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The Distribution of Coccidioidomycosis (Valley Fever) in Southern California.


Abstract.

Los Angeles County General Hospital records indicated that cases had originated near Canoga Park in the San Fernando Valley and suggested this region as an endemic focus. Seven patients with coccidioidomycosis [Valley Fever] were subsequently admitted to the Los Angeles County General Hospital in the fall of 1948 from a Los Angeles County probation camp near Saugus [Camp 4, Bouquet Canyon].

These observations led to the organization of serial skin test and serial complement fixation test surveys in three probation camps within the county, and also to coccidioidin test surveys in Canoga Park and Newhall high schools. A similar survey in Los Angeles High School, located within the city of Los Angeles, was organized as a control.

* * *

In coccidioidin skin test surveys among persons of high school age in Saugus, Canoga Park, Banning and Palm Springs areas the average incidence of positive reaction was 15 per cent. Although considerably less than the 68 per cent incidence reported among high school students of Kern County, it is high enough to indicate pockets of relatively high endemicity in Southern California below the San Joaquin Valley.

Histoplasmin tests were performed on most of the persons tested with coccidioidin in this survey. The overall incidence of positive reaction in the group was 7.6 per cent. Most of the subjects with positive reaction to histoplasmin gave a history of having previously lived in some area in the central United States where histoplasmosis is known to be endemic.

A few subjects who had positive reaction to coccidioidin tests and who had lived in areas known to be endemic for coccidioidomycosis but not for histoplasmosis, also had positive reaction to histoplasmin. However, the induration produced was always smaller than that caused by the coccidioidin reaction, and there was minimal confusion in interpreting the tests.


The 1948 outbreaks of Valley Fever in Saugus and elsewhere, and the subsequent testing for it, do not seem to have been reported in the press. So, instead we offer the following news articles that probably characterize the public's perception of the disease in 1948, to the extent anyone heard of it at all.


Doctors Describe 'Valley Disease,' Like Tuberculosis.


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San Francisco, April 22 — (INS) — A disease which closely mimics tuberculosis but is not nearly as serious was described before the San Francisco convention of the American College of Physicians today.

Dr. Charles E. Smith of Stanford University said the infection is known as "valley fever," "desert fever" or "desert rheumatism." Its formidable scientific name is coccidioidomycosis.

He declared the disease flourishes in certain parts of California, particularly in the southern two-thirds of the San Joaquin Valley; in Arizona, western Texas, southern New Mexico and generally all the areas along the Rio Grande to the Gulf of Mexico.

Scientists believe that nearly 100 per cent of the people living in these areas for any period of years have had the infection, the vast majority of them in mild form.

Symptoms, when they appear, include sporadic red swellings on the body, lung lesions and — more rarely — a usually fatal progressive infection which, like advanced tuberculosis, spreads swiftly through the body.

Women are considerably more prone to contract the mild form, while five times as many men as women are likely to get the most serious and often fatal form of the infection.

Dr. Smith reported the disease is far more dangerous for Mexicans and Negroes than for other peoples.

Smith said physicians must be on guard to distinguish between tuberculosis and "valley fever" which does not require the drastic treatment needed by tuberculosis patients.

Explaining methods of diagnosing the disease, Dr. Smith said the first step is a skin test with coccidioidin, an extract of the disease germ. If this indicates infection, confirming evidence then can be obtained through recovery of the infecting fungus from a patient's sputum or stomach contents.

Blood tests also can assist in establishing the diagnosis.


You Probably Have Had It, But Don't Worry, Anyway


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San Francisco, Apr. 22 — (AP) — If you knew you were going to be sick and you have a choice of illnesses, you might want to consider Coccidioidomycosis.

This multi-syllable ailment produces symptoms resembling tuberculosis but is not nearly as bad as it sounds, two public health researchers told the American College of Physicians today.

Practically 100 per cent of the long-term residents of certain areas in Arizona, west Texas, southern New Mexico and California's San Joaquin valley have had it, they said.

The report, by Dr. Charles K. Smith and Dr. Rodney Beard, of Stanford University Medical School, covered several years of investigation in the areas where valley fever, as the disease is commonly called, is endemic.

The disease is so mild, Dr. Smith said, that many people who have had it cannot recall any illness. But doctors can tell by making skin, sputum or blood tests.

In rare instances, the disease is serious. It has been known to medicine for 50 years but until recently only the serious cases were recognized, Dr. Smith said. It is caused by a fungus.



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[Excerpt.]

[...] Another interesting disease caused by fungi is a condition called coccidioidomycosis. Originally it was believed that this disease was restricted to a valley in California, but it is now known to occur in other parts of the west. It is sometimes called valley fever, desert fever, or desert rheumatism. It is a disease primarily of small mice-like animals living in hot, dry climates, and people are only accidentally involved.


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