Health

Tuesday, May 07 2013 07:10 PM

Explainer: Why official wants at-risk inmates out of valley fever-prone prisons and why the state objects

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    By Casey Christie / The Californian

    Terry Oubsuntia, microbiology specialist, labels valley fever test trays in a laboratory at the Kern County Public Health Services Department in this file photo.

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By TRACY WOOD Reporting on Health Collaborative twood@voiceofoc.org

California prison officials say a receiver's policy for protecting inmates housed at two Central Valley prisons from Valley Fever is "premature" and urged a federal court to oppose its quick implementation.

"The [receiver's] policy is ambiguous and in need of further clarification before it can be appropriately and effectively implemented," said the state Attorney General's Office said on behalf of California Correctional Health Care Services in documents filed Monday in San Francisco's U.S. District Court.

The court is scheduled to hear arguments on June 17.

For Gov. Jerry Brown, the case represents a collision of two decades-long issues -- state prison overcrowding and the failure of federal and state officials to address treatments or a vaccine for Coccidiodomycosis, known informally as "cocci" or valley fever.

People contract valley fever when they inhale spores of a fungus that prevalent in the Southwestern United States. Farmers, construction workers and others who work outside are most likely to contact the disease and studies have shown that African Americans and Filipinos are unusually susceptible.

Most people who contract valley fever develop temporary flu or cold-like symptoms. However, in some people, especially those with compromised immune systems stemming from HIV or other illnesses, the disease can cause severe sickness and even death.

The disease has reached epidemic proportions in California's Central Valley over the past decade and has hit the state's prison population in that area particularly hard. Prisoners are vulnerable both because they are more likely to have chronic diseases like HIV and diabetes, and because they are often coming from outside the area and have not developed immunity to the fungus.

For more than a year, the Reporting on Health Collaborative, which involves seven California news outlets, has reported extensively (http://www.reportingonhealth.org/valleyfever) on the issue. The reporting revealed that valley fever has become a "second sentence" (http://www.reportingonhealth.org/valleyfever/just-one-breath-valley-fever-turns-short-prison-terms-lifelong-penalties) for prisoners.

Prison overcrowding in general compounds the problems that valley fever present. Overcrowding and poor medical care forced the California prison system into federal receivership in 2006. Among other things, the receiver, J. Clark Kelso, is requiring that the system reduce the population of its 33 adult prisons to about 110,000 by the end of the year. The state's prison population has topped 170,000 in recent years.

Kelso has also adopted a Valley Fever policy in recent weeks that applied to prisoners at Pleasant Valley State Prison in Coalinga in Fresno County and Avenal State Prison in Kings County, both in the heart of valley fever territory.

Kelso is arguing that California has been too slow to act in protecting prisoners against valley fever, including dragging its feet in consulting both federal and state health officials.

"In the face of the State's anemic response, the Receiver undertook his own analysis to address the cocci issue and, among other things, requested assistance from CDC [federal Centers for Disease Control] and NIOSH [National Institute for Occupational Safety & Health]," according to a May 1 court filing by Kelso.

"Within days," the filing said, "CDC and NIOSH staff contacted the Receiver to begin determining what resources would be necessary and available for this analysis."

Kelso's policy requires the state to exclude from those two prisons any inmate with a greater than 50 percent chance of contracting valley fever and inmates with general health problems who would face a significantly increased risk of dying if they contracted the disease. That includes inmates with HIV, diabetes, those undergoing chemotherapy, or are pregnant.

Currently, there are about 8,200 inmates at the two prisons and an official from the California Department of Corrections and Rehabilitation estimated about one third of them would be affected in some way by the receiver's policy.

"The receiver is calling for the transferring, and he described it last week as 'effective immediately,' of over 3,000 inmates from those two prisons," said Corrections Department spokesman Jeffrey Callison in an interview Tuesday on radio station KVPR in Fresno with reporter Rebecca Plevin.

"That's a huge, complex undertaking," Callison said. "Could it happen? Of course it could happen, but it would take a long time to implement because it's very complicated."

In addition, according to a statement issued by the Corrections Department, it already has transferred dozens of high-risk inmates from the two prisons and has suspended the transfer of certain high-risk inmates into those prisons.

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