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    • Arizona Valley Fever Cases Increased Nearly 50%
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    Arizona Valley Fever Cases Increased Nearly 50%

    Pabio Posted on

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    As fall and winter approach, seasonal illnesses like the flu are already on the rise. There’s another one to add to the long list of illnesses to watch out for: valley fever.

    The number of Valley fever cases in Arizona jumped 45% in 2024 compared to the same period last year, an increase of nearly 4,000 cases.

    Valley fever, also known by its clinical name coccidioidomycosis, is a lung infection that is rarely fatal and usually goes away without treatment.

    During the first 10 months of this year, the Arizona Department of Health Services reported a total of 11,801 confirmed and probable cases of valley fever, higher than the year’s total of 10,990 last.

    Warm, dry conditions are favorable for the growth of the fungus responsible for the infection, coccidioides. The fungus is endemic to the Valley metro area, and Maricopa County alone accounts for about half of all infections in the United States, according to Dr. John Galgiani, director of the Valley Fever Center for Excellence at the University of Texas. Arizona. The fungus also grows in the Southwest and is widespread in areas of southern California, although cases have been reported as far north as Washington.

    The fungus releases its spores when dirt and dust are disturbed, and infection can occur when a person inhales these spores.

    There is no vaccine to protect against Valley Fever, although one is under development at UA.

    The good news is that valley fever is not contagious; a person must be exposed to the fungal spores to get the infection.

    “People with Valley fever do not need to be isolated,” since the disease is not communicable, Galgiani said. “They pose no risk to their grandchildren or things like that.”

    Diagnosing valley fever is difficult because the symptoms are similar to other illnesses that tend to increase in fall and winter. Galgiani and his AU team partnered with Banner Health to work on disease identification and reporting.

    “We’re slowly getting there in emergency care, but it was with a systematic approach to repeatedly remind people” to test for Valley fever, he said.

    Here’s what Arizonans need to know about Valley Fever.

    Fluctuating environmental patterns cause year-to-year differences

    Better awareness and identification of symptoms may contribute to this increase, and manufacturing issues leading to false positives also play a role in this increase. What’s contributing the most to this increase is actually the environment, Galgiani said.

    “Most likely, (the increase) is mainly due to year-to-year differences in precipitation, its timing and quantity, as well as other weather conditions,” he said.

    The fungus that causes valley fever likes warm, dry climates, perfectly describing central and southern Arizona. Phoenix sits just above the endemic region for the fungus, and Maricopa County accounts for half of the total cases in the United States, according to Galgiani.

    As Phoenix experiences the hottest summer on record, the heat and lack of measurable precipitation have created the perfect storm for the fungus to thrive.

    “Climate change modeling indicates that within this century it will reach the Canadian border,” Galgiani said. “We’ll see if that’s true, but the model would be for the endemic region to extend across the western United States.”

    Coccidioides spores can be disrupted by wind, dust storms and other activities that kick up dust and dirt. Even hiking and horseback riding can disturb the soil enough to release the microscopic spores.

    Symptoms are similar to other fall diseases

    As with other illnesses that occur in fall and winter, fever and cough are just a few signs of valley fever. Other symptoms include fatigue, shortness of breath, muscle or joint pain and headaches, all of which are similar to other illnesses and lead to diagnostic difficulties, Galgiani said.

    Symptoms appear about one to three weeks after inhaling the spores. Chronic infection can lead to pneumonia, although these symptoms are more common in people with weakened immune systems. Knowing the cause of pneumonia-like symptoms can make or break treatment for valley fever. Pneumonia-like symptoms can be treated with antibacterial or antiviral medications, but these types are ineffective against valley fever because it is a fungal infection.

    The most serious infection, disseminated coccidioidomycosis, occurs when the fungus spreads beyond the lungs and into other parts of the body, including the skin, bones, and brain. Disseminated coccidiomycosis occurs in 1 to 2% of cases.

    On average, there is a 3 to 4 percent chance of contracting valley fever, and the risk is cumulative depending on how long a person has lived in an endemic region.

    “Twelve years…that’s the median length of residence before you’re infected, before you’re diagnosed,” Galgiani said.

    Increased awareness can help diagnose earlier

    Diagnosing valley fever requires a blood test, which is not included in routine lab work when a person goes to the emergency room or urgent care, Galgiani said.

    “Getting tested is not a bad idea if you are sick,” he said, especially if a person has persistent or severe symptoms of the flu or pneumonia.

    Immediate testing and diagnosis can avoid wasting time trying different ineffective medications.

    “You get all these antibiotics that don’t do any good, and you might have repeated CT scans and all kinds of health care that you can stop doing once you get a sure diagnosis,” Galgiani said.

    Through a partnership with Banner Health, Galgiani hopes to change the way Arizona health systems treat Valley Fever in emergency rooms and urgent care.

    “It’s just about paying attention and getting people to do what they’re supposed to do,” he said. “If this continues to be what we do at Banner, we hope it rubs off on the rest of the health systems.”

    A vaccine is on the horizon

    Galgiani’s team at UA recently developed the first vaccine to prevent valley fever, a canine type vaccine.

    About 6 to 10 percent of dogs in Maricopa, Pima and Pinal counties contract valley fever each year, according to the Valley Fever Center of Excellence. The spores are inhaled, just like in humans, and they are not transmitted from dogs to humans.

    The researchers hope the federal government will approve their vaccine by next year, allowing veterinarians to begin administering it to dogs and other animals they believe could benefit from it. Cats and even zoo animals can get Valley fever.

    The AU research team received a grant from the National Institutes of Health to take the dog vaccine and design a human version of the vaccine, which Galgiani said is needed as the endemic region spreads.

    “If there are more fungi in the soil and more spores in the air… there can be five times more cases each year,” he said. “This will make the idea of ​​having a vaccine even more attractive.”

    A unique feature of Valley Fever is that it is not spread from person to person, meaning a vaccine would not be necessary for something like herd immunity.

    “Some people don’t like vaccines, and in this case, no one is forced to get vaccinated if they don’t want to because (infections are) not transmissible,” Galgiani said.

    However, without a vaccine, managing symptoms is all an infected person can do. Since it is a fungal infection and not a viral or bacterial infection, antibiotics and antibacterial medications are ineffective against the infection.

    For people with a severe infection, treatment may include an oral antifungal medication for three to six months, depending on the CDC. Valley fever is also only fatal if the infection spreads outside the lungs, which is rare.

    Most people improve on their own, Galgiani said. However, he advises you to see a doctor if you feel sick.

    “The earlier you diagnose it, the more you can manage your disease,” he said.

    Pabio
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