Monday, 6 May 2013

Valley Fever hits: Fungal disease Valley fever hits Calif. and the Southwest

Valley Fever hits: Fungal disease Valley fever hits Calif. and the Southwest, California and federal public health officials say a fungal disease commonly known as Valley Fever has hit areas in the southwestern United States, due to warming climates and drought.

Yahoo! News carried the May 6 Associated Press report on the fever outbreaks.

Valley fever, a potentially lethal but often misdiagnosed disease, is infecting more and more people around the nation, as warming climates have settled in and droughts have kicked up the dust that spreads the fungus.

Termed coccidioidomycosis, but better known as Valley fever, California fever or Desert rheumatism, the disease is caused by fungi that resides in the soil. It is endemic in certain parts of Arizona, California, Nevada, New Mexico, Texas, Utah and northwestern Mexico.

The fever, which lies dormant during long dry spells, develops as a mold with long filaments that break off into airborne spores when soil is disrupted by wind or human activity. Infection is by inhalation, although the fever is not transmitted person by person.

The fever has hit California's agricultural heartland particularly hard in recent years, with cases dramatically increasing in 2010 and 2011.

"Research has shown that when soil is dry and it is windy, more spores are likely to become airborne in endemic areas," said Dr. Gil Chavez, Deputy Director of the Center for Infectious Diseases at the California Department of Public Health.

Longstanding concerns about Valley fever were brought to the fore last week when federal health officials ordered the transfer of more than 3,000 exceptionally vulnerable inmates from two San Joaquin Valley prisons. Several dozen inmates there have died of the disease in recent years.

Although millions of residents in Central California face the threat of Valley fever, experts say people who work in dusty fields or construction sites are most at risk, as are certain ethnic groups and those with weak immune systems.

Newcomers and visitors passing through the region may also be more susceptible.

In California, according to the CDC, Valley fever cases rose from about 700 in 1998 to more than 5,500 cases reported in 2011. The disease has seen the sharpest rise in Kern County, followed by Kings and Fresno counties.

Out of the 18,776 California cases between 2001 and 2008, 265 people died, according to the state health department.

Arizona saw an even steeper rise: The number of reported cases there went from 1,400 in 1998 to 16,400 in 2011, with the highest rates of infection occurring in Maricopa, Pima and Pinal counties.

Drought periods can have an especially potent impact on Valley fever if they follow periods of rain, said Prof. John Galgiani, director of the Valley Fever Center for Excellence at the University of Arizona. Rainfall leads to fungus bloom.

"When it dries up, that's when the fungus goes into the air," Galgiani said. "So when there is rain a year or two earlier, that creates more cases if drought follows."

An estimated 150,000 Valley fever infections go undiagnosed every year, the CDC says. Valley fever is difficult to detect and there's little awareness of the disease. The fever often causes mild to severe flu-like symptoms and in about half the infections, the fungus results in no symptoms.

But in a small percent of cases, the infection can spread from the lungs to the brain, bones, skin, even eyes, leading to blindness, skin abscesses, lung failure, even death.

"Valley fever is a very common problem here, and it devastates people's lives," said Dr. Royce Johnson, professor of medicine at UCLA and chief of infectious diseases at Kern Medical Center. "But many patients don't know about it, and some physicians are only vaguely aware of it because half of our physicians come from out of state."

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