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Thursday, May 09 2013 11:00 PM

Call to action: Moving forward in fight against valley fever

By KEVIN McCARTHY and TOM & PAULINE LARWOOD

Back in the 1950s, after serving our nation as a medical officer against the country he fled as a child, a young German immigrant named Hans drove across the country to complete his residency at Kern General Hospital. After finishing his residency, he began working as assistant medical director at the Kern County tuberculosis sanitarium. But over time, he started noticing that many of his patients didn't have tuberculosis; they had coccidioidomycosis, or valley fever. Of course, Dr. Hans Einstein would go on to dedicate his life to the people of Kern County and to fighting this rare fungal disease.

Thanks to Einstein's tireless work, his family and other local valley fever advocates -- people and organizations like the Valley Fever Vaccine Project of the Americas (a Rotary District 5240 Project), the Valley Fever Vaccine Project Advisory Committee, Dr. Royce Johnson, and Kern County public health officials Dr. Michael Lancaster and Dr. Claudia Jonah -- great strides have been made in understanding and effectively treating this disease. We are proud that our community continues to lead in this effort, but there is still much more work to be done.

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HOW TO HELP

If you have ideas on raising public awareness, combating valley fever, or suggestions for the fall symposium with Rep. Kevin McCarthy and the Centers for Disease Control and Prevention, please email McCarthy at CombatingValleyFever@mail.house.gov.

Just this past March, the Centers for Disease Control and Prevention, or CDC, released a report showing that valley fever incidences have risen over the past decade in the American Southwest for unknown reasons. Unfortunately, the CDC found valley fever cases have increased by 13 percent annually over the past several years in California, and Kern County is ground zero. Furthermore, the CDC report notes that patients with possible symptoms of valley fever often go untested for the disease, meaning it is highly likely that many valley fever cases go undiagnosed and unreported. This is a clarion call to action, and we are committed to working to ensure that valley fever research and prevention, treatment, and eventually a vaccine is a top local, state and federal priority.

We can immediately work to prevent valley fever by educating the members of our communities about how to reduce the risk of contracting this disease and reminding them to get tested for it when symptoms arise. Increasing public awareness among patients and doctors will help diagnose the disease sooner -- before symptoms become more severe -- and maximize treatment to considerably lessen the odds of developing disseminated valley fever. This is one of the issues raised on a recent visit to the CDC to meet with its director, Dr. Thomas Frieden, and leading CDC valley fever experts. We are extremely pleased that Frieden and CDC mycotic diseases scientists have accepted our invitation to come to Bakersfield in the fall to meet with public health officials, valley fever advocates and survivors, and work with us on a public awareness campaign.

However, raising public awareness on valley fever is just one facet of combating this disease. Just as important is improving diagnosis, treatment and prevention. In 2011, the U.S. Food and Drug Administration, or FDA, approved a skin test developed by San Diego-based AllerMed Laboratories Inc. that would help doctors more quickly determine whether or not a patient has been exposed to coccidioidomycosis. But because of a costly annual user fee required by the FDA, AllerMed would pay more in fees to market the skin test than it would take in by putting it on the market. Frieden and Dr. Francis Collins, director of the National Institutes of Health, or NIH, have pledged to work with us to get the FDA to exercise its fee waiver authority so that this skin test can be put on the market as soon as possible.

With regard to treatment, the antifungal drugs in current use are helpful, but they are not as effective as needed. That is why we are working with Frieden and Collins to develop a randomized controlled trial, or RCT, to test and compare the efficacy of current anti-fungal treatments on the market with regard to valley fever. And in another meeting this past week in Washington, D.C., Collins and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, pledged to work with us and Frieden on developing a valley fever RCT, as well as on the challenges we are facing regarding prevention.

Finally, the ultimate goal for prevention is the development of a valley fever vaccine. That is why the importance of prioritizing valley fever vaccine research within the NIH was largely the focus of the meeting in Washington this week with Collins and Fauci. However, developing a fungal vaccine is a long and complicated process, which is why raising public awareness, ensuring more access to skin tests and determining the best medications are critical short-term actions that can be taken to fight coccidioidomycosis.

The late Dr. Einstein was known for bridging the gap between the public and scientific community and, as a result, making the fight against valley fever more effective. As lifelong residents of the Central Valley, many of us know friends or family members who have been affected by this disease and know firsthand how it can affect the lives of patients and their families -- not to mention the amount of commitment, effort and time it takes to overcome valley fever. We must work together to build awareness in our community and beyond, and we are committed to doing our part. That is why in the coming weeks and months, more meetings will take place with the CDC, the NIH, the FDA and local valley fever advocates. Together we can move our shared priorities -- prevention, treatment and ultimately a vaccine -- forward.

Rep. Kevin McCarthy of Bakersfield represents the 23rd Congressional District. His co-authors are former Kern County Supervisor Pauline Larwood and her husband, Dr. Tom Larwood, a longtime Bakersfield physician.

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