Carol Sipan, a lecturer in public health at the University of California, Merced, has another challenge in collecting data, which is the fact that [farmworkers] would go back to Mexico if they got really sick. In Mexico, she added, valley fever is not a reportable disease.
Farmers in the line of fire
Like many farm workers who contract the disease, Gutierrez found the cost of the antifungal drugs needed to treat the valley fever staggering. At the peak of the disease, the pills cost 1,200 US dollars for two months of treatment because he had to take two to three times more than one while he was treating a typical Candida infection.
He did not have insurance at that time and said that his family often had to choose between food and his medication. He is still unable to work regularly and his family survives mainly because of the income of his wife, Maria, in the fields.
"It changed my life a lot," said Gutierrez. "When I worked, I always had money at home – to eat, to buy clothes for my children, for everything. But now, I have debts.
Like 68% of 800,000 farm workers in California, Gutierrez was born in Mexico. It is estimated that 49% of the state's farm workers do not have work permits and most live below the federal poverty line in unincorporated communities with few public services.
Meanwhile, the long harvest season in the Central Valley brings long hours, extreme heat and other harsh conditions. At home, these workers have limited access to health and education, a range of mental health issues and high rates of food insecurity. Valley fever only adds to these challenges.
Isabel Arrollo-Toland intimately knows both sides of this story. She is the daughter of a former farm laborer and runs a small non-profit organization, El Quinto Sol of America, which trains farm workers and other recent immigrants to citizenship in a handful of non-farming communities. formed in Tulare County, one hour south of Fresno.
Arroyo-Toland was diagnosed with Valley Fever in 2007, and again in 2008, when this disease spread to the skin as painful lesions. She subsequently endured months of misdiagnosis. Then, in 2012, she was told that her kidneys were suffering from kidney failure because of the impact of the Valley Fever and the medications she had relied on to treat it. Since then, she has to undergo peritoneal dialysis at home for 10 hours each night. She is currently on the donor list for a kidney.
Arrollo-Toland urges workers to be tested for the disease at the first sign of colds or flu. "Sometimes I talk to a farm worker and they tell me," Oh, I have these symptoms … "And the first thing to do is," You should go for a fever test in the valley. "
It also highlights the many challenges that farm workers face in staying healthy: regular exposure to pesticides and dust clouds, lack of fresh produce and clean water – a growing challenge for many people living in areas undeveloped.
"The fungus of valley fever could actually expand its territory with climate change."
Antje Lauer, microbial ecologist
"It's very difficult to say that you have to maintain your immune system 100% because your environment does not provide you with it," said Arrollo-Toland. "Seeing the doctor for prevention is another problem, because you have to go to the clinic, which is probably 30 minutes … and still full."
Several studies have shown that farm workers suffer from high levels of chronic stress and anxiety – more factors related to the suppression of immune function.
In U.C. Recent research by Professor Davis McCurdy found that those who reported having valley fever "lost about 20 days of work on average when they were sick." McCurdy is currently working with other researchers on two studies involving farm workers and valley fever, including a survey of nearly 120 Latino workers in two migrant worker centers in Kern County.
The stakes are changing, in part because precipitation in the southwest has become less common and less predictable. Very wet winters, such as the one that has just run off, followed by dry summers, have always been particularly painful for the growth of cocci spores, said Antje Lauer, a microbial ecologist at California State University in Bakersfield. Lauer has received funding from NASA and the US Department of Defense to study valley fever in the ground.
"The fungus of valley fever could actually expand its territory with climate change," Lauer said, noting that cocci spores were discovered in the state of Washington in 2014.
Although farm workers and others working outside are in a particularly vulnerable position, Mr. Lauer added that there is only one exposure to render someone ailing. Dust masks can be effective for limiting certain exposures, but this is not a real solution for those who work in the fields.