Brynn Carrigan's headache began in April 2024. Within a few weeks, she became weak.
Her vomiting exacerbated the outrageous pain on her skull. She spent hours in bed almost every hour, and the lid raised her head and blocked all the light. Even her microwave had too many clocks.
"I started training in a marathon and raised two teenagers and were essentially bedridden," said Carrigan of Bakersfield, 41.
Her condition continued to worsen and the doctor could not provide the answer - until her third visit to the hospital, when a doctor asked her if she had respiratory symptoms before the headache began.
She has it. About a month before the headache started, Carrigan felt like a typical cold - although she recalled that her cough lasted longer than usual before she continued to develop a rash on her thigh. Without treatment, both symptoms will get better.
These prove to be key information. Her biopsy of spinal fluid showed that Carrigan had balloon meningitis, a rare complication of a fungal infection called valley fever.
"I know what's wrong, but I think it's such a serious million years," Carrigan said.
Valley fever or coccidioidosis is caused by inhalation Globacteria Spores are a fungus in the hot climate in the southwestern United States. Climate change is creating drier soil that extends eastward, expanding the fungus range. Valley fever is increasingly diagnosed with its usual territory and cases are rising in the western U.S., while Arizona still sees the highest number of people per year, California is closing the gap.
From 2000 to 2016, there were 1,500 to 5,500 cases per year in California. From 2017 to 2023, these figures jumped to 7,700 to 9,000 cases. Preliminary figures for 2024 put the count above 12,600, the highest ever in the state, about 3,000 higher than the 2023 record.
Early data suggests that California is working toward a record year. The state has recorded more than 3,000 confirmed valley fever cases across the state, more than last year’s same time, and nearly doubled in 2023 this time.
“There is no doubt that coccidioycomisois has a much higher number of cases than before,” said Dr. Royce Johnson, Ph.D., director of the Infectious Diseases Department of Kern Medicine and the Valley Fever Institute, in California. "If you want to see me, now you have to wait till July, that's my colleague too."
Carrigan lives in Kern County, a dry, sprawling area between two mountains at the southern tip of the central California valley.
The county has recorded at least 900 valley fever cases so far this year, and the state has had zero fungal infections over the past three years.
However, consistent cases in places like Kern County have not driven upward trends in California, said Gail Sondermeyer Cooksey, an epidemiologist with the California Department of Public Health.
Instead, new hot spots emerged along the edge of the Central Valley—Montrey and San Luis Obispo County on the central coast of California. Contra Costa County cases have doubled east of Berkeley so far this year compared to the same time in 2023.
“It seems to be spreading,” Sondermeyer Cooksey said.
Many factors may affect how Globacteria "The spores reproduce and spread," she said, "but one thing we've identified is the big driving force of those peaks and depressions, which are drought." ”
A 2022 study in Planet Lancet Health found that droughts would suppress cases of valley fever every year, but years of drought followed by a wet winter led to a sharp rebound in cases. This shift in weather patterns driven by climate change appears to have largely affected the emergence of hot spots in the New Valley. Longer, dry summers can also change the transport season, when spores range from late summer and winter to early this year.
“We see wet and dry dryness in the Southwest, but California sees that,” said Jennifer Head, an assistant professor of epidemiology at the University of Michigan, who studies valley fever and climate change.
In Arizona, the state has a more similar climate to that in California than elsewhere in Arizona.
"The highest growth in Arizona is the North Plateau region, similar to California, historically wet and wet," Head said.
The climate pattern of widening fever in California valleys is the one that drives increasingly intense wildfires. Scientists are still trying to understand how fires may worsen the risk of valleys, but some studies have shown a link between wildfire smoke and higher diagnostic rates.
Sondermeyer Cooksey said the state health department warned first responders that the risk of fever in the Walli Mountains in the area could increase due to the fire. There have been outbreaks in field firefighters.
Limited evidence that wildfires may spread Globacteria spore. In a 2023 study, researchers conducted 19 fires in California and observed a higher rate of valley fever following three of the fires. These fires tend to be larger, located near the center of the population, and burning areas have high valley fevers before the fire.
“It is not clear whether there is a connection between wildfires and valley heat, but it is important to know Globacteria "Living in the dirt, anything that disturbs dirt will exacerbate the heat in the valley," Sondermeyer Cooksey said.
Valley fever season has not happened this year. Sondermeyer Cooksey said state and local public health departments are “closely following areas hit by the fire in January” as reconstruction efforts are disrupting the soil in burn scars.
Diagnosing valley fever is tricky, mainly because its symptoms overlap with other respiratory diseases including flu, volumes and pneumonia. If someone has these symptoms, it is important for them to let their doctor know if they have been experiencing disturbing soil or dust (in building areas, camping, hiking, outside or festival work), or in areas where there are known valley fevers.
Symptoms usually appear one to three weeks after exposure, but can take up to eight weeks, so people may not immediately connect, said the head of the University of Michigan.
Last year, at least 19 people attended the Bottle Music Festival Lightning, which was once again held in Kern County this month – a valley fever diagnosed later in the summer. At least eight people were hospitalized.
"The lightning in the bottle is right in the middle of the local area, which is one of the hot spots of the disease," said Dr. George Thompson, director of the Valley Fever Center at the University of California, Davis.
Thompson said it was clear that he and colleagues across the state were treating more patients for the infection. Like Carrigan, only about 1% of cases can cause life-threatening meningitis or other complications, but once a person is infected, they will never remove fungi from their bodies.
“There is no drug to kill cocci, so it’s your immune response that stops you from getting sick,” said Johnson of Kern Medical. To treat the infection, people are given antifungal agents “long enough to make a person’s immune system figure out how to control it. If you do something to destroy that immunity, it starts growing again and can surface in a few years,” he said.
Carrigan has spent the last year with intense antifungal treatment regimens. In the first few months, she lost most of her hair and eyelashes and barely recognized herself in the mirror.
Now, she has fully recovered and even competed in a marathon this spring, but she still takes antifungal drugs. Carrigan said she hopes more people will understand the warning signs of valley fever and tell doctors whether to tell doctors with the case that this could help people diagnose faster.
“Even if only 1% of cases increase, the number of people experiencing complications will increase,” she said.