- Valley fever is spreading and scientists project it will continue to expand east due to climate change.
- Symptoms depend on the stage of the disease and which organs are impacted.
- There is currently no cure, but symptoms can be managed and a vaccine is under development.
Experts are sounding the alarm about the spread of a fungal infection called Valley fever.
While Valley fever is typically found in the Southwest, scientists say it has spread as global temperatures have gone up.
One 2019 study in GeoHealth found that due to climate change, Valley fever could move east, expanding all the way to the Canadian border before 2100.
Here’s everything you need to know about this fungal infection.
What is Valley Fever?
Valley Fever is coccidioidomycosis, which is a fungus that exists in different forms in nature in the soil (where it exists as a mold) and in the human body. The fungus is endemic in dry regions, mainly in the southwestern US and Latin America.
In soil, it forms light spores which are carried by the wind and can be inhaled and infect the lungs. The infection of the lungs is often asymptomatic and others can develop an influenza-like illness with fever and cough.
This syndrome has been called different names in different regions including Valley fever or desert rheumatism. But it tends to subside spontaneously, Dr. Monica Gandhi, professor of medicine and associate chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital, told Healthline.
However, coccidioidomycosis can be more serious, causing nodules and cavities in the lungs and even disseminated disease in the central nervous system, which can result in meningitis. If it affects the bones and joints it can lead to arthritis.
Disseminated disease is rare and risk factors including pregnancy, certain race and ethnicities (e.g. Filipino/a or African American) and advanced HIV infection or other immunosuppressed people are at high risk, Gandhi added.
“Symptoms depend on the stage of disease and also which organs are affected,” said Dr. Emma Harvey, Global Head of Medical Affairs at the clinical-stage biopharmaceutical company F2G. “It starts as a respiratory disease and can be indistinguishable on symptoms from viral or bacterial pneumonia.”
Most infections result in limited symptoms but about 5% of patients may go on to have a chronic lung infection and in these cases they will need antifungal treatment.
A smaller percentage of patients develop disseminated disease which spreads outside the lungs to affect particularly the skin, central nervous system, and bone and joints.
These infections require long-term antifungal agents and infection in the central nervous system – such as cocci meningitis – is often incurable and can lead to death.
Symptoms in patients with disseminated disease include fatigue, inability to perform activities of daily living, and in the worst affected patients, inability to go to work or school and inability to care for family and home, Harvey added.
According to the CDC, additional symptoms include cough, shortness of breath, muscle aches and rash.
There is currently no cure. Many patients will recover over time, but joint infections can take years to clear and cocci meningitis is considered incurable.
Life-long therapy is required and if antifungals are withdrawn, patients may relapse, Harvey explained. Initial antifungal therapy is typically with an oral azole, fluconazole.
If that does not control symptoms, then other azoles medications can be tried.
In the most difficult cases, intravenous amphotericin B formulations may be tried and in cocci meningitis, intra-thecal amphotericin may be required.
“In mild disease (which most often goes undetected), doctors don’t actually use treatment but in severe infections, they use antifungal therapy like fluconazole (an orally administered anti-fungal) for many months,” Gandhi explained. “The concern is that – as the environment heats up- we will have more areas that become arid and are prone to harboring the fungus in the soil.”
A vaccine is in the works
Scientists have been trying to develop a vaccine for Valley fever since the 1960s, but initial attempts in humans have been unsuccessful.
But recently, researchers at the University of Arizona College of Medicine in Tucson have developed a vaccine that’s highly effective in dogs.
Dogs, like humans, are susceptible to Valley fever and this two-dose vaccine creates an immune response against the fungus and protects dogs from developing disease when exposed, Gandhi stated. The vaccine is likely to be approved by the U.S. Department of Agriculture for use in dogs by early 2024 and attempts to adapt this vaccine to humans are ongoing.
Valley fever, a fungal infection typically found in the Southwest, is spreading and scientists predict it will continue to spread east as global temperatures rise.
Symptoms include fatigue, shortness of breath, cough, muscle aches and rash.
At this time there is no cure, but with the right antifungal therapy, symptoms can be managed. A vaccine is also under development.
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