Does Valley Fever require an compromised immune system to be serious? Some sources that should know better say it. Some people think it. But whenever compromised immune systems are mentioned online, we are sometimes asked about why VFS says anyone, even with a fully functioning immune system, can suffer from this disease?
With military scientific literature often excepted, the older medical journals frequently mentioned immunocompromised patients. The more recent the science, the more likely you are to find something like this statement in Diagnostic Cytopathology:
“Immune competent patients outnumbered immunocompromised patients, illustrating the importance of considering the diagnosis in all patients…In endemic areas, the disease should be considered in all patients, independent of immune status, and throughout the year.”
Sometimes people declare that an immune compromise is the only way to have a severe Valley Fever case. It is just as wrong as saying a skeletal compromise is the only way to be hurt when being run over by a truck. In both cases, it is simply a matter of being confronted by a serious threat to bodily health, and all other factors are secondary. Rather than waste time worrying about susceptibility to a particular disease or type of vehicle collision, it would be far more useful just to know what is dangerous and then to avoid the danger whenever possible.
Immune problems can make Valley Fever worse, just as skeletal problems might make an auto accident worse. That is far from the end of the story. Valley Fever is caused by the most virulent fungal parasite known to man and was regulated in two antiterrorism laws. It is serious enough on its own. Quibbling over extraneous matters distracts from the fact that anyone can suffer its most severe symptoms.
This was brought into stark clarity when 45% of a squad of Navy SEALs were infected while training in Coalinga, CA. The elite strength and tremendous vitality required to join the ranks of the world’s most powerful warriors was not a shield against Valley Fever. Thousands of other military personnel have been infected across the decades as well. This disease can attack anyone.
It is not a matter of how healthy you were before you contracted Valley Fever, but how healthy you are after.
Aly FZ, Millius R, Sobonya R, Aboul-Nasr K, Klein R. Cytologic diagnosis of coccidioidomycosis: Spectrum of findings in Southern Arizona patients over a 10 year period. Diagn Cytopathol. 2016 Mar;44(3):195-200. doi: 10.1002/dc.23419.
Crum N, Lamb C, Utz G, Amundson D, Wallace M. Coccidioidomycosis outbreak among United States Navy SEALs training in a Coccidioides immitis-endemic area–Coalinga, California. J Infect Dis. 2002 Sep 15;186(6):865-8.