Sentenced to Death by Spores

One of the things I find most irritating about social media is that a lot of people post articles that they either didn't read before linking to them, or when you see them in person, they can't have a follow up conversation about the subject matter. If we aren't exploiting the hyperaccessibility of information with which the internet has graced us, then what's the point? (Don't get me wrong, I love videos of cute animals, too.)

The hot topic this week that was really reminiscent of this personal irritation of mine was the sentencing of Dzhokhar Tsarnaev for his role in bombing the 2013 Boston Marathon finish line. Tsarnaev, only 21, was given the death penalty.

As you can imagine, the internet started to stir with articles about the history of the death penalty in the U.S., and infographics about how the U.S. is the only developed country that still uses the death penalty. I'll admit, the people I associate with tend to lean towards a specific side on the political scale, so I didn't really see anyone posting relief or word art of "JUSTICE" in red, white, and blue. I didn't really go looking for it either.

I couldn't find any word art, but this is clearly the next best thing. Thank you, internet.

I did see a lot of people posting about the broader concept of execution, whether or not it is moral, or representative of justice. Obviously an age-old issue that I'm not really going to discuss in this blog. But, I will ask: if you post these articles, is that enough? I mean, especially for an issue like this, where someone's life is at stake. Is it ok to say you are pro-choice, but to never donate to a clinic that provides full-scale reproductive health services? Are you standing up for what you believe in if you say you love children and want them all to be happy and healthy, but refuse to vaccinate your own child?

Image courtesy of The New Yorker

I'll admit, standing up for the rights of incarcerated people can be a tricky subject, especially if you don't live near a prison (there are a lot of them, but they tend to usually be in the middle of nowhere), or if you have no knowledge of the legal issues involved. Our society is very quiet when it comes to talking about prisoners, regardless of their sentencing current. But so many of these issues that communities are so polarized about have to do with life versus death.

Photo courtesy of Afro Punk and their coverage of the #ManifestJustice exhibit.

The prison system is a weird in-between. Are you really still living life in prison? Even if you are sentenced to death, you usually aren't executed the very next day, either. I know, you're probably thinking "why is she writing about this? what does this have to do with disease at all?"

The answer to that is EVERYTHING. Most people don't think about how diseases spread rapidly through the prison system, just like they do with agricultural livestock and in refugee camps. Any environment with a lot of living beings in small, enclosed spaces is a hotbed for communicable diseases. Also, many prisons have inadequate health care and clinics to properly serve all of the inmates accordingly.

There's one infectious disease that specifically targets incarcerated people that hasn't received enough attention as it should (I wonder why...): Coccidioidomycosis.

Coccidioidomycosis, or "Valley Fever", is a fungal infection that is really tricky to diagnose, and is often fatal because of that fact. Coccidioides immitis, the causative agent for Coccidioidomycosis, is a soil fungus that loves warm, dry climates because it's spores can be carried far distances by the wind. It's usually found in the southwestern U.S., Mexico, and some parts of South America.

C. immitis spores are carried from dry soil patches, through the air and dust, making it really easy to inhale. Most people inhale these spores and never have any complications or present any symptoms. This is most likely because they were exposed to small amounts of spores that weren't successful at mounting an infection, but it was enough exposure for their immune systems to recognize the treat and prepare a response for future exposures. Some people may also have genes that influence their resistance to Coccidioidomycosis.

Spherules of C. immitis, courtesy of University of Utah School of Medicine.

But some people aren't as lucky. People who have compromised immune systems (HIV/AIDS, autoimmune disease, organ recipients, etc.), people with diabetes, and people who are Black or Filipino are at higher risk for successful infection with complications. Children are at risk, too.

Pulmonary Cavitary Lesions caused by chronic C. immitis infection. Image courtesy of  University of Pittsburgh Department of Pathology.

Symptoms are almost always non-specific, including fatigue, cough, fever, headaches, night sweats, shortness of breath, muscle and joint pain, and rash. Yet, 5-10% of people have severe symptoms, wherein the develop long term respiratory problems due to high fungalemia (which means there's a ton of fungus in your lungs). Approximately 1% of Coccidioidomycosis cases spread to other organ systems, including the central nervous system. This can cause seizures, coma, or death.

Treatment for Coccidioidomycosis involves antifungal medication and symptom-specific management to help ease the illness and stop the spread to other organ systems. As always, treatment depends on how severe the infection is, and what organ systems it is affecting. 

There is a huge problem with inmates getting Coccidioidomysis and not getting proper treatment. Many lawsuits have been filed against the California prison system specifically, because many inmates in the 18+ prisons in the Bakersfield area have contracted Coccidioidomysis, many of which were misdiagnosed or not given proper treatment. California has even dedicated funding to routine inmate screening for Valley Fever.

The dedicated funds for screening came as a result of the lawsuits and the inmates' families advocating for better care. When I say advocating, I'm referring to writing letters to their elected government officials, working with prison system administrators, and encouraging doctors and wardens to listen to the inmates that they care for as a part of their jobs (that are paid for with state taxes)... not posting about it on facebook, per say.

If you want to read a long, drawn out story about Valley Fever, the New York Times published one about a year and a half ago. They even hyphenate "Valley Fever", which is cute?

If you think about a lot of the controversial issues we are constantly arguing about in the U.S., they can all be linked to health and disease in some way. Access to adequate housing reduces the spread of seasonal infections, some parasitic infections, and bacterial infections. Access to proper sanitation reduces the spread of countless infections. Access to education can help limit the spread of all diseases, because sometimes we aren't aware of the risks we are subjecting ourselves to, or ones that may be avoided with some extra steps (hand washing, condom usage, etc.). Access to reproductive rights can help people detect infections or other diseases and get the treatment they need. These are only a few.

What issues are you passionate about?