BAKERSFIELD — Two of the nation's health leaders on Monday announced a clinical trial to study the best way to treat Valley fever, a fungal disease that has risen by alarming rates in the last decade.
The randomized clinical trial will be based in large part in Bakersfield, an epicenter for Valley fever, and will involve 1,000 patients.
"We don't exactly know what the best treatment is for Valley fever and this is why we need a clinical trial," said Dr. Tom Frieden, director of the federal Centers for Disease Control and Prevention.
Frieden and Dr. Francis Collins, director of the National Institutes of Health, announced the Valley fever trial at the first day of a two-day symposium called by Rep. Kevin McCarthy, R-Bakersfield.
Valley fever is an infection that happens from breathing Coccidioides fungal spores. The disease has increased from 5.3 cases per 100,000 people in 1998 to 42.6 cases per 100,000 in 2011 in states where it has become endemic. California has about 31% of the cases and Arizona about 66%. The disease also is found in Utah, Nevada, New Mexico and Texas.
Frieden said CDC researchers are "fairly convinced" this is a real increase, but the reasons for the rise are unclear.
And many more cases likely go undiagnosed. Some researchers estimate 150,000 are infected each year, but many may not know why they are sick.
There also is no consensus on the best treatment for Valley fever, with most people exposed to the fungus not getting sick and some getting flu-like symptoms that last a few days or couple of weeks. Others, however, develop an infection that can spread from the lungs to the rest of the body, including causing meningitis and death.
McCarthy said he called for the symposium, the first of its kind, to bring awareness of the disease that "affects everybody and throughout all walks of life."
He also is pushing to get a Valley fever skin test through the federal Food and Drug Administration that would show whether someone has been infected, he said.
But the clinical trial was the big news of the day, he said. "I'm ecstatic."
The symposium continues Tuesday with experts on the disease discussing problems in diagnosis and in development of a vaccine, which has been elusive.
People packed inside a conference room at the Kern County Department of Public Health Services applauded the announcement of the clinical trial, many of them, like Dan Kemble of Fresno, survivors of Valley fever.
"I want to be educated on Valley fever and the direction they're going?" he said. Kemble, 58, a cotton broker, was diagnosed in September 2011 and continues to experience symptoms that spread into his nervous system. "I have mushy head some days," he said.
The clinical trial will take patients presenting with community-acquired pneumonia to doctors. Research has shown that in Kern County about 30% who go to doctors for pneumonia have Valley fever, Collins said.
Half of the group will receive azithromycin, a standard treatment for bacterial pneumonia and a placebo; the second group will be given azithromycin and fluconazole, a drug for Valley fever.
Researchers will be looking to see whether those who received the Valley fever drug do better, have a shorter illness or less debilitating disease, he said.
Blood will be taken at intervals up to 42 days, and at that time the group not receiving the Valley fever drug will be offered it, Collins said.
From the trial, Collins said, "we should be able to be confident in an answer -- does treatment help."
The clinical trial is expected to cost the federal agencies several million dollars, but Collins and Frieden said it is a priority.
It could be at least a year before people are enrolled, Collins said. And it will be three to four years before results are known.
The CDC will help recruit doctors to participate. "The more involved the community, the more likely we are to get answers and get answers sooner," Frieden told the audience in the conference room.
Valley fever survivors are anxious for answers.
Brenda Gales, 56, of Bakersfield, has lost a lung to the disease.
"I'm hoping to find out if they ever are going to get a cure," she said. By the time Gales had been diagnosed in 1980, it had eaten a hole in her lung. She continues to fight shortness of breath and fatigue, she said.
"I still have it 33 years later. I didn't feel really good today."
The reporter can be reached at (559) 441-6310, email@example.com or @beehealthwriter on Twitter.