The Woolsey Fire has sparked valley fever fears, but how high is the risk?

Virginia Xedos, shown here as a little girl with her parents, died on Dec. 10. A day later tests confirmed she contracted valley fever.

The test results came Dec. 11, the day after Virginia Xedos died.

The 69-year-old Ventura woman had developed what seemed like the stomach flu less than two weeks earlier. The illness grew, making it hard to breathe and spawning a cough that ignored antibiotics.

The infection spread into both lungs.

“It just got progressively worse,” said Tom Xedos, her husband of 50 years. “The doctors couldn’t do anything.”

The test showed she was infected with coccidioidomycosis — valley fever.

Fear of the disease carried by spores swept up from the soil surged a year ago after the Thomas Fire raged across Ventura and Santa Barbara counties. The 97,000-acre Woolsey Fire in November ignited more anxiety, although doctors and public health officials debate whether either blaze is directly linked to a dramatic rise in cases.

“We’re open to that,” said Ventura County Public Health Officer Dr. Robert Levin. “We have not been able to demonstrate it yet.”

Several lung and infectious-disease specialists argue that the timing of the cases means Woolsey and Thomas are very likely contributing causes.

“I think I’ve seen four now,” Thousand Oaks infectious-disease specialist Dr. Ramesh Nathan said of valley fever cases since the Woolsey Fire erupted Nov. 8. “It could be just the time of year.”

Widely misunderstood and often misdiagnosed, valley fever is caused by spores from a fungus called coccidioides immitis. The spores are carried from the soil into the air by the wind or disturbances ranging from construction to the 1994 Northridge earthquake that triggered a flood of cases.

In many instances, symptoms never materialize and people don’t get sick. Other cases can cause flu-like signs and sometimes a red, spotty rash. The symptoms can develop into chronic pneumonia or other long-term issues.

Tests confirming valley fever are sent to specialized labs and it can take several days or longer before results are known. Treatment involves antifungal medication taken for several months or longer, depending on the severity of the symptoms. 

Rising risks

The risks of developing severe valley fever increase for people who:

  • Have HIV or AIDS
  • Have gone through an organ transplant
  • Are pregnant
  • Have been diagnosed with diabetes
  • Are African-American or Filipino

Source: U.S. Centers for Disease Control and Prevention

In rare and potentially fatal instances, the illness can spread from the lungs to the brain and spinal cord, spawning complications like meningitis.

In Ventura County, the disease surged late in 2017 before the early December Thomas Fire. For the year, 240 cases were confirmed in the county, according to state records. Only 64 local cases were reported in 2016 and 48 in 2015.

Tom Xedos shows a family picture of his wife, Virginia. She died Dec. 10. Test confirmed that she had caught valley fever.

The elevated occurrence has continued this year. California Department of Public Health provisional data shows 225 suspected cases in the county through Nov. 30. Levin said six people in the county diagnosed with the illness have died this year, although the role of the illness in several of the deaths is unclear.

In one case, valley fever was listed as the final cause, Levin said.

The surge locally comes as part of a statewide rise. California Department of Public Health data shows a record 7,466 cases reported in the state during 2017, nearly 2,000 more cases than the previous year. Unofficial records show 7,021 possible cases this year through November.

MORE:New data shows valley fever has leaped in Ventura County and California

Although Ventura County’s numbers have risen dramatically, the disease is more common elsewhere. Nearly two of three California patients diagnosed with the disease in 2016 lived in one of seven counties: Kern, Kings, San Luis Obispo, Fresno, Tulare, Madera and Monterey.

Far more cases are found In Kern County — more than 2,700 cases in 2017 — than anywhere else in the state. So far this year, 2,440 possible cases have been reported in Ventura County’s neighbor, according to state records

State officials say they can’t pinpoint reasons for the surge, although they suggest drought followed by heavy rain late in 2016 and early the following year may have contributed to the dramatic increase.

The Thomas and Woolsey theories offered by lung and infectious-disease specialists are simple. The massive wildfires strip the soil of coverage, leaving it barren and dry. Santa Ana winds send spores into the air.

Virginia Xedos of Ventura died on Dec. 10 with doctors saying blood tests confirmed that she had valley fever. Her cremains are shown under the clock.

“These spores are of a very microscopic size, and they can be in the air for days and weeks,” said Dr. Glen Abergel, an Oxnard lung and infectious-disease doctor who is convinced the fires have brought an increase. “Someone comes and along and takes a breath of air. They’re in the wrong place at the wrong time.”

Kat Merrick’s family was in the wrong place.

Merrick’s ranch off Shell Road outside Ventura was burned to the ground by the Thomas Fire. Her adult son, Jesse Merrick, flew to California from Alabama to help with the loss.

Family members sifted through rubble in hopes of finding the military medals Kat Merrick’s father earned or anything else that survived the blaze. They wore gloves and masks and took other precautions.

Almost immediately after the sifting, Jesse caught what seemed to be a bad cold. Back home in Alabama, doctors diagnosed it as pneumonia and then found a fungal ball in his lungs.

Reducing your risks

  • Stay inside during windy, dusty conditions.
  • Keep car windows shut during windy conditions and use recirculating air flow.
  • Consider wearing an N95 air mask during windy conditions.
  • Wet down soil before digging into it.
  • Cover open areas near your homewith ground cover or plants.
  • Change clothes if covered with dirt.

Source: California Department of Public Health

“That’s when they started freaking out,” said Kat Merrick, noting that the illness was finally pinpointed as valley fever. “They hospitalized him for a week, but they thought he was going to die.”

Jesse Merrick recovered, although he still takes medication and feels the impact of the disease when he runs.

“He’ll live it with forever,” said his mother.

Pictures of Virginia Xedos fill the home she shared with her husband, Tom. She died on Dec. 10.

When the Camp and Woolsey fires erupted in California, Kat Merrick recoiled at images of people sifting through rubble without masks or goggles. She posted a Facebook message cautioning people about valley fever.

It went viral.

“I didn’t want to see it happen to someone else’s child,” she said. “I think it’s important everyone understand it’s there.”

Public health officials say dangers are real. But they say there’s not enough evidence to draw a definitive line between the massive fires and the surge in the disease.

MORE:Deadly, destructive fires happening to more Californians, over and over again

“I’m hearing about increased concern, but we’re not seeing an increased incidence,” Levin said of cases reported since the Woolsey and Hill fires started in early November.

In Los Angeles County, public health officials said it’s too soon to know whether the Woolsey Fire’s destruction in Malibu and other areas have brought more valley fever cases. They said the disease incubates for one to four weeks.

“The health effects of most concern related to the dust is irritation to the lungs and eyes,” officials said in a written statement. “The risk of acquiring valley fever is low.”

Officials still urge people to consider precautions, like wearing N95 masks in windy conditions. Levin said construction crews should mist work sites to control the dust. When people drive in windy conditions, they should should use recirculated air flow.

Tom Xedos knew little about valley fever and less about the precautions. The retired oilfield worker has no idea whether fire contributed to his wife’s illness, although a doctor suggested it was at least a possibility.

The couple camped outside Santa Paula in their 27-foot RV for four days in early November. They were there when the Woolsey and Hill fires erupted near Simi Valley and Camarillo. They were there for the Santa Ana winds that followed the fire.

MORE:Many still healing from county’s first mass shooting 25 years before Borderline

About three weeks later, Virginia Xedos started feeling nauseated during an illness that moved into her lungs. Doctors prescribed antibiotics, but symptoms grew worse, triggering two trips to the emergency room.

They conducted a test for valley fever and started treatment for the disease before  results came back.

Tom Xedos carried this picture of his wife, Virginia, in his wallet. She died Dec. 10. Tests showed she had valley fever.

“It was moving so fast through her body that the medicines couldn’t catch it,” Tom Xedos said.

Five days before Christmas, Xedos sat in front of a photograph of his wife on display next to a container bearing shadow images of a person flying like a bird. The box holds Virginia’s cremains.

“Virginia always dreamed of flying. That was her secret desire,” said Tom Xedos.

As Xedos showed pictures of her, he wondered why people aren’t told more about valley fever. He wondered about what he and Virginia could have done if they had known about risks.

“We could have worn masks,” he said.