Stephanie Ray, RN, BSN
What is Valley Fever?
Valley Fever (coccidioidomycosis) is a fungal infection caused by breathing in Coccidioides fungus spores that live in the soil. Though it is named after the San Joaquin Valley in California, it is also found in parts of Arizona, Nevada, Utah, New Mexico, Texas and Washington.
The fungi grow as mold in the soil, with long filaments (strands) that break off into spores. When soil is disturbed, these spores release into the air and can be inhaled.
The fungi spores are very small and can be carried far by the wind. Once they are inhaled into the lungs, the spores reproduce, continuing the disease cycle.
Valley fever is not contagious, meaning it cannot spread from one person or animal to another.
Risk factors
Environmental exposure: anyone who inhales the spores that cause Valley fever, is at risk for infection. Those that live in areas where this fungi is common, especially those that spend a lot of time outdoors, or have jobs that expose them to dust are most at risk. Working in construction, road work, agricultural workers, ranchers, archaeologists, and military personnel are more susceptible to developing serious fungal infections.
Race: For reasons that are not well understood, people of Filipino and African heritage are more susceptible to developing serious fungal infections.
Pregnancy: Pregnant women are most vulnerable to more serious infections during the third trimester. New mothers are more vulnerable right after childbirth.
Weakened immune system: People with already weakened immune systems are at an increased risk for complications. This includes people living with AIDS (acquired immunodefiency syndrome), treated with steroids, chemotherapy, anti-rejection drugs (after transplant surgery). People with certain autoimmune diseases, such as rheumatoid arthritis or Crohn's disease, who are being treated with anti-tumor necrosis factor (TNF) drugs also have an increased risk of infection.
Diabetes: People with diabetes may have a higher risk of severe lungs infections.
Age: Older adults are more likely to develop Valley fever. This may be because their immune systems are less robust or because they have other medical conditions which affect their overall health.
Symptoms
Mild cases of Valley fever usually resolve on their own, some without any symptoms at all. In more severe cases, doctors will treat the infection with antifungal medications.
People who do get sick can have respiratory symptoms or pneumonia. Common symptoms are flu-like and may develop 1-3 weeks after breathing in the fungus.
Chronic: If the initial infection doesn't resolve completely, it may progress to a chronic form of pneumonia. This is most common in people with weakened immune systems.
Disseminated Valley Fever:
The most serious form of the disease is uncommon. It occurs when the infection spreads (disseminates) outside the lungs to other parts of the body. The most affected parts include the skin, bones, liver, brain, heart, and the membranes that protect the brain and spinal cord (called the meninges).
Signs and symptoms depend on the body part affected but can include: nodules, ulcers and skin lesions that are more serious than the rash that sometimes occurs with initial infection.
Diagnosis
To diagnose Valley fever your doctor may order some or all of these tests:
Blood test
Biopsy
Imaging
How is it treated?
Treatment depends on the severity of the condition and how your doctor wants to manage it. They may recommend keeping an eye on your symptoms before prescribing medications, or they might treat you to reduce the risk of serious illness. If you have a serious or ongoing infection or if you have risk factors for severe illness (like chronic pulmonary disease) they may prescribe antifungal medications.
How can I prevent infection?
It is hard to avoid breathing in the spores if you live where they are common. Though not completely preventable there are some steps you can take to reduce your infection risk.
Avoid areas with exposure to dirt or dust. If this is unavoidable, use an N95 respirator mask to help filter fungal spores out of the air you breath.
Close your windows and stay inside during dust storms.
Avoid activities like gardening, digging, or other yard work that expose you to fungal spores.
Use air filters indoors.
To avoid skin infections, clean cuts, and scrapes well with soap and water.
Sources
https://www.cdc.gov/valley-fever/about/index.html
https://www.cdph.ca.gov/Programs/CID/DCDC/pages/Coccidioidomycosis.aspx
https://www.mayoclinic.org/diseases-conditions/valley-fever/symptoms-causes/syc-20378761
https://my.clevelandclinic.org/health/diseases/17754-valley-fever#symptoms-and-causes Assessed and Endorsed by the MedReport Medical Review Board