Valley fever is Arizona’s disease. While rare at the national level, it is common in the southwestern United States and northern Mexico.
It is primarily a disease of the lungs caused by the inhalation of airborne particles of the fungus Coccidioides, which is found in the region. Airborne spores of the fungus are carried by the wind when the desert soil is disturbed.
Sixty percent of people have no symptoms or only very mild flu-like symptoms and do not see a doctor and therefore do not make it into the statistics.
However, those with symptoms can experience fatigue, cough, fever, profuse sweating at night, loss of appetite, chest pain, generalized muscle and joint aches particularly of the ankles and knees. Some people will develop a rash that resembles measles or hives but develops more often as tender red bumps on the shins or forearms.
The length of illness depends on the severity of the infection. Symptoms may take months to even more than a year to resolve. Persons frequently complain of fatigue and joint aches lasting months. The chronic forms of Valley Fever may last years, with a waxing and waning course.
On Nov. 18, the Arizona Board of Regents highlighted its New Economy Initiative that includes support for a Valley Fever Collaborative among the state’s three public universities. This represents a major step in recognizing Valley fever as a significant public-health and economic problem in Arizona.
Californians demanded action on Valley fever
Valley fever or VF, known medically as coccidioidomycosis, is an infection caused by a fungus that grows in dry, sandy soil such as that found in Arizona’s Sonoran Desert and other parts of the Southwest.
The disease is named after the San Joaquin Valley, where the first cases in the U.S. originated over a century ago, and it continues to be a significant problem.
Residents of that area have been demanding help for decades. After pressing California state legislators for support, officials from Bakersfield were finally able to secure more than $8 million in state funding for a Valley Fever Vaccine Project.
Additional millions of dollars have been earmarked for public health, research and a Bakersfield-based Valley Fever Institute.
Arizona turned away from the disease
In 2019, there were 144.1 cases per 100,000 Arizona residents, and in California the case rate was just 22.5 cases per 100,000 residents, according to a recent report by the Arizona Center for Investigative Reporting.
Despite this, calls for action in Arizona have largely gone unheard until now. As recently documented, Arizona’s budget has not dedicated funds specifically to address Valley fever since a one-time allocation 14 years ago.
Including the Valley Fever Collaborative in the New Economy Initiative reflects the growing awareness that this is an important problem in Arizona. The disease presents a very real burden on Arizona’s economy, costing $736 million in 2019 alone, as detailed in an analysis by the Seidman Institute.
How it harms our state economy
But the indirect costs to the economy may be much higher, as the disease may well affect the decision for some individuals or businesses to relocate to Arizona – especially when the sensational, severe Valley fever cases get more attention than does the ability of health care professionals to effectively manage the disease when it is diagnosed early and treated appropriately.
The Valley Fever Collaborative can help Arizona’s economy continue to grow by putting in place a management plan that emphasizes community awareness and provider education.
The University of Arizona’s Valley Fever Center for Excellence was approved by the Board of Regents 25 years ago to be a resource for the entire state. Its clinical activities are conducted in both Phoenix and Tucson through an affiliation agreement between Banner Health and the University of Arizona’s colleges of medicine in Tucson and Phoenix.
Advances in drugs, treatment will lead the way
Since its founding, the Valley Fever Collaborative has developed a novel drug, nikkomycin Z; advocated for earlier diagnosis and awareness; worked on more reliable and accessible diagnostic tests; and most recently invented a promising preventative vaccine for dogs, and potentially humans. The collaborative has played an important part in Arizona’s awakening to the need to address VF.
The concept of a Valley Fever Collaborative began when faculty from the University of Arizona’s Valley Fever Center for Excellence, Arizona State University and Northern Arizona University discussed the synergy that could come from pooling the strengths of all three schools.
For example, NAU’s Pathogen and Microbiome Institute has ongoing studies of the Valley fever fungus as it occurs in the environment. Faculty from NAU and ASU have published methods to detect the fungus in the air, which could be used to identify construction sites that are particularly risky for workers.
Also at ASU, the Biodesign Institute has made numerous inventions that could help manage Valley fever. One in particular, an “immunosignature” technology, has shown the ability to differentiate Valley fever from other causes of pneumonia.
It might also make lung biopsies unnecessary in distinguishing between Valley fever and cancer. This initiative was well underway before the pandemic and is now ripe for inclusion in the New Economy Initiative program.
Arizona’s national leadership in the management of Valley fever cannot come too soon. Ours is the state to benefit most, both in terms of public health and the economy. The Board of Regents deserves credit for the New Economy Initiative and including Valley fever in it.
John N. Galgiani, MD, is a professor and director of the Valley Fever Center for Excellence at the University of Arizona College of Medicine in Tucson. He can be reached at email@example.com.
This article originally appeared on Arizona Republic: Valley fever is a major public health problem for Arizona