Valley Fever

Cases of Valley Fever have increased over 50 percent. Dr. Peter Kelly of the Arizona Department of Health Services will tell us what’s happening and why.

Transcript:

>>Larry Lemmons:
Tonight on Horizon, revenues are down big time for the state and Maricopa County. An economist will explain what's happening. Democratic pundit James Carville gives predictions for the upcoming presidential election--and how Arizona fits into the '08 picture. And cases of valley fever are way up. Get the skinny on that. All that's next, on Horizon.

>>Announcer:
Horizon is made possible by contributions from the friends of eight, members of your Arizona PBS station. Thank you.

>>Larry Lemmons:
Hello and welcome to horizon, I'm Larry Lemmons. The state of Arizona faces a budget shortfall of up to $800-million this fiscal year. And in Maricopa County, revenues could be down by as much as $35-million this year. Lower sales tax revenues are hurting both governments. Here to tell us more is Arizona Sate University economist Tracy Clark. Welcome again, to bring us some bad news.

>>Tracy Clark:
Well, that seems to be the function of the economy.

>>Larry Lemmons:
I guess so. It has been doom and gloom recently. I was wondering, you know, you were talking about Maricopa County and the state overall. But I know probably some of the other surrounding counties are also hurting as well.

>>Tracy Clark:
Yes, Arizona counties and cities are all very dependent on sales taxes. And we've seen, you know, retail sales, which is the largest portion of the transaction privilege taxes, which is why it's really called, that through august year to date is only up 1.4%. And the reason is that auto sales have slowed down so much. Since December of last year they've been either negative or flat. They're down 5.4% year to date. If you take them out of the equation, the rest of retail sales is up 3.4%. So the hard rule that we have is that picture is not being replicated for the nation as a whole. If you look at auto sales nationally they're not doing all that great but they're still growing a little bit. And they certainly haven't fallen like they have here in Arizona.

>>Larry Lemmons:
Is it something of a domino effect? Is that what we're looking at in terms of that ready cash isn't available for people anymore because of the sub prime mortgage mess, maybe they don't have the equity they used to have so they're holding back on getting that car and look at Christmas coming up down the way?

>>Tracey Clark:
They're looking at Christmas. They're looking at all of the things that they have to spend their money on. They can't do the mortgage refire anymore. They're a lot less confident about how much their house is worth. And people tend to spend based on how much they think all their assets are worth. People are also a little bit unsure about the rest of the economy. And those intended to contribute, the first thing you do is cut back on spending on big ticket items, autos --

>>Larry Lemmons:
Washing machines.

>>Tracey Clark:
Things like that.

>>Larry Lemmons:
I wonder, too, is it because, you know, there's always been such a resistance to paying more property taxes. There's always a resistance to paying more income taxes. So the first thing politicians are going to do, they're going to try to cut that down. Well, let's just rely on sales taxes. So is that old three-legged stool philosophy, I think.

>>Tracy Clark:
Yes. And the problem, of course, is that during good times sales taxes tend to grow very, very fast. But during bad times they tend to drop very, very fast. And since one of the responsibilities of good government is assuring a stable revenue source, overdependence on sales taxes tends to be a bad thing.

>>Larry Lemmons:
What are we looking at then in terms of -- when do you project we might be able to see some sort of light at the end of the tunnel?

>>Tracy Clark:
Well, the probability retail sales will stabilize and maybe start turning up as soon as 2009. 2008 is likely to still not be a very good year because most of the resets on the arm mortgages haven't hit yet. Most of them hit in 2008. So we're going to be dealing with that part of the equation. The other problem for our revenue sources is that for the last, well, through most of the 90's an unusually high percentage of the income tax was being accounted for by capital gains. Sales of stock, sales of houses. 2005 was an absolutely banner year in terms of capital gains. But last data point we have from the IRS is 2005. We assume 2006 and 2007 weren't quite as good and significantly worse. But we don't know for sure because we just don't have any data. That is contributed to much slower growth in the income tax, cuts in corporate income tax and how some things are calculated, plus profit margins being squeezed for a lot of corporations means that corporate income tax isn't doing as well. So the pain is kind of all across the board. The biggest manifestation of it, though, is still the transaction privilege or retail sales.

>>Larry Lemmons:
Well, but the rest of the -- if there's any light, too, the rest of the country probably isn't doing as badly as other parts, like in terms of the housing can crunch, for example.

>>Tracy Clark:
Right.

>>Larry Lemmons:
I mean, we are doing worse perhaps because we depend so much on that.

>>Tracy Clark:
And we did so well. We went up so high. So that states like Arizona, Nevada, California and Florida are being hit much harder because they went up much higher during the boom. And so in a sense we're kind of paying the piper for that one.

>>Larry Lemmons:
And construction. Is that down here as well?

>>Tracy Clark:
Construction is down significantly, certainly in the single-family area. It's not been impacted as much yet in the commercial and the government construction sectors, but there's not very much in the pipeline, so we fully expect that those will go -- start going down as well, further impacts on taxes that are collected from construction activities, and construction employment, which finally started going negative. They first had to work off all of the projects that had been stretched out because we never could really hire as many people for construction as we've wanted. They've done that. So now construction employment is down. Employment growth in general is down. September was 2.6% job growth. That was good enough to give us fourth in the nation. So employment growth is down all across the United States. And we're just getting hit harder in the construction and financials are starting to drop significantly and probably will continue.

>>Larry Lemmons:
Very briefly, we're all out of time. But what's a positive thing to end on?

>>Tracy Clark:
There is light at the end of the tunnel. And if you have a job and you didn't overextend yourself on your house, you're probably going to be just fine.

>>Larry Lemmons:
Thanks, Tracy. The keynote speaker at the Arizona Democratic Party's recent hall of fame dinner was James Carville. Carville, of course, known as the "ragin' Cajun," was the lead strategist for Bill Clinton's presidential campaign. He appears on countless television shows as a cheerleader for the Democratic Party. He's written several books, encouraging democrats to get tougher. He's also married to republican strategist Mary Matalin. I spoke with Carville before the democratic event at the Wyndham.

>>Larry Lemmons:
Well, let's put the rumors to rest. There are some people who say you're actually working for Hillary Clinton's campaign. That's not true. You're not working for any campaign, correct?

>>James Carville:
I'm not. But I've contributed to her campaign and described myself as sympathetic to her.

>>Larry Lemmons:
I would imagine it's kind of hard for you to think -- you probably know all the major players. They probably all want to get advice from you.

>>James Carville:
I haven't done any domestic campaigns as a way of earning a living since President Clinton was elected.

>>Larry Lemmons:
I looked on your website and it had a lot of international things that you've done. But it says that you don't specifically do domestic campaigns anymore. Why is that?

>>James Carville:
Well, because it just was time -- after president Clinton got elected it was time to do something else. In America once you become a famous person all you can do is keep being a famous person. I decided I was going to take that track as opposed to being a political consultant in US politics. It's worked out well for me. I've done a lot of stuff overseas. It's afforded me with a lot of freedom I wouldn't otherwise have. Then I'm working with CNN as a contributor, so that ties me up in terms of what I can do and can't do.

>>Larry Lemmons:
Certainly you can observe the horse race.

>>James Carville:
Yes. I can contribute and I can do -- I'm still a citizen.

>>Larry Lemmons:
So Hillary Clinton, Barack Obama, John Edwards and Bill Richardson. Let's just say they're the top four democrats.

>>James Carville:
Right.

>>Larry Lemmons:
How would you handicap them at the moment?

>>James Carville:
Clearly I think Senator Clinton has been in the lead in every national poll I've seen. I think Obama, Edwards, I guess Richardson is probably in fourth place. You know, it doesn't matter. Because Iowa will reconfigure the field and then New Hampshire will reconfigure that. I think that so far that obviously Senator Clinton has been the more skilled of the candidates. But coming down the stretch, anything can happen. The things that propelled Obama's candidacy, which is really one of the truly remarkable stories in American politics, 300 thousand contributors; raised close to $4 billion before this is over, getting close to 1 million people at a political rally. The hunger for change, something different is still there. So I think what have we got here, two months almost to the date that Iowa caucuses, which is pretty close. There's a lot going to happen in that stretch run, believe me. We think we've seen a lot. We haven't seen anything yet.

>>Larry Lemmons:
Do you think the top loading of the primary season is going to create problems? Because you are going to have a really long stretch, an uncommon stretch where you'll just have the democrat and republican running against each other.

>>James Carville:
Yes. My guess is that I think we'll know pretty early in our process. Republicans conservatively will go pretty deep into this. So usually whatever we think going into it turns out to be just the opposite. But it's a thing now. And I don't know what's going to happen next time. Because there was even some talk of New Hampshire jumping it to December. Somebody is going to have to get a hold of this process one way or another or people are going to have to agree on how to do this in a better fashion. Everybody got pretty much ahead of themselves.

>>Larry Lemmons:
Who do you like on the republican side? Well, not personally, of course, unless you're talking about your wife.

>>James Carville:
But yeah.

>>James Carville:
You know, the problem with their field is -- I'm being as honest as I can be -- I don't see how anybody can win but somebody is going to. And I'm not particularly troubled by -- not at all. Outside of most democrats I know would be delighted at either Giuliani or Romney. Fred Thompson, he hasn't woke up yet. McCain looks like he might be finding his footing a little bit. He was confused. He tried to run as somebody other than John McCain and it didn't work out well for him. And I think he's coming back, trying to get back in his own skin. It was kind of painful to watch him go through that process. You know, the country is really looking for change and something different. And I don't know anybody that could pull that; could make that happen. But you know politics in this country is pretty divided. You never take anything for granted.

>>Larry Lemmons:
I'd like to talk about the books that you've been writing with Paul Begalla where you're trying to galvanize the Democratic Party and tell them to get tough. After 2000, 2004, what sort of advice are you going to be giving to the democrats tonight?

>>James Carville:
You know, I think -- I never know until I get up there. I don't sit down and write a speech. I'm just kind of like an old preacher. I got to see which way the spirit moves me. But I think I'll try to do a lot of humor and talk about what's at stake here. And you know, Arizona has become -- it's sort of strange that this is becoming kind of ground zero in this thing. Arizona and Nevada, New Mexico, southern tier of the Rocky Mountain States, and Colorado, boy, these are states that are really, really going to be in play. And there's going to be a lot of action here. There's a lot of congressional action here, a lot of state legislative action here. Kind of surprised, but kind of looking -- Arizona is becoming blue.

>>Larry Lemmons:
The entire west is looking more blue. Why do you think that is?

>>James Carville:
First of all, the country is turning more democratic. Secondly, if you -- no doubt that some of the immigration patterns have probably helped the democrats in the west. And thirdly, just revulsion at the incompetence and the kind of overreaching. The broader west is conservative. But in that guys have done -- in the sense that what these guys have done has sort of turned them off. So you do have -- particularly, all four of the southern tier states are really, really going to be hotly contested in 2008. And it's amazing turn of events. And these are the states where you have the real growth.

>>Larry Lemmons:
So let's just say Hillary Clinton does win. And bill Clinton will be what they've been calling him in Scotland the first laddie. What role do you think he'll be playing in that administration? And will he enjoy it?

>>James Carville:
You know, one thing is that he's a guy who adapts pretty well. All the talking heads who were staying he won't know what to do with himself when he's not president, he'll probably be depressed. In the whole he's found a pretty good niche out there. He's now I think without a doubt the most popular human being on earth, anyway. My guess is that if Senator Clinton is elected president that she will -- I think his role will be defined.

>>Larry Lemmons:
You mean well-defined.

>>James Carville:
Yes. In terms of -- but he's got a lot of -- an enormous amount of respect and love around the world. And that's something that America lacks now. And I think that she would and I hope she does put him to work, restoring some of that. Because I think it's very important to the world that this country gains the respect it had before.

>>Larry Lemmons:
Last question. If you think about the war in Iraq and global warming, looking at all the issues that we're dealing with. What are you looking for in terms of the next four years? What do you hope will happen?

>>James Carville:
That's a great question. And I really do believe -- I've been struggling with this writing the book -- and I think people are looking for a real deal. You know, one of the things that just is like stunning, in the Grand Canyon they couldn't sell books about how the Grand Canyon was formed because somebody's flat earth in 5,000 people came in there and want to tell a story. How can this country compete in the world if we are denying the age of the earth? If we're denying global warming. If we're arguing about things that we know for a fact. So I think people are tired of that. And I think people are ready for this country to get real. If there's problems that we have in the Middle East. The fiscal problems this country has, the environmental problems with energy, the idea that we can somehow or another solve our energy problems if we drill some oil wells in Alaska is silly. It's beyond silly. And I think that low and behold it was kind of surprise. It was almost like after the 2004 elections the country just woke up and said, this is not what this is -- where did we end up here? And I think that '08 is going to be a pretty good -- very good democratic year. And I don't think that they're through fleshing this out. And another thing I find particularly heartening is that young people are turning away from the Republican Party massively, massively. There's been a -- it's hard to overestimate the change in attitudes of younger voters in how they've turned away. And you know, a political party is like a television station and anything else. You want to get every viewer you can but you'd rather have the younger ones than the older ones. And they are turning to the Democratic Party. And I think if we can run an aggressive campaign that focuses on real things that matter to people and level with people and acknowledge our problems, I think that's what people are looking for. I really do. I think people are looking for a real somebody to level with them and be real with them. Hopefully the democrats can do that. Because that's where our opportunity lies.

>>Larry Lemmons:
James Carville, thanks a lot for talking to us on horizon.

>>James Carville:
Thank you for having me. It's good to be in Arizona. The weather is always good out here.

>>Larry Lemmons:
Especially this time of year.

>>James Carville:
The climate is good, you know that the political climate is really getting nice out here. I like the forecast.

>>Larry Lemmons:
The number of valley fever cases last year hit a record high of 5,535 cases. That's up 57% from 2005. Here to tell us about the increase is Dr. Peter Kelly of the Arizona department of health services. Well, Dr. Kelly.

>>Peter Kelly:
Good evening.

>>Larry Lemmons:
So what's the deal? Why did it rise so much in that short period of time?

>>Peter Kelly:
We've been following valley fever cases for a number of years, going well back into the 80's. And two things have happened. One is that the population of the state has grown dramatically in that period of time. Basically it's doubled since 1980. And the people who moved into our state frequently come in from parts of the country where they don't have this disease. It's very much of an Arizona disease. So they are completely susceptible. And as you know, this organism lives in the soil here and creates a small spore that when the dirt is evacuated or when we have a dust storm can suspend it in the air and people can inhale it.

>>Larry Lemmons:
Could you explain for people maybe who have moved in who haven't been around in the valley to know about valley fever, exactly what it is. How does it affect a human being?

>>Peter Kelly:
Sure. Valley fever is a respiratory tract infection. It presents with usually kinds of respiratory symptoms, cough and fever and chest pain, frequently followed by fatigue. It's not like a cold because it lasts much longer than a cold. What we have found out is that patients will frequently be sick for up to 50-days before they seek medical attention.

>>Larry Lemmons:
If someone has a cold, that's what they think it is for 50-days, obviously they know something must be wrong.

>>Peter Kelly:
Certainly.

>>Larry Lemmons:
So it's not diagnosed sometimes I've heard until the third visit to the doctor?

>>Peter Kelly:
It can take a couple of visits to the doctor to get it diagnosed. And one of our major efforts is aimed at physician education. We want physicians, and we strongly recommend that physicians order valley fever testing, a simple blood test, at the time someone comes in with what is known in medicine as a community-acquired pneumonia. That is someone who has a cough and a fever and perhaps an abnormal chest x-ray. And if we can get that done early, we think we'll be able to make a diagnosis in less than two or three visits.

>>Larry Lemmons:
Well, why do you think it has been misdiagnosed so much?

>>Peter Kelly:
Well, I think that there is a certain lack of awareness of how common this disease is and the dramatic increase in cases really was quite surprising to us when it occurred. And the rate has gone up well in excess of the growth in population. So the rate of valley fever has doubled since 1980.

>>Larry Lemmons:
Are there higher reporting numbers?

>>Peter Kelly:
There certainly are higher reporting numbers because that's how we collect our cases.

>>Larry Lemmons:
You were saying that even though it's more than 5,000 cases, it could be and you don't know because people won't tell you, but mathematically you determine it could be as high as 30,000 actually of people actually having that.

>>Peter Kelly:
Yes. There have been several estimates that look at what is the projected number of valley fever cases. And that would be the maximum number. But even if it's only half of that, that's still a substantially greater number than 5,500 that we found last year.

>>Larry Lemmons:
Do you think, too -- now, I don't know, but we do have a lot of construction going on down here. And it's stirring up the desert floor. Could it be that it's caused to some degree by particulate pollution?

>>Peter Kelly:
Well, the organism itself is very small, and would be invisible in the air. But if you look at the visible dust that we have, that is an indication that soil has been disturbed. And the organisms may well be in that particular environment. The other thing that's important to point out is that valley fever is an infection you catch by inhaling something that's come out of the soil. It is not communicable from one person to another.

>>Larry Lemmons:
That's very important to people they can't catch it from another human being.

>>Peter Kelly:
And they can't spread it. Right. So they should take some comfort in that.

>>Larry Lemmons:
Thank you, Dr. Kelly for coming by and talking to us about valley fever.

>>Peter Kelly:
Thank you.

>>Larry Lemmons:
Governor Napolitano is in Washington this week. Find out what she wanted from the federal government. And the latest fight against the employer sanctions law. A federal judge heard arguments from those for and against the law that penalizes those who hire illegal immigrants. It's on the journalists' roundtable Friday at 7:00 on horizon.

>>Larry Lemmons:
Thank you very much for joining us on this Thursday edition of horizon. I'm Larry Lemmons. Join us every evening for the best in public affairs programming. Have a good evening.