FRESNO -- 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, in Kern County.
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, according to preliminary data from the California Department of Public Health.
"It's an incredibly expensive disease to treat," especially if a patient develops complications or conditions requiring surgery, said Dr. George Thompson, assistant professor of medicine at the University of California at Davis, and the assistant director of the school's coccidioidomycosis serology laboratory.
Difficult to diagnose
Even in Kern County, where cases of valley fever are more common than anywhere else in the state, no doctor seemed to recognize Parra's symptoms. So they misdiagnosed her repeatedly.
She was prescribed Xanax when she described pain in her chest, and she underwent a biopsy on her knee while the doctors searched for a cancer that didn't exist. "Aggravating factors -- everything," one doctor noted.
When she was finally diagnosed, the valley fever had spread and was causing coccidioidal meningitis -- brain swelling. She was hospitalized, and the bill reached $52,000, mostly covered by her insurance.
The total charge statewide of hospitalizing people with cases of valley fever ranging from pneumonia-like symptoms to life-threatening cases such as Parra's, was close to $140 million in 2010, according to an analysis by the Office of Statewide Health Planning and Development.
That represents a 28 percent increase in costs just since 2008. Nearly half of those charges came from the eight-county San Joaquin Valley, which holds about 10 percent of the state's population.
That sum reflects all charges for services, based on a hospital's established rates. Patients and their insurance companies typically pay a fraction of that charge, however, because each payer negotiates different rates.
In 2010, the average valley-fever-related hospital stay was more than 10 days, and the average total charge per individual for hospitalization was $102,166, according the state health planning office.