Beware the air you breathe may be deadly. In Southern California and the American Southwest, the air is filled with dust churned up by bulldozers and held aloft by the hot wind. But dust isn't the only problem in these overheated regions. Another is a lung disease, called valley fever, known medically as coccidioidomycosis, or cocci. Remember the heat spell in California last year? Well, Coccidioides, dormant during long dry spells, "blooms" when it rains and is swept into the air by anything that disturbs the soil: earthquakes, storms, farming, construction. With the increase of global warming and population, cases of "Vally Fever" have gone up more than three fold in California and Arizona since1993.
Most people who inhale the valley fever fungus have few, if any, problems. But some, especially pregnant women, people with weakened immune systems, and those of Asian, Hispanic and African descent, may develop a serious or even fatal illness from valley fever. I know because my nephew is now sitting in Mission Hospital here in Asheville, North Carolina in a coma after visiting California in November and December 2006, where he probably came into contact with the fungus.
Mild cases of valley fever usually go away, but when valley fever is more serious, doctors prescribe antifungal medications that can treat the underlying infection. In my nephew's case, the problem is so serious that they started administering the antifungal medication directly into his spinal fluid and now through a catheter inserted through his skull. Because Valley Fever is more common in California, the doctors here in Asheville were so perplexed by his worsening condition, they (Doctor H. McClain, M.D. heading a team of five doctors with the Asheville Infectious Disease Consultant Center), called California for advice. (Something they never do. After all they are experts in their field.) The advice they received was shocking, jam it into his spinal fluid (Anphotericin B Liposomal (Ambisome); an anti-fungal medication). This procedure was something they had never come across and one that has the entire medical community here talking.
Thanh le, 24 years of age, moved to North Carolina in 2006 and was visiting his wife's relatives in San Jose this last holiday season when he started coughing. At first he thought nothing of it. He returned home where his condition worsened. In January 2007 he admitted himself to the hospital where the doctors thought he had pneumonia. They subscribed antibiotics and sent him home. After 2 days Le's body broke out with a rash, so, the doctors assumed it was a reaction to the medication and changed meds. During this whole time Thanh experienced more and more sever headaches until finally he started hallucinating. His wife called his aunt, my wife, and we took him to the hospital. Three days later he was in a coma and is now fighting for his life.
The first case of valley fever was recognized more than a century ago. Since then, doctors have diagnosed upward of 100,000 cases a year in endemic areas. Climate change.
In Arizona, most outbreaks occur in June, July, August, October and November. In California, the risk of infection is highest during the summer months, usually June through August. Valley fever isn't limited to humans; dogs, horses, cattle, bats, snakes, coyotes and most other animals also are susceptible to the disease. Even house cats can catch valley fever when dust seeps in around windows and doors during storms.
The acute form of valley fever is often mild, with few, if any, symptoms. When symptoms do occur, they tend to resemble those of the flu, and can range from minor to severe:
- Chest pain, which can vary from a mild feeling of constriction to intense pressure resembling a heart attack.
- Night sweats.
- Shortness of breath.
- Joint aches.
- Rash. Some people develop painful red bumps that may later turn brown - mainly on the lower legs but sometimes on the chest, arms and back. Others may have a raised red rash with blisters or eruptions that look like pimples.
If you don't become ill from valley fever, you may only learn that you've been infected when you later have a positive skin or blood test or when small areas of residual infection (nodules) show up on a routine chest X-ray. Although they don't cause problems in and of themselves, nodules can look like cancer on X-ray, leading to unnecessary biopsies.
If you do develop symptoms, especially severe ones, the course of the disease is uncertain. It can take from six months to a year to fully recover, and fatigue and joint aches can last even longer. The severity of the disease depends on several factors, including your overall health and the number of fungus spores you inhale. There is a simple skin test available like the one conducted for Tuberculosis that can be done. Although not one hundred percent accurate at least it's a start.