Valley fever: A very real threat, and growing

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East Valley Life

Valley fever: A very real threat, and growing

By , Tribune

October 31, 2004

Ellis used to think valley fever was no big deal until he

nearly died from the disease this year.

Ellis, 44, was infected by the valley fever fungus Coccidioides

immitis in one of the worst places possible: The sacrum, at the

bottom of the spinal column.

After multiple surgeries and daily intravenous treatments with the

strongest antifungal medications available, the Chandler resident\'s

health continued to decline. Diagnosed in April 2003, he dropped

more than 40 pounds, slept in a pool of sweat every night and ran a

fever constantly for a year.

When his doctors gave up, Ellis went to the Valley Fever Center for

Excellence in Tucson, where a surgeon drilled into his sacrum and

planted antifungal medication. Within days, the infection cleared

and Ellis started thinking about life without valley fever.

\ " It kind of sucks the life out of you,\ " he said. \ " You cannot take

it

for granted.\ "

As Arizona enters the peak season for valley fever, health

authorities expect cases this year to surpass all previous years.

With two of the three biggest months for valley fever left this

year, Maricopa County has already reported nearly 2,000 cases, close

to last year\'s total.

Valley fever is becoming a serious health threat in the state, yet

many people underestimate the disease, physicians said. Although

most people can fight off the infection with little or no symptoms,

others remain sick for months, with a handful dying from it each

year.

\ " The probability for these (valley fever) numbers to magnify is

very, very high,\ " said Dr. Craig Rundbaken, an infectious disease

specialist who opened a valley fever clinic in Sun City last

month. \ " The threat here is real for the future because we have

tremendous growth.\ "

PERFECT COMBINATION

Arizona\'s mixture of dry weather, dust, monsoons and construction

activity creates the perfect environment for valley fever, which was

first discovered in a California valley. Moisture helps the

Coccidioides immitis fungus grow in desert soil, and dust storms and

construction spread spores from the fungus in the air. Once inhaled,

the spores can grow into the infection, valley fever.

Although most people\'s immune systems fight off the fungus, others —

especially newcomers to the state who have not built up immunity —

are believed to be more vulnerable to infection.

A recent Arizona study by the U.S. Centers for Disease Control and

Prevention found that the highest incidences of valley fever and

related hospitalizations occurred in ZIP codes where the most

building permits were issued. Those locations were in outlying areas

of the Valley, including the far East Valley. Whether construction

was a factor in the infections, or there were simply more people to

become infected, is unclear.

Health authorities predict that the state is in for a dramatic rise

in valley fever cases because of the prolonged drought. Once wet

weather returns, the soil will be ripe for fungus growth. When the

soil is disturbed by wind or construction, spores will be more

prevalent and people more susceptible to inhaling them.

\ " It\'s a growing public health problem for which we don\'t know how

to

respond,\ " said Dr. Galgiani, director of the Valley Fever

Center For Excellence. \ " It could be different if we were interested

in the answer.\ "

SUPPORT ABSENT

Although Arizona has more valley fever cases than anywhere else in

the world, attempts to get local financial support to test a

promising valley fever vaccine have been futile, said Galgiani.

With a vaccine candidate that protects mice from the fungal

infection, researchers at the Valley Fever Center For Excellence are

anxious to prove its safety and effectiveness in human clinical

trials — a multimillion-dollar project. But neither the state nor

local organizations known for funding medical causes have offered

any financial help, Galgiani said.

\ " We have a vaccine that might prevent the disease altogether,\ " he

said. \ " It\'s a question of priorities.\ "

Pharmaceutical manufacturers are backing away from making vaccines

because they are less profitable than medicines people take more

than once, medical authorities said. There is even less incentive to

make a valley fever vaccine because the disease is considered

regional, not global, like malaria.

\ " It\'s not trivial, but because (valley fever) is in competition

with

every other disease out there, it\'s tougher,\ " said Comrie,

associate professor of geography at the University of Arizona.

Better medicines to treat valley fever also have been lacking,

physicians said. Although today\'s antifungals are effective in most

patients, the drugs have side effects. In some patients, the drugs

don\'t work. Others have a reoccurrence of the infection if their

immune system weakens because the drugs don\'t kill the fungus, they

make it dormant.

\ " The availability of antifungals is very limited,\ " said Dr.

Salas, a sdale infectious disease specialist. \ " In 10 years, one

or two new drugs have been developed.\ "

BETTER WARNING

Researchers are trying to determine what conditions produce fungal

spores in Arizona so they can better predict when people will be

more at risk for valley fever.

\ " If we can identify a particular time, even seasons, or particular

events during particular seasons, that will really help give us some

sense of what (the fungus) is like from a public health point of

view,\ " Comrie said.

The key, however, to effective warning signs, better drugs and

vaccine trials for valley fever is more interest in the disease,

Galgiani said. \ " It takes people to decide this is important,\ " he

said.

Awareness meeting

What: Presentation to the Paradise Valley Town Council on the

importance of valley fever awareness to economic growth

Why: In recognition of Valley Fever Awareness Week, Nov. 8-15

Speaker: Dr. Galgiani, director of the Valley Fever Center For

Excellence

When: 7 to 8:30 p.m. Nov. 10

Where: Paradise Valley Police Department, 6433 E. Lincoln Drive

Information: (520) 792-1450, Ext. 664

Contact by email, or phone (480) 898-6535