Governor proposes Valley Fever fund

Gov. Janet Napolitano’s proposed executive budget for fiscal years 2008-09 includes a one-time increase of $1.8 million for Valley Fever research with some of that earmarked for a drug that just may be a potential cure for the fungal disease.

“Of this, $1.5 million would be used to cover a portion of the funding necessary for the first stage of clinical trials for nikkomycin Z,” said John N. Galgiani, M.D., director of the Valley Fever Center for Excellence at the Southern Arizona VA Heath Care System and University of Arizona.

“Of course this won’t happen unless the Legislature agrees to what the governor has proposed,” Galgiani added. “It might be helpful if your readers let their elected officials know what they think.”

According to Galgiani, there are currently only four drugs on the market to treat Valley Fever, but none cure the patient.

“Nikkomycin Z has been proven to cure mice of Valley F iever,” he said. “The remaining $300,000 would be used for the development of a diagnostic test to distinguish Valley Fever from other causes of community-acquired pneumonia.”

Rarely diagnosed

The University of Arizona estimates that Valley Fever causes one in three cases of CAP but it is rarely tested for or diagnosed.

“Instead, physicians treat the Valley Fever as CAP, uselessly prescribing antibiotics,” Galgiani said. “A reliable diagnostic test would improve the clinician’s ability to rapidly diagnose Valley Fever and also limit inappropriate treatment.”

Galgiani said that current treatments for Valley Fever do not always work and when they do, they mainly assist the immune system in controlling infections.

“None are curative,” he added. “The Valley Fever Center for Excellence has become the sponsor of nikkomycin Z because pharmaceutical companies have been unwilling to do it since Valley Fever in an ‘orphan’ disease and the market is relatively small.”

Partial development funds are being obtained from the National Institutes of Health, the Federal Drug Administration and from a foundation donation.

Also a small business has been created, Valley Fever Therapies, LLC, to assist the Valley Fever Center for Excellence in drug development.

“Together, they are applying to the NIH for small business grants totaling $1.6 million,” Galgiani explained.

“With this and Arizona state’s support, it will be possible to restart clinical trials of nikkomycin Z this year. If nikkomycin Z appears as promising in these studies as is hoped, it should be possible to complete partnership with a pharmaceutical company to support the commercialization.”

The Valley Fever Center for Excellence and the University of Arizona Bio5 Institute are engaged in collaboration with scientists at the Arizona State University Biodesign Institute to develop new diagnostics to help physicians more rapidly diagnose Valley Fever.

“State support will be used to translate these discoveries into practical testing procedures, too,” Galgiani said.

Valley Fever (coccidioidomycosis) is a fungal disease endemic to Arizona. Each year, 150,000 infections occur in the United States.

Of these, 60 percent occur in Arizona, 30 percent in California, and 10 percent elsewhere.

Last year, there were 46 percent more infections reported to the state than reported in 2005.

After infection, a third of the patients develop symptoms of pneumonia often lasting from weeks to months.

A small percentage develop complications involving skin, bones, and the brain which require years to life-long medical treatments.

Arizona Department of Health statistics estimate that about 25 Arizonans die of Valley Fever each year.

Costs related to hospitalization for Valley Fever in Arizona were more than $19 million in 2001. This published estimate did not include lost time from work for the large number of persons whose infections are managed without hospitalization.

At-risk groups

Particular groups have special risks of complications. These include the elderly, pregnant women, organ transplant recipients, those with AIDS, diabetics, minority groups (African-Americans, Filipinos), and the military involved in desert training.

Recently published evidence from the Valley Fever Center for Excellence indicates that Valley Fever is responsible for about a third of all community-acquired pneumonia in southcentral Arizona.

This finding has prompted the Department of Health Services to issue a health advisory notice to physicians about this problem.

“Because so much of this problem originates in Arizona, it is appropriate for the state of Arizona to allocate resources to reduce the public health impact of this disease,” Galgiani said. “Last spring the governor released $50,000 to educate health acre professionals about this issue.”

rford@gvnews.com | 547-9740