Tuesday, April 30, 2013

‘Medical receiver J. Clark Kelso ordered the Department of Corrections and Rehabilitation to exclude black, Filipino and other medically risky inmates from Avenal and Pleasant Valley state prisons because those groups are more susceptible to the fungal infection, which originates in the region’s soil.’

Through Medicare, Medicaid and other government programs, taxpayers cover a large percentage of the valley fever bill. An estimated 60 percent of valley fever-related hospitalizations — resulting in charges of close to $2 billion over 10 years in California alone — are covered by government programs,


So is it Valley Fever or Rift Fever?


Molecular biology and genetic diversity of Rift Valley fever virus

Abstract

Fig. 2. Distribution of RVF as of 2011. Countries that have experienced substantial epizootics and epidemics are shown in dark blue, while those with serologic evidence or virus isolation are marked with light blue. Years of major outbreaks are shown. Based on ( and ).
read link>>>Rift Valley fever virus (RVFV), a member of the family Bunyaviridae, genus Phlebovirus, is the causative agent of Rift Valley fever (RVF), a mosquito-borne disease of ruminant animals and humans. The generation of a large sequence database has facilitated studies of the evolution and spread of the virus. Bayesian analyses indicate that currently circulating strains of RVFV are descended from an ancestral species that emerged from a natural reservoir in Africa when large-scale cattle and sheep farming were introduced during the 19th century. Viruses descended from multiple lineages persist in that region, through infection of reservoir animals and vertical transmission in mosquitoes, emerging in years of heavy rainfall to cause epizootics and epidemics. On a number of occasions, viruses from these lineages have been transported outside the enzootic region through the movement of infected animals or mosquitoes, triggering outbreaks in countries such as Egypt, Saudi Arabia, Mauritania and Madagascar, where RVF had not previously been seen. Such viruses could potentially become established in their new environments through infection of wild and domestic ruminants and other animals and vertical transmission in local mosquito species. 

SACRAMENTO, Calif. — The federal official who controls medical care in California prisons on Monday ordered thousands of high-risk inmates out of two Central Valley prisons in response to dozens of deaths due to Valley fever, which is caused by an airborne fungus.

Medical receiver J. Clark Kelso ordered the Department of Corrections and Rehabilitation to exclude black, Filipino and other medically risky inmates from Avenal and Pleasant Valley state prisons because those groups are more susceptible to the fungal infection, which originates in the region’s soil.
Aside from the racial minorities, high-risk inmates include those who are sick, infected with HIV, are undergoing chemotherapy or otherwise have a depressed immune system. In addition to the deaths, the fungus has hospitalized hundreds of inmates.
The order will affect about 40 percent of the more than 8,200 inmates at the two prisons, said Joyce Hayhoe, a spokeswoman for the receiver’s office.
“The state of California has known since 2006 that segments of the inmate population were at a greater risk for contracting Valley fever, and mitigation efforts undertaken by CDCR to date have proven ineffective,” she said in an emailed statement. “As a result, the receiver has decided that immediate steps are necessary to prevent further loss of life.”
That creates problems for the corrections department, which faces a December deadline to reduce overcrowding in prisons statewide by an additional 9,000 inmates as part of a federal court order to improve medical and mental health care.
The department must file a plan with the federal courts by Thursday outlining what steps it will take to reduce the prison population by year’s end. Corrections Secretary Jeffrey Beard has said the department still wants to bring home more than 8,400 inmates who currently are being housed in private prisons in other states.

 Valley fever costs mount for patients and taxpayers

Berenice Parra was sick for eight months before doctors realized she had a severe form of the fungal disease valley fever.
“I was literally dying without a cure,” said Parra, a 25-year-old mother of three from Arvin.
Desperate for relief and concerned that doctors in the Bakersfield area weren’t taking her illness seriously, she drove 245 miles to Tijuana, three times, to see a doctor recommended by relatives.
Her health insurance wouldn’t cover those visits, so she paid out of pocket about $2,000.
Parra and her husband missed so much work that the family sank into debt.
With valley fever cases soaring in the southwest, more and more people’s lives and finances are being upended. Misdiagnosis of the disease adds to the costs for doctor’s visits, hospitalizations and long-term treatment with drugs. At more than $100,000 for a typical hospital stay, valley fever, on average, is more costly to treat than any of California’s 25 most common conditions requiring hospitalization, according to a state analysis of 2010 data.
It’s harder to pay those hospital bills when you’re out of work. Valley fever forces people to miss about three weeks of work, on average, according to recent studies, and that lost productivity is costly for businesses, too.
Above all, valley fever is a drain on taxpayers.
Through Medicare, Medicaid and other government programs, taxpayers cover a large percentage of the valley fever bill. An estimated 60 percent of valley fever-related hospitalizations — resulting in charges of close to $2 billion over 10 years in California alone — are covered by government programs,

Valley fever

Treatments and drugs

Rest 
Most people with acute valley fever don’t require treatment. Even when symptoms are severe, the best therapy for otherwise healthy adults is often bed rest and fluids — the same approach used for colds and the flu. Still, doctors carefully monitor people with valley fever.
Antifungal medications
If symptoms don’t improve or become worse or if you are at increased risk of complications, your doctor may prescribe an antifungal medication, such as fluconazole. Antifungal medications are also used for people with chronic or disseminated disease.
In general, the antifungal drugs fluconazole (Diflucan) or itraconazole (Sporanox, Onmel) are used for all but the most serious forms of coccidioidomycosis disease.
All antifungals can have serious side effects. However, these side effects usually go away once the medication is stopped. The most common side effects of fluconazole and itraconazole are nausea, vomiting, abdominal pain and diarrhea.
More serious infection may be treated initially with an intravenous antifungal medication such as amphotericin B (Abelcet, Amphotec, others).
These medications control the fungus, but sometimes don’t destroy it, and relapses may occur.


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