July marks the beginning of the high risk season for valley fever, a prevalent fungal infection in Arizona that can be hard to diagnose and treat, and last week’s dust storm may have exposed many residents to its spores.
The tiny particles can stay airborne for extended periods of time, even after the storm is over, said Pat White, a local valley fever expert and founder of Arizona Victims of Valley Fever.
“If you live here for long enough, you will probably be exposed to it,” White said.
About 60 percent of the people exposed to the fungus either have few or no symptoms, according to the Arizona Department of Health Services. The majority of these people will not need to see a doctor. But for those who do, the disease can be life changing.
“It knocked me for a loop,” said Richard Thayer, 75, of Apache Junction.
Last September, Thayer started out with flu-like symptoms: a fever and extreme fatigue. His doctor treated him for pneumonia after a chest x-ray.
About a month after becoming sick, Thayer found answers after a couple rounds of antibiotics and a five-day hospital stay. He was sent to a pulmonologist and, following bloodwork and a CAT scan, was diagnosed with valley fever.
“I lost all kinds of energy,” Thayer said. “I lived in the recliner for a month.”
The once-active man couldn’t even get up to eat, instead taking his meals in his chair.
“It was the complete lack of energy; I’d do one thing and then I’d be done for the day,” Thayer said.
Now, Thayer is feeling about 85 percent back to his old self. He’s also off the anti-fungal medication after nine months.
Thayer’s case is both the exception and the rule. Although he is one of the few who experience prolonged symptoms, diagnosis and treatment for those who do get it can be a long journey. The blood test doesn’t always get a positive result even for those who have valley fever. In an effort to reduce the number of false-positive test results, the sensitivity for true positive test results are reduced, according to the website of the Valley Fever Center for Excellence at the University of Arizona.
White was diagnosed six years ago with valley fever and she never had a positive blood test. It took a lung biopsy to confirm she had the disease.
“It is common that people go to multiple doctors,” said Dr. Loreto Sulit, a pulmonologist at Banner Baywood Medical Center in Mesa.
Dust storm aftermath
In the search for a correct diagnosis, the UA center reports valley fever can be mistaken for cancer, tuberculosis, chronic obstructive pulmonary disease, chronic fatigue syndrome and others.
People who react to valley fever spores from the July 5 dust storm probably will start experiencing symptoms this week at the earliest, Sulit said.
Sulit is expecting to see an influx of patients with valley fever, but it probably won’t happen for another three to four weeks.
A typical patient is treated for pneumonia with a couple rounds of antibiotics, Sulit said. Since those antibiotics treat bacterial pneumonia, it’s not effective against a fungal lung infection.
There are a slew of valley fever symptoms, but the top five to look for are cough, fever, shortness of breath, rash and extreme fatigue, Sulit said.
Other symptoms include headache, joint ache, chest pain, night sweats, nausea, loss of appetite, and rapid weight loss.
Some people may not exhibit all the symptoms. Thayer lost 20 pounds during his episode of valley fever, but never had much of a cough or a rash.
Valley fever is caused by a fungus — Coccidioides immitis (commonly referred to as “cocci”) — that grows in the soil of California, Arizona, New Mexico, Texas and southern portions of Utah and Nevada, according to the Centers for Disease Control and Prevention.
When spores of cocci are lifted into the air, they can be easily inhaled. Most people who are exposed to spores won’t show symptoms for seven to 28 days. The highest times for exposure in Arizona are July through August and October through November.
In 2010, there were 11,888 valley fever cases in Arizona, according to the Arizona Department of Health Services. Two-thirds of cases diagnosed in the United States are from Maricopa, Pima and Pinal counties, according to the Valley Fever Center for Excellence.
Many labels, little research
The center describes valley fever as an “orphan disease,” which means that although there are a large number of people in Arizona who contract it, there isn’t a large enough group in the country to make it worth the research and drug production costs for pharmaceutical companies.
Because pharmaceutical companies aren’t trying to find new ways to treat valley fever, most of the new research is being done in Tucson by the UA center. It is funded primarily by contributions from Arizonans, local businesses and cities in Maricopa, Pinal and Pima counties.
The best way to reduce chances of exposure is to stay inside when dust is blowing, according to Cara Christ, an Arizona Department of Health Services medical officer.
The department doesn’t recommend that people wear masks, because the particles are so small that barriers don’t protect very well, Christ said. As many as 15 trillion spores can fit in a square inch.
Instead, people who have been treated for pneumonia and aren’t getting better after a few weeks should ask their doctor for a valley fever blood test, Christ said.
“It’s a hidden disease,” Thayer said. “There is a lack of knowledge for a lot of people. People need to know about it.”
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