Arizona valley fever cases soar to a record high; diagnoses up 56 percent;

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COCCIDIOMYCOSIS - USA (ARIZONA): REQUEST FOR INFORMATION

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A ProMED-mail post <http://www.promedmail.org>

ProMED-mail is a program of the International Society for Infectious

Diseases

<http://www.isid.org>

Date: Thu 11 Jan 2007

Source: AZ Central [edited]

<http://www.azcentral.com/news/articles/0111valleyfever0111.html>

Arizona valley fever cases soar to a record high; diagnoses up 56

percent; dry weather may account for spike

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Valley fever is at epidemic levels in Arizona, afflicting 56 percent

more people last year [2006] than in 2005. A record 5493 Arizonans

were diagnosed with the disease, but as in years past, health

officials say thousands of other cases went unreported. Health

officials are unsure what caused the increase but point to weather

changes as a possible culprit. The wet winter of 2005, followed by

many dry months in 2006, was a probable one-2 punch that has wreaked

havoc on the lungs and joints of many residents. Valley fever is an

infection in the lungs caused by a fungus, _Coccidioides immitis_,

found in soils primarily in southwestern states. The fungus flourishes

in rain, and then is stirred into the air in dry conditions.

About 60 percent of the people who inhale the micron-sized spore and

contract the disease have mild symptoms. The patients may suffer

extreme pain in joints and difficulty in breathing, and sometimes, the

infection migrates to the brain.

28 Arizonans died of valley fever in 2005; the count of deaths in 2006

was unavailable Wednesday [10 Jan 2007].

" It strikes me very much as an epidemic of valley fever, " said Shoana

, program manager for the infectious-diseases division of the

Arizona Department of Health Services.

The dry months of 2006 gave valley fever spores " a field day, " said

Will Humble, deputy assistant director for the DHS. " They were just

sitting there waiting for the wind. " He explained further: " As the

winter soil starts to dry out, the organism spends its remaining

energy forming spores. " Once the wind comes along, the spores spread

quickly.

Over the years, several theories have emerged as to the cause of

valley fever, occurring most often in Arizona and other desert states,

said. " It could be the construction and increased dust that

arises, " she said. Some research points to the effects of drought and

rainfall. " But I think the answer is a combination of the above. " It's

unknown whether air pollution and its particulates are a factor.

One of the problems that torments patients is that valley fever is

often misdiagnosed. The patients know they are sick, but the medicine

they are given does not work. Some doctors believe their patients have

pneumonia. Once a correct diagnosis is made, " it's very empowering for

the patient; they finally know what's going on, " said Dr.

Galgiani, director of the Valley Fever Center for Excellence at the

University of Arizona and Southern Arizona VA Health Care System in

Tucson. He said physicians need to adjust their diagnosis strategy,

thinking immediately that the disease is a possibility. Antibiotics

don't work on valley fever. The most common treatment is anti-fungal

medication.

[byline: Connie Cone Sexton]

-- ProMED-mail <promed@...>

Date: Sat 13 Jan 2007

Source: KVOA News 4 [edited]

<http://kvoa.com/Global/story.asp?S=5934473 & nav=HMO6HMaY>

Valley fever reaches epidemic level

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According to health officials, valley fever is at epidemic levels in

Arizona, afflicting 56 percent more people last year [2006] than in

2005. Cases were already breaking records last May 2006. A study at

that time showed that one in every 3 Arizonans diagnosed with

pneumonia actually had valley fever [coccidiomycosis]. Last June

[2006], governor Janet Napolitano freed up USD 50 000 to fight the

valley fever outbreak by educating doctors. Nearly 5500 Arizonans were

diagnosed with valley fever in 2006, the most ever. Valley fever is an

infection in the lungs caused by a fungus. That fungus is found

primarily in the desert, and it grows and flourishes when the desert

is rainy and wet.

It's found in the soil and, on a day when it's windy and dry, the

spores spread. We actually live near the epicenter for this disease.

Throw in the desert climate and a growing population and " there are

more cases in Arizona than anywhere else in the country, and about

half of the cases in the U.S. come out of Maricopa County, " says

Galgiani.

Symptoms of valley fever include chest pain, weight loss, rashes, and,

most often, fatigue. The exhaustion can linger for months. Very

seldom, it can lead to other complications that may require life-long

therapy.

-- ProMED-mail <promed@...>

[ProMED reported 623 cases of coccidiomycosis in 1995, compared to the

5493 cases reported here, a 10-fold increase in 11 years. The point

raised that the increase may be due to an increasing population

settled in an endemic area is interesting, and we will be happy to

post any data on demographic development in the area over the past

decades. - Mod.EP]