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Agencies to Launch Randomized Controlled Trial for Valley Fever

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Agencies to Launch Randomized Controlled Trial for Valley Fever

Audience members listen in as expanding research into valley fever is discussed at a symposium on September 23, 2013. Henry A. Barrios/The Californian

Reporting on Health Collaborative
Tuesday, September 24, 2013 - 7:30am

BY RACHEL COOK, Reporting on Health Collaborative

The Centers for Disease Control and Prevention and the National Institutes of Health will launch a randomized controlled trial to get a better understanding of how to treat valley fever, officials announced in Bakersfield Monday.

The endeavour, announced on Day 1 of a two-day valley fever symposium, will cost millions of dollars and involve roughly 1,000 patients. The trial could help determine the best practices for treating the fungal infection.

It will take researchers at least a year to determine where the trial will be conducted and which clinical partners will participate, said Dr. Francis Collins, director of the NIH.

“It will take some time to mount this trial, to plan it, to put it forward, but I just want to assure all of you from this part of California that we’re serious about trying to get some of those answers even in the face of difficult budget times,” Collins said.

Kern County, and the San Joaquin Valley generally, are a valley fever hot spot.

“What we’ve seen is a steady increase in the number of diagnosed cases of valley fever, or coccidioidomycosis,” said Dr. Thomas Frieden, director of the CDC. “We don’t know why that’s happened and there’s a lot that we need to learn.”

Symposium participants called the announcement a major development in the fight against valley fever. The news comes after U.S. Rep. Kevin McCarthy, R-Bakersfield, who spearheaded the symposium, courted the leaders of the CDC and NIH for months about valley fever.

The trial will involve some 1,000 people diagnosed with community-acquired pneumonia, the most common presentation of valley fever. One half will be randomly chosen to receive a traditional antibiotic used to treat bacterial pneumonia and placebo; the other half will be treated with the antibiotic plus fluconazole, an anti-fungal medication frequently used to treat valley fever.

The patients will be tested immediately and then every two weeks to see if they have valley fever and which treatments prove most effective. Collins said the trial will spread awareness about the disease and educate people about diagnostics and treatment.

“We all recognize that there’s more that needs to be done. There’s so many unknowns (about valley fever),” Collins said. “We don’t know exactly what the right treatment is for people who become infected with this fungus.” 

Dr. Royce Johnson, professor of medicine at UCLA and Kern Medical Center’s chief of infectious disease, called the trial exciting news.

“There is a real difference of opinion about who should be treated, when they should be treated and how much they should be treated with,” Johnson said. “It would answer some of those questions.”

After the trial was announced to reporters, about 200 people packed the Hans Einstein Education Center at the Kern County Department of Public Health Services for a survivors reception and public forum. The gathering brought together people battling the disease, doctors working to developed a vaccine, and past and present politicians.

“This is a particularly unusual (event) because this is not as common a condition as many of the things that Dr. Frieden and I spend our time worrying about,” Collins said. “But it is a compelling situation because of the rise in (reported cases) and the fact that there’s so many unknowns that could be answers so it seems like the right time to get all of the smart people together and see what we can do.”

Men, women and one little girl shared their stories of living with valley fever. Many asked specific questions about their own condition and symptoms, telling stories of misdiagnosis and uncertainty. 

Darrin Blackmon Sr. of Buttonwillow brought a plastic bag filled with medications and bills he has accrued while dealing with the disease for one year. 

“It’s an honor, it’s a privilege to still be living,” Blackmon said after briefly meeting Frieden. “When I first got it, oh your body (makes) you feel like you (are) dying already.”

Lisa Limbeck of Rosamond, who has lived five years with valley fever, said after several brain surgeries and ongoing daily antifungal treatments, she stills deals with chronic pain akin to a day-long severe migraine.

“I just wanted to hear other stories of people who’ve battled what I’ve gone through and how they’re coping and how they’re living and how it’s changed their world because I know it’s changed mine,” she said.

She hoped public health leaders would be open to new ideas for advancing testing and technologies to understand valley fever. 

Lynda and Stewart Resnick, owners of Roll Global, the parent company of Paramount Farms, also attended the forum, and sat in the front row as Frieden and Collins fielded questions from the audience.

“When we knew the symposium was happening we really wanted to be here because we want to be on forefront of helping cure this disease,” Lynda Resnick said.

She said the couple might be interested in giving money to support curing valley fever. 

She said medical staff from their company’s free employee clinics would attend the second day of the symposium in order to better recognize and treat valley fever.

The symposium continues Tuesday at Cal State Bakersfield.

About This Series

This project results from a new venture – the Reporting On Health collaborative – which involves the Bakersfield Californian, the Merced Sun-Star, Radio Bilingüe in Fresno, The Record in Stockton, Valley Public Radio in Fresno and Bakersfield, Vida en el Valle in Fresno, the Voice of OC in Santa Ana and ReportingonHealth.org. The collaborative is an initiative of The California Endowment Health Journalism Fellowships at the University of Southern California’s Annenberg School for Communication and Journalism.

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