What is Valley Fever and who is at risk?

What is valley fever

Valley fever, also known as coccidioidomycosis, is a fungal infection caused by inhaling spores of the fungus Coccidioides. This condition is common in the Southwestern United States, particularly in Arizona, where the fungus is found in the soil.

When the soil is disturbed, through haboobs, or dust storms, especially during Monsoon Season the fungus spores can become airborne and be inhaled, leading to infection. Even something as benign as construction or gardening can kick up spore-laden dust.

Fact: Two-thirds of all U.S. valley fever infections are contracted in Arizona.

Valley Fever Symptoms

Research tells us that symptoms of valley fever can vary widely, with some people experiencing mild symptoms or no symptoms at all, while others may have severe symptoms that require medical intervention. Valley fever symptoms generally occur within three weeks of exposure. Common symptoms of valley fever include:

  • Fatigue
  • Cough
  • Fever
  • Chest pain
  • Chills
  • Night sweats
  • Headache
  • Muscle aches
  • Joint pain
  • Rash on upper body or legs

In some cases, valley fever can lead to more severe complications, such as pneumonia, meningitis, or skin lesions. If you experience any of the symptoms listed above, it is important to seek medical help. Additionally, if you have a weakened immune system or are pregnant, you may be at higher risk for developing severe valley fever and should seek medical attention promptly.

man on ATV making a tight turn in the dirt

Who is Likely to Get Valley Fever?

People working in certain occupations such as construction, excavation, agricultural work, archaeological digging, or pursuing activities like biking or driving ATVs which disturb soil in endemic areas, may have an increased risk of exposure and disease.

If you are interested in the Valley Fever Dashboard for Maricopa County Cases, click here.

How is Valley Fever Diagnosed?

Valley fever is typically diagnosed through a combination of tests, including:

  • Blood tests to detect antibodies against the Coccidioides fungus that causes valley fever. This is the most common diagnostic test. The blood test measures the levels of antibodies (titer), with higher titers indicating a more severe infection.
  • Sputum or tissue sample testing to directly identify the Coccidioides fungus under a microscope or grow it in culture. This involves examining samples of sputum, fluid, or tissue from the lungs or other infected areas.
  • Imaging tests like chest X-rays or CT scans may be ordered if pneumonia from valley fever is suspected, to look for lung abnormalities.
  • Skin tests, while indicating prior exposure, are not useful for diagnosing a current valley fever infection.
  • It’s important to note that a negative blood test does not rule out valley fever, as up to a third of infected patients may initially test negative. Repeat testing over time may be necessary.

The diagnosis is typically made by considering the patient’s symptoms, exposure history (travel or residence in endemic areas), and the results of the above tests. Early and accurate diagnosis is crucial for appropriate treatment and management of valley fever.

How is Valley Fever treated?

Valley fever is typically treated based on the severity of the infection. Here are the main treatment approaches:

For mild cases:

  • Most mild valley fever infections resolve on their own without treatment, only requiring rest and fluids.
  • Doctors closely monitor patients with mild cases, but no medication is prescribed unless symptoms persist or worsen.

For moderate to severe cases:

  • Antifungal medications are prescribed, usually for 3-6 months.
  • The most common antifungal drug used is fluconazole (Diflucan). Other azole antifungals like itraconazole (Sporanox) may also be used.
  • For very severe infections that have spread beyond the lungs, intravenous amphotericin B may be used initially, followed by an oral azole.
  • Newer antifungals like voriconazole (Vfend), posaconazole (Noxafil), or isavuconazonium (Cresemba) can treat serious infections.

For chronic or disseminated infections:

  • Long-term antifungal treatment, sometimes lifelong, is required.
  • This is especially important for immunocompromised patients or those with meningitis, as the infection can be fatal without treatment.

To Summarize

Supportive care like rest, fluids, and management of symptoms is recommended for all cases of valley fever. Early diagnosis and appropriate antifungal therapy is crucial for preventing complications in moderate to severe infections.

Most people with valley fever, recover on their own, but if you have any concerns seek immediate medical help. If you suspect you may have valley fever, it is important to see a healthcare provider for a proper diagnosis and treatment. Early detection and treatment can help prevent complications and promote a faster recovery.

 

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