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...related couples, helped clarify what proportion of risk was attributable to heredity rather than environment. "What's fabulous about this study is that they were able to isolate a population so that you have a more uniform environment," notes Dr. Andrew Ahn, a neurologist at the University of California, San Francisco (UCSF) who authored an independent editorial on the Dutch study...
...didn't contain any studies linking agranulocytosis with cocaine. However, in April of that same year, a New Mexico lab had identified a small number of unexplained cases of the disorder, also in people who had snorted, injected or smoked cocaine. Later, in 2009, a few cocaine addicts in San Francisco - crack smokers, mostly - began displaying even stranger symptoms, like dead, darkened skin. "It looked like people were getting burns all over their body," says Dr. Jonathan Graf, a rheumatologist at the University of California, San Francisco. "[Their skin was] black, as if you had taken a cigarette butt...
...stretch supplies - levamisole appears to be added to cocaine from the outset, in the countries of origin. The substance has been found in various concentrations in cocaine analyzed in countries around the world, from Switzerland to Australia. And urine tests of cocaine users attending a drug clinic at San Francisco General Hospital in 2009 - one floor above Graf's office - found that 90% of samples were positive for levamisole; similar tests in Seattle revealed that 80% of cocaine users there had levamisole in their systems...
...despite the wide use of levamisole, cases of agranulocytosis are relatively uncommon. According to government surveys, nearly 2 million Americans have used cocaine at least once in the past month. "Why aren't 90% of cocaine users [in San Francisco] getting sick?" wonders Graf, who says he sees about one case every few weeks, mostly in women. He suspects that men are less likely to be affected because they are less vulnerable to autoimmune disorders than women, but says the truth is that no one really knows why certain users become ill. Zhu and Graf urge users who are suffering...
...Dust Bowl years of the Great Depression, farmers who fled West out of the prairies found a paradise of citrus groves in Southern California: miles upon miles of navel and Valencia oranges, planted in a vast swath of Riverside and San Bernardino counties, which stretch from East Los Angeles to the Arizona and Nevada borders. Starting in the 1970s, that area, now known as the Inland Empire, became a mecca for a new kind of homesteader: young families lured by cheap land and an easy commute to L.A. By 2008, it was home to 4.1 million people...