Valley Fever: incidents are increasing

A New Commentary Each Wednesday Jan 22, 2014

I just finished reading an article in New Yorker magazine about something with the medical name of Coccidioidomycosis (kok-sid-e-oy-do-my-cosis) or "Cocci" (kok-see), but more commonly called "Valley Fever." I will use the three terms for the malady interchangeably.

I first heard about Valley Fever when I came to Arizona in the late 1950s. The son of my Radio Station's Advertising Sales Manager became very sick with it while attending the University of Arizona. He first had a high fever and cough; was desperately ill for months, but recovered, although muscular and joint pain, weakness and lethargy persisted for more than a year. His lungs were permanently damaged.

Sometime since, I read that most of the German POWs who worked in the vegetable fields that were surrounded by desert near Florence, Arizona during WWII, contracted Valley Fever in varying degrees of severity.

According to the National Centers for Disease Control and Prevention, Coccidiodomycosis is caused by a very tiny spore of a fungus found in warm, arid regions of the United States, much of which was identified as being desert; with minimal rainfall. It occurs in Northern Mexico and in many other like areas of Latin America. In fact, it was first diagnosed in Argentina.

Soil disruption by any means can cause spores of this fungus to be released. It very often strikes down farm workers and others who work with the soil, including laborers in the building industry in dry, warm regions. It can be carried by prevailing winds for many miles and be inhaled by a victim.

Initial symptoms persist for an average of 120 days. Symptoms can mimic some strain of influenza or tuberculosis.

The spore is so small it can enter the blood stream and spread to multiple organs, including the lining of the brain, causing a form of meningitis that can be fatal. Lesions in the lungs are common, although the severity of pulmonary cavities can vary from patient to patient.

The only good news that can be offered is that symptoms usually pass quickly from most persons affected. Most victims never suffer any serious symptom; never knew that had it. Only when pulmonary scars are discovered on imaging results or a skin or lab test later in life shows positive, do the victims find out that they have been visited ever so slightly by the malady. It has come and gone with little or no lasting effect.

They also probably are also not aware that they are immune to another attack of Valley Fever. This is true, irrespective of the severity of the attack.

There is also no person-to-person transmission of Coccidioidomycosis - it is not "catching."

For some reason, Valley Fever affects people of color more adversely than other races. Among Asians, Filipinos especially. The most adversely affected are persons of African ancestry or patients with a weakened immune system.

Everything that I've read adds up this way: "More people, more buildings, more agriculture, more soil disruption, more Valley Fever." In one area it is called "San Joaquin Fever," after the broad agricultural valley in California, where the incidence of it is increasing rapidly - in step with soil disruption, due both to urbanization and agricultural expansion.

Data compiled by the Arizona Department of Health Services also confirms a worrying uptrend. Though testing methodology has improved since 1998, 1,474 cases of Cocci were reported that year in Arizona. By 2001, 1,917 victims were confirmed to be adversely affected and in 2010 4,630 cases of Valley Fever were reported in Arizona. I couldn't find a more recent compilation. The continuing increase in the number of victims is very troubling.

According to the National Centers for Disease Control and Prevention, more than 60-percent of all confirmed incidences in the USA occurred in Arizona and more than 30-percent of all patients in the USA who tested positive for Coccioidomycosis, live in California.

According to the Centers for Disease Control and Prevention, 40-percent of all "Cocci" sufferers went to an Emergency Room, 41-percent were hospitalized for an average of six days and approximately 20-percent saw their doctor an average of ten times during the course of the illness.

As more and more soil is being turned over and the emergence of higher wind velocities in the past decade is causing dust storms of increasing intensity - the likes of which have not been seen since the great dust storms of the depression era that carried away much of Oklahoma - has to be augmenting the dramatic increase in incidents of the disease.

The Phoenix, Arizona area is having episodes from time to time when a dark wall of dust that is hundreds of feet high, sweeps through the entire metropolitan area. Chain reaction accidents caused by dense dust storms are occurring with greater frequency in the 100-mile stretch of Interstate Highway 10 between Phoenix and Tucson.

Empirical evidence taken outside of prisons, residences and businesses has found that dust gathered in various areas of Central and Southern California have identified the presence of Cocci spores. I think that similar tests in Arizona, New Mexico and Texas where the fungus thrives, will confirm the same results as the samples of dust in California do.

Though two anti-fungal medicines, Fluconazole and Amphoterican B show promise for treatment, I could not find a record of clinical trials of them, though they may be ongoing. I dislike saying it, but there is no preventative and no cure for the core disease.

Persons who are severely stricken are hospitalized, at which time the affliction is usually quickly and correctly diagnosed. Treatment of secondary issues, notably pneumonia and meningitis, is important.

Your primary care physician probably has already ordered a lab test for "Valley Fever." If you are uncertain, I suggest you ask, especially if you are experiencing long-lasting, flu-like symptoms.

I had a long-time business acquaintance who contracted "Valley Fever" forty years ago. However, a doctor who reported that there were spots all over my Insurance Agent's lungs (imaging at that time was confined to X-Rays), told him he had lung cancer. He wound up his affairs and prepared for the end of his life. Surgery revealed that he was suffering from Valley Fever and not cancer. Happily, he recovered and the last time I heard from him, continued to enjoy favorable health and was once again selling life insurance.

-Phil Richardson, Storyteller and Observer of the Human Condition.

Phil's current post can be read at: http://www.imrightagain.com

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k7os (at) comcast (dot) net

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