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Catching On

Viruses and bacteria walk among humans
Illustration
/
Kaitlin Brito

The infectious diseases defining Nevada’s public health landscape, and the simple solution that eludes officials

Benjamin Clayton recalls the moment his life trajectory changed forever. “I remember when I got the call ...
And I remember just afterwards being in the bathroom, on the floor, and crying and just telling myself, ‘I just don’t want to live.’” That call informed Clayton that he had tested positive for HIV, an incurable virus that attacks the body’s immune system.
“It took me about three, four years to just get out of that constant, highly depressive stage,” Clayton recalls. Now, years later, the German native has found a supportive community and renewed purpose in Las Vegas, serving as a peer navigator for The Center, a local LGBTQ+ community center and health clinic. Clayton is often the first person with whom patients speak after finding out they have HIV. He connects them to local resources and uses his own HIV experience to show patients that “life does get better.”

Clayton is one of more than 12,800 people living with HIV in Nevada, a state which has the fifth-highest HIV rate in the nation, as of 2019. Nevada also ranks fourth in the U.S. for STD rates overall. Add to that the rising prevalence of Candida auris (C. auris) and Valley fever (coccidioidomycosis), the constant circulation of COVID, seasonal spikes of influenza and RSV, and the odd tuberculosis scare, and Southern Nevada seems to be
a uniquely unwell region.

The explanation for this will be unsurprising for longtime residents. “There’s a multiplicity of things that lead to these numbers here,” says Dr. Jerry Cade, medical director for The Center. “One is, we don’t have the healthcare infrastructure. Two is, we don’t have the insurance, we don’t have the money spent.” A growing population — and a physician pool that is failing to keep up with said growth — exacerbate the situation.

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These three illnesses defined Southern Nevada’s communicable disease landscape in 2023.

HIV/AIDS

Standing out among Nevada’s viral infections is HIV/AIDS: The state recorded nearly 500 new HIV diagnoses in 2021 and, since 2012, Southern Nevada has seen a year-after-year increase in HIV diagnoses. On a national level, 17 percent of America’s HIV infections are in Nevada. These consistent upticks of HIV rates, and data showing that one in five HIV-positive Nevadans aren’t aware of their status, prompted the state legislature to pass SB 211 — which requires healthcare providers to offer optional STD tests to patients — during the 2021 session. There is no cure for HIV, but experts say that individuals diagnosed with HIV have the same life expectancy as those without the virus if they receive treatment.

“My favorite comparison in 2023,” Cade says, “is, when a patient comes in — because they are all scared, because they’ve always heard these horror stories. Treating HIV is more akin to treating high blood pressure than anything else. You take a pill, and you’re fine.”

It really is a time for fun and relaxation. And, unfortunately, it’s time for something we don’t want to think about after three years of COVID-19: disease.

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Tuberculosis

On the bacterial side, Las Vegans have also been forced to contend with tuberculosis, as news of one TB-positive person exposing more than 600 people across 26 Clark County schools broke in December. Case rates for the disease, which is spread through coughing, speaking, or sneezing, have declined in Southern Nevada in the past 50 years because of increasingly effective treatment options. However, Haley Blake, the communicable diseases supervisor for the Southern Nevada Health District, cautions that numbers are on the rise. “Post-COVID, we are seeing some case rates go up,” Blake says. “We average between 40 and 60 cases a year here in Clark County for active disease.” Yet there’s still no reason to panic, she adds. “It’s not gone, but it’s not very common.”

Fungal infections

On the other hand, health officials say fungal diseases, like Valley Fever and Candida auris, are cause for concern. The latter, which made national news when the CDC deemed Southern Nevada a Candida auris hotbed, has hit the region hard: In 2022, Nevada’s healthcare facilities housed 16 percent of all Candida auris cases in the U.S. which, according to Brian Labus, an epidemiologist and assistant professor at UNLV’s School of Public Health, poses the greatest risk for already-vulnerable subpopulations. “This isn’t something that we worry about in the general community,” Labus says. “We’re talking about the sickest patients in the hospital, (who) wind up getting infected with this yeast, and on top of the serious problems they are (already) having, it can cause pretty high death rates — a third of people with this can wind up dying from it.” Since 2021,
more than 100 Nevadans have.

While tackling our community’s infectious disease spread might seem insurmountable, public health experts say this is a treatable problem — provided that more resources are allocated for it. “We’re dead last in public health funding nationwide,” Labus says. “So, no matter how many times I try to push people, unless you have the entire community say, ‘This is something that we think should be our priority,’ it’s very difficult to do things. We have a lot of problems in Nevada. And so, every time there’s money, everybody’s fighting for it ... It’s the challenge of politics, and I don’t think it’s something that any one of us can easily solve.”

Cade concurs. “There’s a lot that we could do that would make a difference,” he says, “and we haven’t chosen to do that yet.”