Valley Fever

Dr. John Galgiani (right) and Dr. Susan Hoover (second from right) talk with members of the audience during break Sunday.

Sixty percent of all Valley Fever cases in the United States occur in Arizona, but one in five people here have never heard of it.

Those were among the statistics shared Sunday when the Valley Fever Center for Excellence at the University of Arizona held its fourth annual Valley Fever seminar in Tucson.

The majority of the Arizona cases occur in what’s called the Valley Fever Corridor that includes Maricopa, Pima and Pinal counties.

The other 40 percent of cases in the U.S. occur in California, New Mexico and Texas; there also is a significant number of cases in six states in Mexico, including Sonora.

Valley Fever, clinically known as “coccidioidomycosis,” is caused when the soil-borne “coccidiodes pasadasii” fungus is inhaled and the body’s immune system can’t fight it.

Orion McCotter, an epidemiologist with the state Department of Health Services, said the cocci fungus grows in soil in hot, dry soil where there is little rainfall.

Southern Arizona has ideal weather and soil conditions for the cocci fungus to grow and dust makes inhaling the fungus possible. However, 60 percent of people who do inhale the fungus are asymptomatic. Those who do show symptoms have a cough, fatigue, fever and chest pains. In severe cases the cocci spores are disseminated and may affect the bones, joints, skin, lymph system, brain and central nervous system.

“It can be life-threatening; there’s still room for improvement in diagnostics,” McCotter said.

Ties to pneumonia

Anyone with pneumonia should be tested for Valley Fever, he said, and gave some eye-opening statistics:

•One in five persons in Arizona have never heard of Valley Fever,

•One in three persons don’t know how it is transmitted,

•A person with Valley Fever is sick an average of seven months, and

•75 percent missed one month of work.

McCotter said there are more cases of Valley Fever in Arizona than California because all cases here must be reported, and the population in endemic regions in Arizona is much higher than in California’s rural regions where the fungus is found.

Dr. John Galgiani, director of the Valley Fever Center for Excellence, told the audience that one-third of all cases initially diagnosed as pneumonia is Valley Fever.

Doctors can’t tell what is causing pneumonia without a specific test, 25 percent of patients with Valley Fever need 10 or more doctor visits and 40 percent of patients are hospitalized.

“The Valley Fever Alliance of Arizona has been formed to educate physicians, to create awareness, to develop better care, better diagnostics and new drugs,” Galgiani said.

A woman from Green Valley asked about the incidence of Valley Fever when living close to a mine. Galgiani said there is little oxygen deep in the soil for the cocci fungus to exist, but while no data exists, “it’s theoretically possible cocci could be in mine soil.”

Assistant Professor of Medicine Susan Hoover spoke about Valley Fever in patients with rheumatoid arthritis and said there are no guidelines.

Chief of the Section of Rheumatology at the University of Arizona Dr. Jeffrey Lisse said rheumatoid arthritis is the most common auto-immune disease, and Valley Fever may affect the joints. Lisse will speak in Green Valley at the West Center in January.

Clinical trial

If you are diagnosed with Valley Fever you might be eligible for a clinical trial for a new medication, Nikkomycin Z. Contact the Valley Fever Center for Excellence at 520-629-4777.