Health

Thursday, Aug 23 2012 06:49 PM

Case highlights cost, complexity of battling valley fever in prisons

BY JASON KOTOWSKI Californian staff writer jkotowski@bakersfield.com

Arjang Panah was in reasonably good health when he entered the Taft Correctional Institution in February 2005 to serve his federal prison sentence for distributing methamphetamine.

By December of that year, Panah began experiencing symptoms of valley fever, including high temperature, constant coughing, loss of appetite, weakness and fatigue, according to a lawsuit he filed against the federal government in 2009.

After initial misdiagnosis and treatment of his illness as pneumonia, blood tests on Jan. 11, 2006, confirmed Panah had the potentially deadly disease, and during an epidemic in the prison at that time, as many as 80 others also contracted valley fever.

Panah continued to suffer from valley fever after being released from prison around February 2008, spending $450 a month on doctors, health insurance and medicine, plus missing time from work, the lawsuit says.

The U.S. Department of Justice, while admitting no fault, settled the case for $425,000 Tuesday.

"This is very important to our client and his ability to deal with this horrendous disease," said attorney Jason Feldman, who, along with Ian Wallach, represented Panah.

Feldman said Panah, who lived in Rancho Palos Verdes prior to his arrest and again lives in Los Angeles County, still suffers from the disease and was hospitalized as recently as six months ago.

While Feldman and Wallach don't have any other similar cases pending, Feldman said they've received hundreds of letters regarding inmates contracting valley fever while in prison, mostly in state facilities.

Federal Bureau of Prisons spokesman Ed Ross said he didn't know how many inmates have been contracting valley fever or whether the agency has made changes to help prevent them from getting the illness.

Valley fever is a respiratory infection caused by the spores of a fungus that lives in soil. Many people never get sick after inhaling the spores, but others become very ill and even die.

It is endemic to large areas of California, Arizona and Texas; Kern County is a hot spot for the non-contagious illness.

Symptoms include fever, cough, fatigue, chest pain, shortness of breath, skin lesions, chills, muscle and joint pain, night sweats, lack of appetite and weight loss, according to the Valley Fever Americas Foundation.

Panah alleged in his lawsuit that the federal government failed to provide the private contractor that operates the prison with a facility that gives inmates safe air to breathe, guidance on how to prevent dust inhalation, or adequate equipment and resources to reduce the disease-bearing dust.

The lawsuit asked for $2.5 million plus money for general damages, medical and related expenses, lost earnings and the cost of the lawsuit.

"This prison was, in essence, a petri dish for valley fever, into which the BOP inserted human beings without their consent," the lawsuit says.

The government argued that the Bureau of Prisons acted reasonably by recognizing an increase in valley fever cases with inmates at the Taft prison in late 2004 and contacted the Centers for Disease Control to investigate and recommend measures that could be taken, according to a memorandum filed in court.

The CDC did not recommend any environmental changes to the prison, the memorandum says, and the Bureau of Prisons, on its own initiative, began transferring inmates most susceptible to valley fever to other facilities.

The number of cases of valley fever at the prison decreased in 2005, the memorandum says.

From 2006 to 2010, valley fever rates at Pleasant Valley State Prison in Coalinga, Avenal State Prison, Wasco State Prison and North Kern State Prison in Delano were higher than those in the counties in which they are located, according to a report by the California Correctional Health Care Services.

That's the federal receiver that's been overseeing reform of the state's prison medical care.

Compared to California's rate of contraction of 7 out of 100,000 people, the rate at Pleasant Valley State Prison was 1,001 times higher, at Avenal State Prison 189 times higher and at Wasco State Prison 114 times higher.

"We estimate that each year, CCHCS spends approximately $23.4 million for contract hospital care for inmates with cocci, medical guarding for these patients at outside medical facilities, and antifungal treatment for patients with cocci," the report says.

What can be done to help reduce these rates? The report offers several suggestions: educate inmates and staff about valley fever; relocate the highest-risk groups to different areas; increase ground cover throughout prison property to reduce airborne spores; advise inmates to stay indoors on windy or dusty days; and wet ground before digging.

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