Valley Fever

Valley Fever is also called Coccidiomycosis.

What is Valley Fever?

Valley Fever is finding itself again in the news in the United States (U.S.). Valley fever is a pneumonia that is caused by a fungus called Coccidioides. Pneumonia is an infection of the lungs and often causes fever, shortness of breath, and cough. Pneumonia can be caused by different bugs such as bacteria, fungi, parasites, or viruses. Our article, What’s all the fuss about antibiotics, is a great review of the different types of bugs, or infections, and how they are treated. 

Where does the coccidioides fungus come from?

Coccidioides live in soil, most commonly in the Southwestern U.S., Mexico, Central America, and South America. This fungus was recently found farther north in Washington. We become more exposed to it when it gets stirred up during dry times, excavation, farming, or other myriad reasons for the dust to be in the air. 

How can I catch Valley Fever?

You can get Valley Fever by breathing in the spores of the coccidioides fungus. Obviously, things that stir the soil up are going to increase your risk for exposure to this fungus. 

Many people are exposed to coccidioides but they do not become ill. If they do become ill it usually resolves within 2-4 weeks with mild symptoms such as cough.

Rarely, you can get an infection through a cut on your skin leading to a skin infection. 

You cannot “catch” this Vally Fever pneumonia from other people but you can catch the skin infection from another infected person. Though, you could inhale the spores from the skin infection and develop Valley Fever.  But again, skin infections are rare, and further catching it from another person is even rarer, though possible. 

What are the symptoms of Valley Fever?

• Fever

• Rash

• Cough

• Shortness of breath

• Fatigue

• Body Aches

• Headache

You may start to develop symptoms anywhere from 1-3 weeks after you have inhaled the fungal spores. 

What is the treatment?

The basics here to understand is that Valley Fever is caused by a fungus. Fungi are not treated with antibiotics. Antibiotics only kill bacteria. Our entire body has trillions of different bugs on it normally to protect us. These bugs include bacteria and fungi. If we take an antibiotic it kills the good bacteria on our body as well as the bad. Now that good bacteria can’t protect us and the fungus that we have can overgrow. So….as you can imagine, treating the wrong infection of your lung can be disastrous. You do not want this fungus to overgrow. Nor do you want to waste time while it gets worse, and possibly die due to the wrong treatment—antibiotics. 

I recently read an article on Yahoo about people laying in beds for hours getting their “antibiotic” treatment for Valley Fever. The writer was very confused, these patients didn’t have Valley Fever or someone is going to be in big trouble! 

Those diagnosed are treated for 3-6 months with an anti-fungal medicine. This medicine is usually diflucan/fluconazole. Severe cases are treated for longer than 6 months. Fungi are slow-growing bugs so the treatment needs to be longer. They are not like bacteria that grow quickly allowing shorter treatments to be used. 

There is no vaccine for Valley Fever. 

What puts me at risk for exposure to this fungus?

• People 60 years old and older

• Black or Filipino persons

• Pregnant persons

• People with diabetes

• People with an organ transplant

• People with HIV or AIDS

• People who take medications that decrease their immune system such as steroids

These risk factors also increase your risk of a worsening infection. 5-10% of these infections can lead to long-term lung disease. 

The fungus can also spread to different organs such as your joints, brain, skin, spinal cord, and bones. This happens in about 1% of cases. So that would be 1 out of every 100 cases or 10 out of every 1000 cases. 

How can I keep from getting Valley Fever?

Well, if you live in the southwest U.S., Mexico, or Central or South America it will be a bit difficult to avoid coccidioides. The fungus is very common in the environment and it is hard to avoid breathing it in. Understand you may have already been exposed and never knew you were previously infected. Most people who have been infected with coccidioides make an immunity to it and never contract it again. Just like most things in life, there are always exceptions, but for the most part, people are immune once infected. 

If you are an at-risk person try the following measures:

• Do not travel to these areas during dusty times.

• Wear an N95 respiratory mask if you are going to be in any type of dusty environments, such as construction, a dust bowl, working with dirt in a garden, etc. 

• Stay indoors during high dust times.

• Avoid people with known skin infections. 

• Keep people’s dirty shoes out of your home so that you don’t inhale the spores that may be on them.

What happens if I get Valley Fever?

As mentioned before, most people heal without ever knowing they had Valley Fever. There is a skin test that can let you know you are immune due to past infection, but a negative result doesn’t mean you haven’t had it. 

There were about 20,000 cases of Valley Fever documented in 2019 in the U.S. Of these about 200 people died from the disease. It is thought there are tens of thousands more cases but people were just not tested for the fungus. It is usually diagnosed with a blood test. Patients will often have had a chest X-ray or CT Scan, as well, for pneumonia. 

Conclusion

If you are an at-risk person (elderly, have decreased immune function, have diabetes, organ transplant patient or are pregnant, etc) then take preventative measures to avoid the fungal spores, such as staying indoors and wearing an N95 respirator during possible exposure. 

If you have been in an area that may have the coccidioides fungus or were exposed to someone with a coccidioides skin infection and you have symptoms of Valley Fever seek immediate medical attention locally.