By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

HUSBAND SHOULD RECOVER FROM VALLEY FEVER, HAVE LIFELONG IMMUNITY

Question: My husband has valley fever, and I want to know if a vaccine was going to be ready in the near future? Who will be able to get this vaccine? Will it be expensive? Will people with valley fever be able to get it?

Answer: Valley Fever, also called coccidioidomycosis, is caused by a fungus that lives in dry soil. This is a common illness, affecting an estimated 500,000 or more Americans each year. In this country, it’s most prevalent in the desert southwest, where the land is very arid. Valley fever is also found in Central and South America.

In the southernmost sections of California, Arizona, New Mexico and Texas, over 50 percent of citizens show evidence of exposure to the fungus that causes coccidioidomycosis. This is also true of individuals who have regularly visited these areas.

People get valley fever by inhaling spores of the Coccidioides immitis fungus that live in the soil in the areas I’ve mentioned. When this dry soil is stirred up by walking, dust storms, or any activity that puts contaminated dust into the air, people inhale the spores. When the spores get into the lungs, they cause infection.

In less than 1 percent of cases, the infection spreads outside of the lungs. This might involve skin lesions, a central nervous system infection like meningitis, or a bone and joint infection. Immunocompromised persons are at greatest risk of this type of disseminated infection. Also, pregnant women during the third trimester have an increased risk. Disseminated disease is very serious and can cause death.

The good news is that most cases of valley fever heal on their own. In fact, more than 60 percent of people who have had this disease report never having had any symptoms at all. When people do get symptoms, they usually are similar to a flu-like illness, with fever, cough, headache, and muscle aches. Most people recover in a few weeks to months, and then have life-long immunity to the disease. Some people require treatment with antifungal medications. So, with or without treatment, the odds are your husband will make a full recovery.

In cases like your husband’s, where symptoms were bothersome enough that he sought a doctor’s advice, a diagnostic workup was probably necessary. This may have included a serological test where his doctor took a specimen of blood or other body fluid and looked for antibodies against the Coccidioides immitis fungus. He also might have had a biopsy of the affected tissue, or a culture of tissue or body fluids.

In the last decade or so, there has been an increase in cases of coccidioidomycosis. There are occasional outbreaks when the number of cases spike. This is particularly true following earthquakes or other events that disturb large amounts of soil in areas where the Coccidioides immitis fungus is prevalent. Outbreaks have also occurred among military trainees and archeological workers.

Prevention is the best treatment, and there is ongoing research around vaccine development. Since people who have had this illness have life long immunity, they would not need vaccine. Also, this illness is not spread from person to person or from animals to people.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.