Valley Fever: Symptoms, Causes, Diagnosis and Treatment

What is Valley Fever?

Valley fever, or coccidioidomycosis, is a fungal infection caused by inhaling Coccidioides spores, which are found in dry, dusty soil. These spores become airborne when soil is disturbed by wind, farming, or construction. The fungus is most common in the southwestern United States and parts of Central and South America. Many people exposed to the spores experience no symptoms, but others may develop flu-like symptoms, including fever, cough, fatigue, and joint pain. In rare cases, valley fever causes complications beyond the lungs, affecting the skin, bones, or central nervous system, leading to severe medical issues. While mild cases often resolve without treatment, severe infections may require antifungal medications.

What are the symptoms of Valley Fever?

The symptoms of valley fever often mimic those of the flu and typically appear within one to three weeks after exposure. Common valley fever symptoms include fever, cough, fatigue, headache, shortness of breath, chest pain, night sweats, muscle aches, joint pain, and rash (mainly on the lower legs). It's important to note that many people infected with the fungus don't experience any valley fever symptoms. However, if you live in or have recently travelled to an area where valley fever is common and develop these symptoms, it's crucial to consult a healthcare provider for an accurate diagnosis.

How do you get Valley Fever?

Valley fever is contracted by inhaling Coccidioides fungal spores found in soil, particularly in hot, dry climates like the southwestern United States, Mexico, and parts of Central and South America. These spores become airborne when the soil is disturbed by activities such as construction, farming, digging, or strong winds. Once inhaled, the spores can settle in the lungs, potentially causing infection.

People who spend time outdoors in endemic regions, especially during dusty conditions, have a higher risk of exposure. Certain individuals, including those with weakened immune systems, pregnant women, and people of certain ethnic backgrounds, may be more susceptible to severe forms of the disease. However, valley fever is not contagious and cannot spread from person to person. While many infections are mild and resolve on their own, others can cause flu-like symptoms or lead to severe complications, requiring medical attention and antifungal treatment.

Who is most at risk for getting Valley Fever?

While anyone living in or travelling to areas where the Coccidioides fungus is prevalent can contract and display valley fever symptoms, certain groups are at higher risk for severe infections:

• People over 60 years old
• Pregnant women
• Individuals with weakened immune systems due to conditions like HIV/AIDS, cancer, or organ transplants
• People of African or Filipino descent

Additionally, those who work in occupations involving soil disturbance, such as construction or agriculture, are at increased risk of exposure to the fungal spores.

What are the complications of Valley Fever?

In most cases, valley fever causes mild respiratory symptoms that resolve without serious complications. However, in some individuals, particularly those with weakened immune systems, the infection can spread beyond the lungs, leading to disseminated valley fever. This severe form of the disease can affect the skin, bones, joints, and central nervous system, potentially causing skin lesions, chronic bone infections, painful joint swelling, and even meningitis—an infection of the membranes surrounding the brain and spinal cord.

Valley fever prevention focuses on reducing exposure to fungal spores, especially in endemic areas. Wearing masks in dusty environments, staying indoors during windstorms, and moistening soil before digging can help lower the risk.

For severe cases, valley fever treatment typically involves antifungal medications such as fluconazole or itraconazole to control the infection and prevent complications. Early diagnosis and treatment are essential in managing the disease and preventing it from becoming life-threatening.

Is Valley Fever contagious?

No, valley fever is not contagious. The infection is acquired by inhaling fungal spores directly from the environment and cannot be transmitted from person to person. You cannot contract valley fever by coming into contact with someone who has the infection.

How is Valley Fever diagnosed?

Diagnosing valley fever is challenging since its symptoms resemble other respiratory illnesses. Valley fever diagnosis may involve blood tests to detect antibodies, sputum culture to identify the Coccidioides fungus, and imaging tests like X-rays or CT scans to check for lung abnormalities. A skin test may confirm past exposure.

What tests will be done to diagnose Valley Fever?

If your doctor suspects valley fever based on your symptoms and history of exposure, they will order tests to confirm the diagnosis. Common diagnostic tests for valley fever include:

• Blood tests: These check for antibodies your body produces in response to the Coccidioides fungus. Two main blood tests are used:
  • Enzyme-linked immunosorbent assay (ELISA)
  • Immunodiffusion (ID) assay
• Sputum smear or culture: If you're coughing up sputum, a sample may be examined under a microscope or cultured to detect the fungus.
• Chest X-ray or CT scan: Imaging tests can reveal lung abnormalities, such as pneumonia or cavities, which are common in valley fever.
• Tissue biopsy: In rare cases, a biopsy of affected tissues may be necessary, especially if the infection has spread beyond the lungs.

How is Valley Fever treated?

Most cases resolve without specific valley fever treatment. However, for severe infections or those affecting people with weakened immune systems, antifungal medications may be prescribed. The choice of medication and duration of valley fever treatment depend on the severity of the infection and the patient's overall health. In some cases, hospitalisation may be necessary for more intensive treatment and monitoring.

What medications are used to treat Valley Fever?

The most common antifungal medications used to treat valley fever include Fluconazole (Diflucan), Itraconazole (Sporanox, Tolsura), and Amphotericin B (for severe cases). In some cases, other antifungal medications like voriconazole, posaconazole, or isavuconazonium sulphate may be used, especially for complex or disseminated infections.

How long does treatment for Valley Fever last?

The duration of valley fever treatment varies depending on the severity of the infection and the patient's response to the antifungal medication. In most cases, treatment with oral antifungal drugs lasts for three to six months.

How can we prevent Valley Fever?

Valley fever prevention involves taking steps to reduce your exposure to the fungal spores. If you live in or plan to travel to an area where the fungus is common, consider the following valley fever prevention measures:

• Avoid activities that disturb the soil, such as digging or excavation, especially during dry and windy conditions.
• Wear a mask (like an N95 respirator) when engaging in activities that involve soil disturbance.
• Stay inside during dust storms and close windows and doors to prevent spores from entering your home.
• If you work in an occupation that involves soil disturbance, talk to your employer about ways to minimise exposure, such as using water to suppress dust and providing appropriate protective equipment.

What can we expect if we have Valley Fever?

If you're diagnosed with valley fever, your experience will depend on the severity of your infection. Most people with mild to moderate infections can expect flu-like symptoms, such as fever, cough, chest pain, and fatigue, that last for a few weeks to months. There will be a gradual improvement of symptoms with or without treatment and a full recovery within several months. However, some people may develop more severe infections or complications, such as pneumonia or lung nodules or cavities.

How long does Valley Fever last?

The duration of valley fever symptoms varies by individual. Mild infections often resolve within a few weeks to a few months, while more severe cases can last several months or longer. Chronic or disseminated infections may require ongoing treatment and medical management. Most people recover fully within 3-6 months, but some may experience lingering symptoms such as fatigue, joint pain, or respiratory issues for extended periods. Recovery time depends on factors like overall health, immune function, and the severity of the infection. Prompt diagnosis and treatment can help manage symptoms effectively.

Can you get Valley Fever twice?

While it's rare, it is possible to get valley fever more than once. However, if you've had valley fever before and recover, you may have partial immunity that protects you from severe infections in the future. If you do get valley fever again, your symptoms may be milder and resolve more quickly.

How do we take care of ourselves if we are at risk for Valley Fever?

If you live in or travel to areas where valley fever is common, take precautions to reduce your risk. Be aware of symptoms like persistent cough and fever, seek medical attention if needed, and avoid dusty activities. Those at higher risk should consult a doctor for additional precautions. Follow prescribed treatment plans, attend check-ups, and maintain a healthy lifestyle to support recovery. Early diagnosis and proper management help prevent complications and promote healing. Wearing masks in dusty conditions and staying informed can further reduce the risk of infection.

When to see a doctor?

If you develop flu-like symptoms after visiting a valley fever area, seek medical attention, especially if you have a persistent cough, fever, chest pain, or severe fatigue. A valley fever rash, skin lesions, or unexplained weight loss may also indicate infection. Your doctor can diagnose and recommend appropriate treatment.

Conclusion

Understanding valley fever is essential for protecting your respiratory health, especially in high-risk areas. Is valley fever curable? Most cases resolve on their own, while severe infections require antifungal treatment. Staying informed, taking preventive measures, and seeking timely medical care can help reduce risks.

If you experience symptoms, consult a healthcare provider for accurate diagnosis and treatment. Metropolis Healthcare offers comprehensive diagnostic testing services, including blood tests and imaging studies, to accurately diagnose valley fever and other infectious diseases.