When Jeremy Romo was packed off to prison in 2012 for illegal possession of a firearm, he says he was as healthy as anyone, a construction worker who ran three miles each weekday and five miles on weekends.
By the time he was released in July 2013, the 34-year-old Manteca man says he had become a physical wreck, unable to run, suffering from joint pain and consigned to a life sentence of taking expensive medications to combat the Valley fever he contracted while in prison.
“This has just ruined my whole life,” Romo said. “This disease is incurable. You can never get rid of it.”
Hundreds of inmates have contracted Valley fever in recent years in an epidemic that has plagued state prisons in the Central Valley. The disease is more prevalent in that area of California and has contributed to the deaths of more than 30 inmates since 2005. Typically, symptoms of the disease include fatigue, fever, cough, night sweats, a shortness of breath and a rash on the upper body or legs.
The state spends more than $23 million each year treating inmates stricken by the disease – $9 million for hospital care, $2.4 million for antifungal care and $12 million guarding the patients – and soon may be paying much more because of a series of lawsuits by inmates claiming that their incarceration has resulted in a life sentence of pain and illness.
The latest suit, filed earlier this month in federal court in Sacramento on behalf of 58 current and former inmates, accuses the state of knowing for years that its Central Valley prisons were incubators for the incurable sickness, but doing nothing to address the problem.
The state has imposed on inmates “a lifelong, crippling, and sometimes fatal disease in addition to their lawfully determined sentences,” the suit claims.
Like several other suits pending in courthouses throughout California, the lawsuit seeks monetary damages to offset the medical costs inmates will face for the rest of their lives – $5,000 a year for antifungal medication to keep the disease in check, $1,000 annually for testing, and $25,000 in hospitalization expenses for inmates with the worst infections.
It also seeks punitive damages and alleges that state officials were negligent and reckless in housing at-risk inmates at prisons in areas where the airborne spores that cause the disease are prevalent in the Valley soil.
The suit was filed July 14, two weeks after the federal Centers for Disease Control and Prevention issued a report recommending testing all inmates eligible for housing at Pleasant Valley and Avenal state prisons – the two hardest hit by the illness – to identify, if possible, those who are susceptible to the disease.
Corrections officials declined to comment on the latest suit, but the battle over Valley fever has been raging since an epidemic of the disease broke out in some state prisons a decade ago.
Since then, attorneys for the inmates and lawyers for the state have traded jabs over whether enough has been done to protect prisoners from the disease. Last year, a federal judge took the extraordinary step of ordering the state to remove all inmates considered to be at “high-risk” for contracting the disease from Pleasant Valley and Avenal state prisons.
While corrections officials would not comment on the lawsuits, they contended the department has worked diligently for years to address the problem.
“CDCR has been working to mitigate Valley fever for years,” spokeswoman Deborah Hoffman said in an email. “We have put in place numerous measures in our prisons to reduce the amount of dust, and the movement of dust, particularly into buildings.
“We have also moved inmates deemed at higher risk and who chose to move out of the two prisons in the Valley fever endemic zone. We have also worked with state and federal public health partners to study further methods of reducing the incidence of Valley fever in Avenal and Pleasant Valley prisons.”
Hoffman added that the department is now considering the findings in the CDC study.
The respiratory disease is not uncommon in California, especially in the southern San Joaquin Valley, where the fungal spores that cause it are in the soil and infect victims when the spores become airborne.
“The public health burden of Valley fever is substantial and has increased in recent years,” the CDC study states. “In 2011, over 20,000 cases were reported, most in Arizona or California.”
Most people who breathe in the spores do not get sick, and many of those who do become ill recover on their own, according to the CDC. For others, however, the disease never goes away.
The CDC cited infection rates among the state’s general population to be 11.7 per 100,000 people. In the Central Valley, the rate is much higher: 241 per 100,000 people.
The rates among inmates in prisons in the Central Valley are dramatically higher. At the two most affected prisons, where 83 percent of the state’s Valley fever cases have occurred, the rates were measured at the equivalent of 3,799 per 100,000 at Avenal and 6,911 per 100,000 at Pleasant Valley during the peak year of 2011.
“Although incidence rates declined in 2012, they were still over 20 times higher than the rates among civilians in counties where (Avenal in Kings County) and (Pleasant Valley in Fresno County) are located,” the study noted.
Statistics compiled by the state show 197 cases in the state prisons last year, and 2,450 from 2008 through 2012.
Complicating the issue for corrections officials is the fact that some inmates are more susceptible to severe illness after contracting the disease than others, particularly Filipinos, African Americans and Latinos. Inmates with health problems such as diabetes also are more prone to greater illness if infected.
Lawyers for the inmates say in court filings that state officials knew some prisoners are at an elevated risk of contracting the disease, and that those inmates should never have been housed at Pleasant Valley or Avenal, but were placed there anyway.
It took a court order last year from U.S. District Judge Thelton E. Henderson of San Francisco to get high-risk inmates at the two prisons transferred elsewhere, and the judge noted in his sternly worded order that the state had known of the dangers and ignored them.
“There is no question here that defendants are aware of the substantial risk of serious harm … ,” he wrote in reference to prison officials.
The litigation targeting Valley fever has run on a parallel track to long legal fights over the prison system’s medical services – which Henderson placed in the hands of a receiver – and over California’s effort to reduce its inmate population to a court-ordered level.
Lawyers for the inmates say part of the blame for the epidemic in the first place belongs to the state’s prison-building from 1987 to 1997, during which eight prisons were constructed – including Avenal and Pleasant Valley – in the worst areas for Valley fever.
The excavation and construction tossed Valley fever spores into the air and topsoil and made conditions worse, the lawyers contend. The latest lawsuit charges that state officials made matters worse at Pleasant Valley in 2005, when the state began construction of the Coalinga State Hospital “immediately adjacent to the prison, less than 200 yards away.”
“The excavation and construction adjacent to the prison churned an inordinate amount of the endemic Coccidioides fungal spores into the ambient air in and around the prison,” the lawsuit states.
The lawyers and inmates say they believe that in some instances the illness was contracted in part from spending time outside on dirt exercise yards, which they contend should have been treated or paved.
They also contend that, until recently, the state had done little to mitigate the ever-present threat of the disease, or to help sick inmates receive regular care once they are released.
“Once infected, no compensation is provided for this additional punishment that has been unfairly added to their sentences,” a lawsuit filed last year in federal court in Fresno states.
Romo, the once-healthy Manteca man, said that he must use $400 worth of the antifungal drug Fluconazole each month to keep his infection under control; an expense he cannot afford because the illness has left him unable to work.
“He has skin lesions on his legs and feet,” says a federal lawsuit filed in January in Fresno, which includes Romo as a plaintiff. “His lung is scarred; he is easily fatigued and short of breath and is generally lethargic, whereas before he was energetic and strong. He is depressed and experiences night sweats.”