  • Heat Stroke: Signs include extremely high body temperature (above 103 degrees) taken orally, red, hot and dry skin with no sweat, rapid strong pulse, dizziness, confusion or unconsciousness. Take action by calling 9-1-1 or getting the person to a hospital immediately. Cool down with whatever methods are available until medical help arrives.

 

WORKING OUTDOORS

Under OSHA law, employers are responsible for providing workplaces free of known safety hazards. This includes protecting workers from extreme heat. An employer with workers exposed to high temperatures should establish a complete heat illness prevention program.

  • Provide workers with water, rest and shade.
  • Allow new or returning workers to gradually increase workloads and take more frequent breaks as they acclimatize, or build a tolerance for working in the heat.
  • Plan for emergencies and train workers on prevention.
  • Monitor workers for signs of illness.

California’s Division of Occupational Safety and Health – also known as Cal/OSHA – has led the charge on developing stringent regulations to protect employees working outdoors in the heat. Overall, these regulations require California employers with outdoor workers to provide more than adequate water, shade, rest breaks and training. This rule applies when temperatures exceed 80 degrees. Additional requirements go into effect when outdoor temperatures top 95 degrees. You can find all of the regulations under Title 8 Section 3395 – Heat Illness Prevention.

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If you or someone you know is injured in an accident at the fault of someone else, or injured on the job no matter whose fault it is, contact the attorneys at Chain | Cohn | Stiles by calling (661) 323-4000, or fill out a free consultation form at chainlaw.com.

Staying safe in the hot summer and how to prevent, ID, and treat heat exhaustion

July 11, 2018 | 10:22 am


Lots of regions throughout California are experiencing heat waves this summer, including in Kern County and record temperatures hitting Southern California in particular. In these cases, it’s important to be extra careful to avoid heat-related illnesses.

Heat-related illnesses occur when the ability to sweat fails and body temperature rises quickly, and can lead to delirium, organ damage and even death. The reason is scary: the brain and vital organs are effectively cooked as body temperatures rise to a dangerous level in a matter of minutes.

In fact, nearly 250 people died in the United States from exposure to excessive heat, according to Injury Facts 2017, a report produced by the National Safety Council. Thousands of others are affected.

There are several heat-related illnesses, including heatstroke, heat exhaustion and heat cramps. Those most at risk include infants and young children, elderly people, pets, people with long-term illnesses, athletes and people who work outdoors.

For this article, and since Chain | Cohn | Stiles focuses on accident and injury law, including work injuries and workers’ compensation, we’ll focus on what you can do to prevent heat illnesses while working outdoors, how to identify symptoms, and what to do if you or someone you know suffers a heat-related illness.

 

PREVENTION

The best way to avoid a heat-related illness is to limit exposure outdoors during hot days. Let air conditioning be your friend. But, if you must work outdoors, here are some important tips:

  • Drink more liquid than you think you need and avoid alcohol and caffeine.
  • Wear loose, lightweight clothing, a long-sleeve shirt, and a hat.
  • Replace salt lost from sweating by drinking fruit juice or sports drinks.
  • Avoid spending time outdoors during the hottest part of the day, typically from 11 a.m. to 3 p.m.
  • Take frequent breaks.
  • Wear sunscreen (at least SPF 15) and re-apply every two hours; sunburn affects the body’s ability to cool itself.
  • Use buddy system to watch for symptoms

California’s Division of Occupational Safety and Health – also known as Cal/OSHA – has led the charge on developing stringent regulations to protect employees working outdoors in the heat. Overall, these regulations require California employers with outdoor workers to provide more than adequate water, shade, rest breaks and training. This rule applies when temperatures exceed 80 degrees. Additional requirements go into effect when outdoor temperatures top 95 degrees. You can find all of the regulations under Title 8 Section 3395 – Heat Illness Prevention.

 

WARNING SINGS

Symptoms of heat-related illnesses are similar to those of the flu and can include severe thirst, fatigue, headache, nausea, vomiting and diarrhea. Other symptoms include profuse sweating, clammy or pale skin, dizziness, rapid pulse and normal or slightly elevated body temperature, according to the CHIPS study by UC Davis.

Specifically, take note of these 10 symptoms to ID heat illness:

  1. Extremely high body temperature.
  2. Hot, dry, skin. An inability to cool the body through perspiration may cause the skin to feel dry.
  3. Increased heart and respiration rates as blood pressure drops and the heart attempts to maintain adequate circulation.
  4. Throbbing headache, nausea or vomiting due to dehydration.
  5. Weakness, fainting, or dizziness – especially in standing up quickly – due to low blood pressure from dehydration.
  6. Muscle cramps.
  7. Dark-colored urine – a sign of dehydration
  8. Confused, hostile, or seemingly intoxicated behavior
  9. Pale or bluish skin color in advanced cases due to constricted blood vessels
  10. Seizures or unconsciousness

 

WHAT TO DO

Ridding the body of excess heat is crucial for survival. Here’s what you can do if you or someone you know is experiencing a heat-related illness, courtesy of the California Department of Industrial Relations.

  • Move the person into a half-sitting position in the shade or air-conditioned area, or fan and spray with cool water. If humidity is below 75 percent, spray the victim with water and fan them vigorously; if humidity is above 75 percent, apply ice to neck, armpits or groin, or having them take a cool shower.
  • Do not give aspirin or acetaminophen.
  • Loosen or remove unnecessary clothing.
  • Give them water or other cool, nonalcoholic beverages, or a sports drink.
  • Stretch affected muscles.
  • Call for emergency medical help immediately if symptoms are more severe.

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If you or someone you know has suffered an injury while at work, contact the workers’ compensation attorneys at Chain | Cohn | Stiles by calling (661) 323-4000, or visit the website chainlaw.com for more information.

Work-related illnesses, Valley Fever, could result in workers’ compensation claim

January 20, 2015 | 10:22 am


Some people wouldn’t consider getting sick on the job as a workers’ compensation* injury issue.

“But you could be entitled to benefits under the workers’ compensation system if you get ill on the job, and the illness is as a result of the job,” said James Yoro, workers’ compensation attorney and partner at Chain | Cohn | Stiles.

Yoro recently spoke about this issue with radio deejay Sheri Ortiz on her show on The Groove 99.3. You can listen to the full interview by clicking here. Yoro and Chain | Cohn | Stiles associate attorney Beatriz Trejo also published an article recently in the Kern Business Journal focused on valley fever. To read that article, click here.

Specifically in the radio show, Yoro spoke about Valley Fever related to the workplace.

Under California law, Employers have responsibility to immediately report to Cal/OSHA any serious injury or illness, or death (including any due to Valley Fever) of an employee occurring in a place of employment or in connection with any employment, according to the California Department of Industrial Relations. Employers also have responsibilities to control workers’ exposure to hazardous materials.

Valley Fever is caused by a microscopic fungus known as coccidiodes immitis, which lives in the top two to 12 inches of soil in many parts of California. When soil is disturbed by activities such as digging, driving or high winds, fungal spores can become airborne and potentially be inhaled by workers.

In Kern County, around 500 cases of Valley Fever are reported in a typical year. Of those cases, about 5 people die from Valley Fever., according to Kern County Public Health Services Department. Kern County is also a leader and resource for treating and taking care of those infected with this disease.

When fungal spores are present, any work activity that disturbs the soil, such as digging, grading or other earth moving operations, or vehicle operation on dirt roads, can cause the spores to become airborne, and therefore increase the risk of Valley Fever. All workers on sites where the fungus is present, and who are exposed to dusty conditions and wind-blown dusts are at increased risk of becoming infected, according to Cal/OSHA. Some of those workers include: construction workers and other workers on construction sites, including road-building and excavation crews; archeologists; geologists; wildland firefighters; military personnel; workers in mining, quarrying, gas and oil extraction jobs; and agricultural workers.

Because there is no vaccine to prevent Valley Fever, important steps must be taken to limit risk, especially for employers. Some of those steps are as follows:

  • Determine if your worksite is in an endemic area.
  • Adopt site plans and work practices that reduce workers’ exposure, which may include minimizing the area of soil disturbed; using water, appropriate soil stabilizers, and/or re-vegetation to reduce airborne dust; stabilizing all spoils piles by tarping or other methods; providing air conditioned cabs for vehicles that generate heavy dust and make sure workers keep windows and vents closed; suspending work during heavy winds; placing any onsite sleeping quarters, if provided, away from sources of dust.
  • Employers must develop and implement a respiratory protection program in accordance with Cal/OSHA’s Respiratory Protection standard.
  • Take measures to reduce transporting spores offsite, such as cleaning tools, equipment, and vehicles before transporting offsite; providing coveralls and change rooms, and showers where possible if workers’ clothing is likely to be heavily contaminated with dust.
  • Train workers and supervisors about the risk of Valley Fever, the work activities that may increase the risk, and the measures used onsite to reduce exposure. Also train on how to recognize Valley Fever symptoms.
  • Encourage workers to report Valley Fever symptoms promptly to a supervisor.

“It’s important that people are aware that if they work in dusty outside conditions and they acquire Valley Fever, there’s a strong possibility that it could be work related,” Yoro told Sheri Ortiz.

It’s important to note that half of all people with Valley Fever show no symptoms, or show symptoms similar to a cold. Another 40 to 50 percent develop an illness severe enough to prompt the person to go to a healthcare provider, which includes flu-like symptoms. Those symptoms typically develop between 7 and 20 days after the spores enter your body. And another 1 to 5 percent of Valley Fever cases have the fungus leave the main site (lungs) and spread to other parts of the body.

If you suspect you’ve gotten Valley Fever, or another illness, due to your job, first see a doctor to make sure diagnosis is correct, Yoro said. And if you believe you’ve contracted an illness or disease related to your profession, it’s important to retain an attorney as soon as possible.

James Yoro has been serving Kern County as an attorney for nearly 40 years. He specializes in workers* compensation cases with the Bakersfield-based law firm Chain | Cohn | Stiles.

Call him at 661-323-4000 or visit the website chainlaw.com. Viisit Yoro’s specialized workers* compensation website by clicking here.

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*NOTICE: Making a false or fraudulent Workers’ Compensation claim is a felony subject to up to 5 years in a prison or a fine of up to $150,000 or double the values of the fraud, whichever is greater, or by both imprisonment and fine.