The following myths are simply a few of the common
misconceptions about Valley Fever (coccidioidomycosis).
MYTH: Valley Fever is
a benign disease.
FACT: It is not
benign. It can destroy lives and causes an estimated $120 million in expenses in the United States. (Cocci Study Group Meeting, March 2001) Coccidioides is also considered the world's most virulent fungal parasite. (Fromtling
RA, Shadomy HJ. An overview of
macrophage-fungal interactions.
Mycopathologia 1986 Feb;93(2):77-93)
MYTH: Valley Fever only affects the people and animals of the desert
Southwest.
FACT: With millions of travelers from the United States and
around the world entering this area, Valley Fever takes a global toll. With
300,000 members of the United States Armed Forces stationed in endemic areas,
Valley Fever threatens military readiness. With Arizona as the second fastest
growing state, the spread of this disease will only get worse, and the infection
rate is rising higher than the population growth. Unless politicians and state
and federal health departments issue warnings nationally, they will be
responsible for debilitation and suffering due to hundreds of thousands of cocci
infections every year. Conservatively at the current rate, over a million people
are infected with Valley Fever in the United States every five years. Even in
endemic areas, most will not be diagnosed (Barnato AE, Sanders GD,
Owens DK. Cost-effectiveness of a potential vaccine for Coccidioides immitis.
Emerg Infect Dis. 2001 Sep-Oct;7(5):797-806).
MYTH: There already is a cure for Valley Fever.
FACT:
There is presently no cure for Valley Fever, nor sufficient funding for the research to bring a cure to market. Once the fungal parasite has infected a person, it remains with that person for life. The drug nikkomycin Z may be promising, but human trials are only beginning and approval for the drug is many years off. Dr. Garry Cole's live vaccine project may both prevent and cure Valley Fever, but it is also in the experimental stages and needs funding to progress. In patients, if symptoms of the disease have stopped, Valley Fever is not truly cured but in remission or dormant. Reactivations are common so a cure could stop Valley Fever in all those already infected.
MYTH: Sublimed sulfur (also known as flowers of sulfur) can cure Valley
Fever.
FACT: We have not found any medical research on the validity of these
claims. Sublimed sulfur is unrelated to "sulfa" drugs (sulfonamides) and there
can be serious side effects if sulfur is ingested. Warning labels on sulfur
packages have stated that it is not for ingestion. No doctor to our knowledge
has ever suggested a person take this toxic, explosive substance.
MYTH: A person or
animal can only contract Valley Fever at certain times of the year.
FACT: Although some
weather patterns make Valley Fever outbreaks more likely, the spores can infect
anyone at any time, 365 days a year. In addition to the VF spores that are blown
about during dust storms, the spores are microscopic and can float unseen for a
long time. These spores are a risk at
any time of day, no matter how sunny and clear the sky may be. (Galgiani JN. Coccidioidomycosis. West J Med. 1993
Aug;159(2):153-71)
MYTH: Since I am very
healthy and have a great immune system, I don't have to worry about contracting
VF.
FACT: Valley Fever
can harm anyone just by taking in the wrong breath of air. All it takes is the inhalation of one spore
to cause a Valley Fever infection. (Nicas M, Hubbard A. A risk
analysis for airborne pathogens with low infectious doses: application to
respirator selection against Coccidioides immitis spores. Risk Anal 2002
Dec;22(6):1153-63 and VFCE personal communication)
MYTH: Only
immunocompromised people have severe cases of Valley Fever.
FACT: Even entirely
healthy people can suffer, be debilitated and die from this disease. (Pappagianis D. Clinical presentation of Infectious
Entities. In Einstein, Hans E,
Catanzaro, Antonio. (Eds)
Coccidioidomycosis. Proceedings
of the 5th International Conference on Coccidioidomycosis. Stanford University, 24-27 August, 1994. Washington DC: National Foundation for Infectious Diseases,
1996: p9-11)
MYTH: I can't
contract Valley Fever unless I visit an endemic region to VF.
FACT: Spores can rest
on objects like cotton, food, and clothing, resulting in infections thousands of
miles away from endemic areas. (Drutz DJ, Catanzaro A:
Coccidioidomycosis. Part I. Am Rev Respir Dis 1978 Mar; 117(3):
559-85)
MYTH: You can't
contract VF just because you received a package, plants, fruits, or vegetables
from an endemic region.
FACT: “Sources of
infection include many fomites such as infected soil on fruits, vegetables,
cars, and trucks, which can be carried over long distances.” (Rao S, Biddle M, Balchum OJ,
Robinson JL. Focal endemic
coccidioidomycosis in Los Angeles County.
Am Rev Respir Dis 1972 Mar;105(3):410-6)
MYTH: You can't
contract VF just by driving through an endemic region.
FACT: We have
encountered several reports of people who had simply driven through the endemic
regions and contracted serious and chronic cases of Valley Fever. We recommend
people keep their windows and vents closed while driving through an endemic
region. Please set your car's air conditioner to "inside air."
MYTH: You can't
contract VF by flying on a plane that has stopped in an endemic region.
FACT: The Department
of Transportation noted that “passengers and cabin crew members boarded on an
aircraft could be exposed [to Valley Fever] when the aircraft is grounded and
the doors are opened for unloading passengers, baggage, and other materials.”
(Geomet Technologies.
Airliner cabin environment: contaminant measurements, health risks and
mitigation options. Washington: US Department of Transportation,
1989). The idea that cocci spores
remained on a plane after it left an endemic area was the only theory for a
mysterious Valley Fever case in someone who had never even been to North or
South America. (Papadopoulos KI, Castor B,
Klingspor L, Dejmek A, Loren I, Bramnert M.
Bilateral isolated adrenal coccidioidomycosis. J Intern Med. 1996
Mar;239(3):275-8)
MYTH: No one can
contract VF from a blood transfusion.
FACT: Doctors make
this claim. However, the American Association of Blood Banks doesn't test for
Valley Fever (AABB,
personal communication) and no testing has been conducted to see whether
this is truly possible. Since Valley
Fever can spread through an infected person's bloodstream, it only seems logical
that the disease could be spread by transfusions and that the blood supply
should be screened.
MYTH: No one can
contract VF from an organ used for transplantation.
FACT: Unfortunately
cocci infected organs have been transplanted with fatal results. Valley Fever SurvivorTM believes
all donated organs and donors should be checked for cocci. (Wright PW, Pappagianis D,
Wilson M, Louro A, Moser SA, Komatsu K, Pappas PG. Donor-related
coccidioidomycosis in organ transplant recipients. Clin Infect Dis. 2003 Nov
1;37(9):1265-9)
MYTH: I must have had
Valley Fever years ago. Everybody who
lives here gets it so there’s nothing anyone can do and therefore nothing to
worry about.
FACT: Unfortunately
there is something to worry about because, once inhaled, there is no
cure. Even if the infection is dormant
it can activate at any time to sicken, debilitate, or kill a person who is
infected. Also, proper dust control
measures have proven that the number and severity of infections can be reduced,
so there is definitely something people can do besides moving away from the
endemic region. (Werner SB, Vugia DJ, Duffey
P, Williamson J, Bissell S, Jackson RJ, Rutherford GW. California Department of Health Services'
Policy Statement on Coccidioidomycosis. In Einstein, Hans E, Catanzaro, Antonio.
(Eds) Coccidioidomycosis. Proceedings of the 5th International
Conference on Coccidioidomycosis.
Stanford University, 24-27 August, 1994.
Washington DC: NFID, 1996:
p363-372)
MYTH: If I wear a
bandanna or dust mask it will protect me from contracting Valley Fever.
FACT: The microscopic
spores that cause Valley Fever are approximately the same size as the spores
that cause anthrax. They can slip
through the tiny holes in a bandanna or a standard dust mask like marbles can
pass through a fishing net. A respirator that prevents the inhalation of particles 2-4 micrometers in size may help. Ordinary N95 or N100 respirators are often sold as paper masks and will almost certainly let spores through the sides since they can't form a perfect seal around the face. Miner's masks (or other masks with a complete seal and protection against 2-4 micrometer particles) can provide the needed protection. Also, facial hair prevents the seal that is necessary for the effectiveness of many masks.
MYTH: My VF infection
was asymptomatic or mild so it can't come back again.
FACT: Valley Fever
has been known to activate or reactivate even four and a half decades after the
initial infection, causing severe illness and death (Cocci Study Group, April
2002). It can reactivate many
times.
MYTH: Places like
Arizona and California, where Valley Fever is endemic, are healthy places to
visit and live.
FACT: Based on the estimate that the diagnosed cases of Valley Fever are only 2% of all the people infected in a given year, Valley Fever infected well over 400,000 people in 2006. Before 2006, 65% of America’s Valley Fever cases were said to be contracted in Arizona. However, Arizona's caseload in 2006 was the worst Valley Fever epidemic in history and 2007 is not far behind. The Bakersfield area in California is considered “hyperendemic” to Valley Fever. Most victims suffer without an adequate diagnosis, antifungal medications are frequently ineffective at resolving symptoms, and reactivations are common. The fungus that causes Valley Fever is regulated as a biological weapon in the Antiterrorism and Effective Death Penalty Act of 1996 and the Public Health Security and Bioterrorism Preparedness and Response Act of 2002. The spores can also be blown hundreds of miles beyond an endemic region and can therefore infect people in other regions of the states.
