MYTH: Valley Fever is a benign disease.
FACT: It is not benign. It can destroy lives and caused an estimated $120 million in expenses in the United States in 2001 (Cocci Study Group Meeting, March 2001). More recent data pushes this over $1 billion annually. 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 over 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. 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 have both prevented and cured Valley Fever, but it was in the experimental stages and needed funding to progress. It is unclear how much further it will be developed by additional researchers since Dr. Cole retired.
If symptoms of the disease have stopped in a patient, 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 immunocompetent (perfectly 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 will not contract Valley Fever unless I visit an endemic region to Valley Fever.
FACT: Spores can rest on objects like cotton, food, and clothing, resulting in infections all over the world. (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 Valley Fever 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 Valley Fever from an organ used for transplantation.
FACT: Unfortunately cocci-infected organs have been transplanted with fatal results. Valley Fever Survivor® 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 in one’s life 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 for those who choose to remain in endemic areas. (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, almost every following year was also “the worst Valley Fever epidemic in history”, and the totals have gone far enough for the 2% estimate to reach dramatically higher numbers. 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 was 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 and animals in regions that are not normally considered endemic to Coccidioidies sp.