Valley fever

Valley fever

• Valley fever, also called coccidioidomycosis, is an infection caused by the fungus Coccidioides.
• The fungus is known to live in the soil in the southwestern United States and parts of Mexico and Central and South America.
• The fungus was also recently found in south-central Washington.
• People can get Valley fever by breathing in the microscopic fungal spores from the air, although most people who breathe in the spores don’t get sick.
• Usually, people who get sick with Valley fever will get better on their own within weeks to months, but some people will need antifungal medication.
• Certain groups of people are at higher risk for becoming severely ill.

Symptoms

Valley fever is the initial form of coccidioidomycosis infection. This initial, acute illness can develop into a more serious disease, including chronic and disseminated coccidioidomycosis.

Acute coccidioidomycosis (valley fever)

The initial, or acute, form of coccidioidomycosis is often mild, with few or no symptoms.Signs and symptoms occur one to three weeks after exposure. They tend to be similar to flu symptoms. Symptoms can range from minor to severe, including:

• Fever
• Cough
• Tiredness
• Shortness of breath
• Headache
• Chills
• Night sweats
• Joint aches and muscle soreness
• Red, spotty rash, mainly on lower legs but sometimes on the chest, arms and back

Chronic coccidioidomycosis

If the initial coccidioidomycosis infection doesn’t completely resolve, it may progress to a chronic form of pneumonia. This complication is most common in people with weakened immune systems. Signs and symptoms include:

• Low-grade fever
• Weight loss
• Cough
• Chest pain
• Blood-tinged sputum (matter discharged during coughing)
• Nodules in the lungs

Disseminated coccidioidomycosis

The most serious form of the disease, disseminated coccidioidomycosis, is uncommon. It occurs when the infection spreads (disseminates) beyond the lungs to other parts of the body. Signs and symptoms of disseminated disease depend on the body parts affected and may include:

• Nodules, ulcers and skin lesions that are more serious than the rash that sometimes occurs with other forms of the disease
• Painful lesions in the skull, spine or other bones
• Painful, swollen joints, especially in the knees or ankles
• Meningitis — an infection of the membranes and fluid surrounding the brain and spinal cord

Causes

• Like many other fungi, coccidiosis’s species have a complex life cycle.
• In the soil, they grow as a mold with long filaments that break off into airborne spores when the soil is disturbed.
• A person can then inhale the spores.
• The spores are extremely small and can be carried far by the wind.
• Once inside the lungs, the spores reproduce, continuing the disease cycle.

Treatment

• Valley fever usually doesn’t need medical treatment.
• For people who are otherwise healthy, bed rest and drinking plenty of fluids are enough.
• If the symptoms hang on or get worse, your doctor might prescribe a drug that attacks illnesses caused by fungus.
• There are several options, depending on how severe the symptoms are.
• In the most extreme cases, such as people who develop meningitis, lifelong medication may be necessary.
• One bit of good news: In many cases, people who have valley fever become immune for the rest of their lives.
• Since you can’t spread it to other people, you don’t have to stay home for that reason.
• But it’s important to get as much rest as possible until your symptoms are gone.

Prevention

• There’s no vaccine, but if you live in or visit a region where valley fever is a possibility, it helps to take common-sense precautions, such as:
• Avoid dusty areas, such as construction sites
• Stay indoors during dust storms, and keep the windows shut
• Avoid activities that put you in contact with dust and soil, such as yard work and gardening
• Filter the air inside your home
• These steps are particularly important for people who are at high risk.