Fellowship Story Showcase
Valley fever basics
Why are people still dying from valley fever and tens of thousands getting sick? Misdiagnosis. A lack of public awareness. And a long history of inaction by government agencies. In this series, we will explore the startling rise of cases, the science of studying the disease, the high costs to patients and taxpayers, the weak federal and private interest in funding treatments and vaccines, and the public health response.
Valley fever, also known as coccidioidomycosis, is a disease caused by a fungus called coccidioides immitis found in the soil primarily in certain parts of the Southwestern United States, Mexico and Central and South America. A person can become infected by inhaling the spores of the fungus. The infection starts in the lungs, but can spread to other organs in the body and the bones.
What are the symptoms?
Fever, a persistent cough that won’t go away, night sweats, weight loss, and different kinds of rashes. Once a person is infected with the fungus, it does not leave the body.
How is it diagnosed?
Most commonly through a blood test. It can also be diagnosed through a biopsy of where the infection is located.
How can it be treated?
The first step is correctly diagnosing the disease. Clinicians should find out whether it has spread and identify the patient’s risk factors for it causing severe illness. If the infection is confined to the lungs and a patient has no other risk factors, current guidelines call only for monitoring the patient to see if the fever goes away. If the infection has spread and patients are at high risk of complications, clinicians often turn to antifungal drugs, such as fluconazole, sold as Diflucan, and surgery.
How common is valley fever?
Researchers estimate that there are 150,000 people stricken with valley fever every year nationally, but the vast majority of cases are not misdiagnosed as something else or never treated. Those cases that are diagnosed have been rising dramatically, by more than 12-fold since 1995. It kills about 100 people every year.
How can people prevent becoming infected?
One of the challenges in preventing the disease is a lack of clear guidelines. In known high-risk areas, people working outdoors are encouraged to wear a mask and construction crews are encouraged to keep dust down by wetting the area. Studies in mice have shown that, in principal, a vaccine would work, but funding for developing a vaccine has been scarce.
Who is at most risk?
Blacks, Filipinos, people with chronic health conditions, such as diabetes or cancer, recent organ transplant recipients and pregnant women are at most risk for developing severe complications from the disease.
Sources: Michael Mac Lean, health officer for the Kings County Department of Public Health; Dr. James McCarty, head of the pediatric infectious disease unit at Children’s Hospital Central California in Madera; The Environmental Health and Safety Division at California State University, Fullerton.