Tiny spores are causing major headaches for the California Department of Corrections and Rehabilitation after a judge ordered the department to move thousands of high-risk inmates from two prisons that have been plagued by valley fever outbreaks in recent years.
On Tuesday officials at the CDCR said they would comply with an order by U.S. District Judge Thelton Henderson to move approximately 2,600 inmates from two prisons, although they said they did not know exactly where or when all the inmates would be moved.
Henderson ordered that the high-risk inmates in the Pleasant Valley Prison and the Avenal Prison be moved within 90 days, but officials could still ask for an extension. The prisons are located 10 miles apart and are approximately 175 miles from San Francisco.
Valley fever, an infection caused by the coccidioides fungus, which is prevalent in the dry soil of the West and Southwest, and often spreads through the air when dirt is disturbed or kicked up and then inhaled. Symptoms include fever, chills or in more severe cases chronic pneumonia or meningitis.
According to the Centers for Disease Control and Prevention, approximately 40 percent of those infected require hospitalization, and the disease can be fatal.
Henderson's ruling is based on the recommendations of J. Clark Kelso, the receiver in charge of health care for California's correctional facilities.
Those considered to be at a higher risk for contracting a severe form of the illness include African-Americans, Filipinos, pregnant women or anyone with a suppressed immune system or other medical problems, according to the CDC.
Henderson elected not to follow Kelso's recommendations that inmates older than 55 be considered high risk, although they could be included at a later date.
The decision to remove prisoners based partially on race has lead to fears that the move could create additional security problems.
Department spokesperson Deborah Hoffman told The Associated Press that moving the prisoners could create a racial imbalance, which could worsen gang violence in prisons.
"That can dramatically affect the safety and stability of prisons," Hoffman said. "We have to be careful about sparking racial and gang violence."
The order to move the prisoners comes at a difficult time for the department, which is already appealing an earlier court order to decrease the entire prison population by 10,000 by the end of the year.
Inmates who could be categorized as high risk could challenge their placement in either the Pleasant Valley or Avenal prisons, and inmates who don't want to be transferred from these locations could decline.
Dr. Joyce Blair, a professor of medicine and infectious diseases consultant at the Mayo Clinic in Tucson, Ariz., said it was not known why some people of certain races were at a higher risk for contracting the severe form of the disease.
"Most of the time, these people are otherwise completely healthy," said Blair. "There's probably a genetically inherited deficiency that is very unique [in relation to] valley fever."
Other experts worry that the ruling to move only high-risk inmates doesn't go far enough.
Dr. Royce Johnson, a professor of medicine at UCLA and chief of infectious medicine at the Kern Medical Center in Bakersfield, Calif., has been treating valley fever for more than 30 years and said he questioned the effectiveness of the proposed solution.
"My own prejudice about Pleasant Valley, a misnamed place if there ever was [one], is the rate of disease is so high the site ought to be abandoned," said Johnson. "You cannot tell by looking at someone's skin color what their risk is."
According to an April report by the Receiver's Public Health and Quality Management Units, the Pleasant Valley State Prison had a valley fever infection rate that was 400 times higher than its county's. The Avenal State Prison had an infection rate that was nearly 10 times higher than the county with the highest rate in California.
Between 2006 and 2010, there were a reported 27 inmates who died from the disease in California.
Cases of valley fever have dramatically increased in the U.S. in the past 15 years. In 1998, Arizona, California, Nevada, New Mexico and Utah recorded 2,265 cases; by 2012 that number had increased to 22,401.
The Associated Press contributed to this report.