How the Government Put Tens of Thousands of People at Risk of a Deadly Disease

If it killed politicians instead of prisoners, this illness would be national enemy No. 1.


Sika Eteaki.

SIKA ETEAKI LAY IN BED, shaking uncontrollably. The pillow and sheets were soaked through with sweat, but now he couldn’t get warm. It felt like there weren’t enough blankets in all of Lancaster State Prison to keep him warm.

Just a few months earlier, Eteaki had turned himself in for illegal possession of a firearm. He’d been arrested with a gun while driving back from a camping trip. He and his family had used the pistol for target practice, for fun, but a spate of nonviolent priors from the decade before had prosecutors threatening to put Eteaki away for years. Since those early arrests, Eteaki had turned his life around. He now had four kids under five, a renewed faith in Mormonism, and steady work at a foundry. The prosecutor went easy, and after months of negotiation, Eteaki pleaded guilty to felony firearm possession and got eight months in Lancaster, on the outskirts of Los Angeles. In July 2010, Eteaki’s wife, Milah, drove him to the Long Beach courthouse, outside LA, where he surrendered and entered the system.

Eteaki lost more than 40 pounds. And still, no one seemed to know what was wrong with him.

A hulking if slightly overweight presence, Eteaki stood 5-foot-10 and weighed 245 pounds, with broad shoulders, tattoos, and close-cropped black hair. His family was from the Polynesian archipelago of Tonga, and he’d arrived at Lancaster a strong, healthy man. But a few months into his stay, he started getting headaches and running a fever. He’d landed a plum job in the prison’s cafeteria and didn’t want to risk losing it by calling in sick, so he suffered through what he figured was a particularly rough flu for a week. He stopped by the prison clinic and was given ibuprofen and told to drink more water. He didn’t get better. He went back to the clinic and got more of the same. After a few more days of delirium, Eteaki learned from another inmate how to get the docs’ attention: “Tell them your chest hurts.” The next day, he was admitted to the prison’s hospital with a high fever and a diagnosis of pneumonia.

The prison hospital cell was cold concrete. Doctors set up intravenous drips and pumped him full of antibiotics. Eteaki asked what he was getting, but answers weren’t forthcoming; they were making him better, they said. But his fever wouldn’t recede. For days it hovered around 103, 104. He was drowsy and couldn’t eat. He also couldn’t write or receive letters in the medical wing, couldn’t tell his wife where he was or why he’d been ignoring the letters he knew she sent daily.

After three weeks of isolation in the clinic, he heard chains outside his door. Guards came in and ordered him to change into an orange jumpsuit. They shackled his wrists and ankles, strapped a surgical mask over his nose and mouth, and transported him to a hospital in Lancaster. There, chained to a bed, he continued to deteriorate. Doctors came and went, performed tests, and cycled him through a series of drugs. He lost more than 40 pounds. And still, no one seemed to know what was wrong with him.

One night, as Eteaki drifted in and out of consciousness, someone came in and asked for his emergency contacts. “Holy shit,” he thought, “they don’t know what to do with me. They’re just going to leave me here.” He tried to sleep, but the chills and hacking cough and fear were too much. He cried and thought of his wife and children. He remembered the hymns he’d learned in church as a child. “I need thee, oh, I need thee,” he sang.
FOR CENTURIES, RESIDENTS OF California’s Central Valley have fallen ill with a mysterious disease that seemed to come with the great swirls of dust that periodically swept across the landscape. The illness, which killed some of its victims and left others debilitated and frail, appeared to choose its prey at random.

Valley fever, we know today, is born of a microscopic fungus that thrives in the valley’s fertile soil. Unlike most other infectious diseases, it does not spread through person-to-person transmission, but rather through dust particles that make their way into our lungs. Each individual fungus is a spore, a single-celled organism capable of asexual reproduction. When kicked up by cars or backhoes or tractors, spores can float across a county in an afternoon. They thrive in the dusty, dry swath of land that cuts from California to Texas, and billions of them are sent into the air with each subdivision we carve out from unclaimed expanses. Outside cities like Bakersfield or Fresno, you may inhale hundreds of these invisible fungal specks in a day. For most people, however, breathing in a few spores amounts to nothing—60 percent of people who inhale the fungi feel no symptoms at all. Thirty to 35 percent develop illness—usually flulike symptoms. Most people never even know they encountered the fungus—and for that reason, experts believe that valley fever may be much more common than official reports suggest.

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