Valley Fever: A Disease In The Dust

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The California Department of Health’s Center for Infectious Diseases says valley fever causes disease in 5,000 Californians each year.

By Angel MedFlight Contributor

At Angel MedFlight Worldwide Air Ambulance, it is important for us to keep you informed about trending topics in health care. One story that opened our eyes recently concerned the rising number of cases of valley fever — a serious disease that affects thousands of people in California, Arizona and the Southwest.

What is valley fever? According to the Centers for Disease Control, valley fever is caused by a fungus (Coccidioides) found in the soil of dry, low rainfall areas. It is endemic in many areas of the southwestern United States, Mexico, Central and South America.

The CDC says valley fever is a common cause of pneumonia in endemic areas. At least 30%-60% of people who live in an endemic region are exposed to the fungus at some point in their lives.  People can get the disease by breathing in the spores in the air, especially after a soil disturbance.

Symptoms  include fever, cough, headache, a rash, muscle aches and joint pain in the knees or ankles, night sweats and weight loss. More advanced cases include skin lesions, chronic pneumonia, meningitis and bone or joint infection.

California and its agricultural heartland have been especially hard hit by valley fever in recent years. Dr. Gil Chavez is the deputy director of the Center for Infectious Diseases and is the state epidemiologist in the California Department of Public Health. He tells Angel MedFlight, “Valley fever causes disease in over 5,000 Californians each year. High risk groups include African-Americans, Hispanics and those with health issues or comprised immune systems.”  The number of valley fever cases in California was just over 2000 in 2003. Dr. Chavez says construction, agricultural workers and others who are exposed to dust are susceptible to the disease.

The University of Arizona’s Valley Fever Center for Excellence says two-thirds of all valley fever infections in the United States are contracted in Arizona. Diagnosis can be difficult as the symptoms can be caused by bacteria or viruses. It takes specific laboratory testing to accurately diagnose valley fever. According to the Arizona Department of Health Services, there were 26 deaths caused by valley fever in 2011, compared to 18 in 2008.

While valley fever is the second highest reported communicable disease in the state,  Arizona Department of Health Services valley fever expert Clarisse Tsang says, “We are constantly monitoring for odd peaks in the numbers and haven’t seen any this year.” Tsang says the number of reported cases in the state actually went down from 16,422 in 2011 to 12,920 in 2012. But Tsang adds, “Since valley fever is here and can blow in the air almost any time, education of the public and physicians is our best tool to keep track of it.”

In a recent Associated Press story, Valley Fever Center for Excellence director, Prof. John Galgiani said drought periods can have an especially potent impact on valley fever if they follow periods of rain. Rainfall leads to fungus bloom, but limits dust. He says, “When it dries up, that’s when the fungus goes into the air. So when there is rain a year or two earlier, that creates more cases if drought follows.

The Phoenix Valley Fever Center at St. Joseph’s Hospital and Medical Center says approximately one-third of pneumonias in Maricopa, Pinal and Pima counties are valley fever infections. And often, the illness lasts many weeks or months. Last year New York Mets first baseman Ike Davis was sidelined by the disease, suffering bouts of extreme fatigue.

Most people with acute valley fever don’t require treatment. The Mayo Clinic recommends bed rest and fluids as the best therapy. But it’s still best to have your doctor monitor your condition if you are diagnosed with valley fever.

California public health officials advise that persons living, working, or traveling in valley fever endemic areas, especially those at increased risk for more severe disease, should limit exposure to outdoor dust.

Dr. Chavez says, “we recommend local health departments and local community business organizations promote prevention for employees.” He adds, “The sooner the diagnosis, the better the health outcome.”

More information on valley fever can be found on the CDC website.

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