Number of Phoenix metro Valley Fever cases rising - East Valley Tribune: Health

Number of Phoenix metro Valley Fever cases rising

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Posted: Friday, August 31, 2012 8:14 am | Updated: 10:35 am, Mon Sep 3, 2012.

The Phoenix metro area is seeing an epidemic of Valley Fever after last summer’s massive dust storm and this year could lead to a high number of cases too.

“We’re going to have cases start showing up,” said Dr. Larry Spratling, a practicing pulmonologist for 30 years and chief medical officer at Banner Baywood Medical Center in Mesa. “I expect we will have a bump-up as we do every year.”

Last year, there were 16,472 cases reported to the Arizona Department of Health Services. That’s 4,584 more than the number reported in 2010 and an increase of 11,657 from what was reported in 2007.

While some of the increase can be attributed to better reporting, Spratling believes those numbers are growing because more people are exposed to the fungus through more frequent dust storms.

“There is a real increase in cases,” he said.

And while some people can be exposed to the fungus through hiking and running in the desert, many are sickened from spores pushed into cities and towns through dust storms.

“I found myself outside during a small dust storm in August or early September,” said Corey Schubert, a public relations specialist for Banner Health. “It was probably only about five to eight minutes. I was just wrapping up work in the yard. But I guess I was out for a little bit too long.”

It didn’t seem like a big decision at the time, Schubert said. But about a month later, the Gilbert resident started developing symptoms.

“I’m 30 years old, 6-foot and 200 pounds,” he said. “I exercise; I’m a relatively healthy person.”

But by late October, Schubert started feeling heartburn that eventually got worse, he said. Eventually it was extremely painful to take a deep breath.

“Symptoms don’t come on a day after exposure,” Spratling said.

“I was lucky because Dr. Spratling’s office is just down the hall, so I stopped into him and he listened to my heart,” Schubert said. “He suspected it was Valley Fever, so I scheduled an appointment with a pulmonologist.”

But before Schubert could see a pulmonologist, he started having more acute symptoms.

“It felt like I had an elephant on my chest,” he described one fall night. “It felt very similar to asthmatic symptoms.”

The following morning, while his wife was out of town, Schubert felt like he was having a minor heart attack, he said.

“I know you’re not supposed to do this, but I drove myself to the hospital,” he said. “I didn’t want to be that person who calls an ambulance for something minor.”

After arriving at the emergency room, doctors took a chest X-ray.

“He called it a white-out,” Schubert said, describing the pneumonia on the X-ray. The pneumonia was on the lung over his heart, causing pressure.

In a study by the University of Arizona, 29 percent of people diagnosed with pneumonia, had pneumonia caused by Valley Fever, Spratling said.

For Schubert and most people who contract Valley Fever, a course of antibiotics to treat the pneumonia is ordered along with an antifungal medication to get rid of the fungus.

“The antifungal was not a mild medicine,” Schubert said.

Valley Fever is caused by a fungus called Coccidioides immitis found in the soil of the Sonoran Desert.

It grows in the top two inches of soil and lives on decaying organic material, Spratling said. Spores can be picked up and carried in the air.

When a monsoon brings rain, it helps the fungus grow in the desert, but when it’s followed by a dust storm, it can carry those spores to towns and cities, Spratling said.

“The peak of cases is in the fall and winter,” Spratling said.

There are a wide range of symptoms, he said. And while they are typically respiratory, exposure to the fungus can cause few to no symptoms or, on the other side of the spectrum, death.

“Seventy percent of patients are undiagnosed because they didn’t have enough symptoms to seek medical attention,” Spratling said.

But for those who do develop symptoms, it can lead to pneumonia and even death, Spratling said.

Valley Fever typically affects those who are middle-aged and older, newcomers to the desert and people who have compromised immune systems, such as chemotherapy patients, Spratling said.

“My wife and I had moved here four-and-a-half years ago from Florida,” Schubert said. “There aren’t hurricanes and earthquakes, but in the first four years here, I got Valley Fever.”

When it comes to the dangers of dust storms, most people focus on the immediate hazards, such as driving conditions dust storms create, Spratling said.

“The focus is on traffic accidents and that’s certainly a real concern, but Valley Fever can take months to recover from,” he said. “We ignore it at our own risk.”

“It’s like playing Russian roulette with your life,” Schubert said.

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