VALLEY FEVER: Inland inmates may replace transferred prisoners
August 06, 2013; 06:36 PM
Valley Fever has been blamed for 62 deaths among California prison
inmates statewide, most at the Avenal and Pleasant Valley facilities.
A report prepared by a court receiver looking into the illness in
California’s prisons said 200 prisoners yearly spend 5,000 days in
hospital for treatment of their severe conditions, at an estimated care
cost of about $23.4 million. African-American and Filipino inmates are
particularly susceptible to Valley Fever, as are prisoners who have
weakened immune systems.
Along with death, the disease can leave some with permanent
disabilities.
The court-ordered transfer affects as many as 2,600 inmates at
Avenal and Pleasant Valley.
At Pleasant Valley State Prison in Coalinga the rate of infection
was 38 times that of residents in Coalinga, and 600 times the rate of
the entire Fresno County. A court document that cited those figures did
not detail outbreak numbers for the Avenal prison, which is in the city
of the same name in Kings County.
While the disease is not contagious, experts believe people exposed
to it constantly may develop immunities, and there may be
disproportionately more prisoners who are vulnerable to the disease.
In the state’s crowded correctional system, the transfers mean
inmates from throughout California -- including prisons in Riverside
and San Bernardino counties -- will have to take the places of those
moved from Avenal and Pleasant Valley. Men’s state prison locations in
Riverside and San Bernardino counties include Norco, Chino, and two
prisons near Blythe.
The replacements will be chosen from prisons around the state, said
Bill Sessa, a spokesman for the California Department of Corrections
and Rehabilitation. “We are taking a system-wide look at the candidates
to go. They will not be people who have the susceptibilities described
in the court action.”
“Inmates, generally speaking, don’t have any choice about where we
assign them,” Sessa said. “We move inmates around all the time for
various reasons.”
The transfers were ordered after the Prison Law Office, a prisoner
advocacy group, filed court papers citing high rates of Valley Fever
infections in the prisons and alleging that the corrections department
had not taken adequate action to protect inmates who might develop
complications.
The exact number of inmates who will be transferred from Avenal and
Pleasant Valley remains uncertain. Prisoners there can ask not to be
transferred, even if they are considered susceptible to Valley Fever.
Some prisoners will be required to transfer, including “seriously
immuno-suppressed inmates,” said Warren George of the Prison Law Office
in Berkeley. “How that shakes out between the number of inmates who
cannot opt out, and those who can, is still ongoing,” he said in a
telephone interview.
George said physicians and registered nurses were “talking with the
prisoners and informing them of their right to be transferred out, and
walking them through the waiver process; some are choosing to waive
their right to be transferred.”
Deaths caused by Valley Fever at individual prisons are difficult to
track – extremely ill prisoners are transferred to the system’s medical
facility at Vacaville, or to local hospitals, and their deaths are
recorded there, George said.
But he said the high rates of Valley Fever at Pleasant Valley and
Avenal would make it a “fair conclusion” that many of the deaths can be
associated with those two prisons.
George said the transfers will begin sometime this week and continue
into September. The Corrections Department has 90 days to complete the
transfers, ordered on July 1.
The action was filed as part of Plata vs. Brown, the ongoing federal
court case that went to the U.S. Supreme Court. In 2011, the justices
upheld a lower court ruling that found California had
unconstitutionally denied adequate medical and mental health care to
its prisoners; the state was ordered to reduce its prison population by
more than 30,000 inmates this year.
The fungus that causes Valley Fever exists naturally in the soil in
the southwestern United States, particularly Arizona, California’s
southern San Joaquin Valley and southern Texas. When the fungus spores
are sent airborne by the wind or farming, a small number of people
develop flu-like symptoms.
The number of cases has risen in recent years. Between 2001 to 2006,
the incidence of Valley Fever nearly doubled in California, largely
because of the population explosion at prisons, according to the state
Department of Public Health.
About 150,000 cases nationwide are diagnosed annually. About 1,200
of those people go on to develop pneumonia. In about 600 people per
year, the fungus gets into the bloodstream causing meningitis, stroke,
infections that eat away at vertebrae in the back and, for some, death,
said John Galgiani, a professor at the University of Arizona medical
school and founder of the Valley Fever Center for Excellence in Arizona.Galgiani in April filed a declaration in support of the Prison Law Office’s action.
Galgiani said there could be several reasons for a higher rate of
infection in the prisons: Increased awareness may be bringing more
testing; a lack of protocol for deciding when and whom to test for the
disease; a mix of prisoners who are more prone to Valley Fever.
In his April declaration, Galgiani classified the outbreak in the
two prisons as a public health emergency that puts lives at
“substantial risk.”“The only reasonable public-health decision to be made is to cease placing prisoners in Pleasant Valley State Prison and Avenal State Prison altogether,” Galgiani wrote.
He criticized the prison system’s management of the disease as ineffective and cited four deaths in Central Valley prisons that he said could have been avoided if they had been properly diagnosed. In each case, a diagnosis of Valley Fever wasn’t made for months, bringing on complications that eventually killed the men, Galgiani said.
“Medical staff at prisons … are still slow to recognize the early signs of Valley Fever, particularly in African-American men, and are slow to begin timely and proper treatment for the disease,” he wrote.
Dr. Benjamin Park of the U.S. Centers for Disease Control and Prevention, who heads up an epidemiological team investigating the outbreaks, said some geographical areas have very high concentrations of Valley Fever spores. The prisons could be among the hotspots, he said.
“Part of the issue might be there are a number of prisoners who are from outside the endemic area and because their bodies are not immune they may have a higher risk,” Park said.
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