Valley fever severity rises to level that is 'unbelievable'

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Valley fever severity rises to level that is 'unbelievable'

By Carla McClain

ARIZONA DAILY STAR

Tucson, Arizona | Published: 03.12.2006

http://www.azstarnet.com/dailystar/metro/119698

Slap a record-breaking drought on top of a rainy winter and you have

set the stage for what is happening in Tucson right now ¡ª a spike in

valley fever infections, especially severe cases that can cause

disability and even death.

" Since the fall, the severity of cases is at a level I don't

remember ever having seen before, " said Dr. Eskild sen,

longtime infectious-disease specialist at the University of Arizona.

" This has been unbelievable. These are cases where the infection has

moved beyond the lungs, when people really suffer from valley fever.

This is a very different, very unusual year. "

Valley fever infections have been rising steadily in Arizona since

the late 1990s, due in part to the steady influx of vulnerable

newcomers, experts say. But the last six months have produced the

worst outbreak, by far, in this overall increase, sen said.

At the only valley fever clinic in Tucson, at University Medical

Center, doctors have seen 30 new cases ¡ª about a third of them

extremely severe ¡ª during this period.

" We usually don't get more than one or two new cases a month, " said

sen. " I've never seen that number in so short a time. And it's

not just at our clinic. It's the general feeling out there that

something very serious is happening. "

The problem is starting to show up in the records. In Pima County, a

total of 259 valley fever cases have been reported in the most

recent three-month period, from November through January. That is an

increase of more than 40 percent over the 183 cases reported during

the same period last year.

Known scientifically as coccidioidomycosis, valley fever is caused

by a soil fungus that grows only in parts of the southwestern United

States, Mexico and South America.

When inhaled, the fungal spores usually attack the lungs, but they

can spread through the bloodstream to the brain, skin and bones to

cause severe, sometimes fatal disease.

Most infected people ¡ª 60 percent ¡ª experience no symptoms or very

mild ones, requiring no treatment. The remainder develop flulike

symptoms and fatigue that can linger for months, with a small

number, about 1 percent, going on to widespread disease.

It is no coincidence that the timing of this current spike jibes

exactly with the onset of an extreme dry period in Southern Arizona,

which left the region virtually rainless from October until this

weekend.

That was the final step in what experts call the " grow and blow "

weather pattern now known to trigger outbreaks of valley fever.

The pattern requires a period of sufficient moisture to grow the

infectious fungus in the soil ¡ª and that happened last winter ¡ª

followed by a severe drought to get the fungal spores up into the

air.

" These conditions have stirred up the valley fever spores, in

greater volume than we would normally see. People are much more

exposed in this situation, " said Comrie, a UA climatologist

who has studied the effects of weather on valley fever.

Other factors pushing the outbreak include the home-building boom on

the outskirts of the city ¡ª disturbing vast swaths of native soil

where the fungus grows, creating dusty conditions ideal for spore

inhalation.

And as long as people keep moving here from areas where valley fever

doesn't exist, they arrive with no immunity to it and are

immediately vulnerable to infection.

" It can take only one spore to cause an infection, even a serious

infection, " said Dr. Galgiani, director of the UA's Valley

Fever Center for Excellence.

But the volume of spore exposure also has an impact, especially for

people who work under conditions that require digging, such as

archaeologists, he said.

" You see more severe pneumonia in these patients, often several

primary pneumonias in one person, " he said.

This current valley fever outbreak is affecting much of Arizona ¡ª

all of the drought-stricken, low-elevation areas where the fungus

thrives.

With monthly case numbers also spiking statewide, Arizona expects to

easily surpass last year's total 3,778 cases.

" We're going to top 4,000, no doubt, " said Will Humble, state chief

of public health preparedness. " We're on track for a very big year. "

Man's best friend especially vulnerable

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¡ñ Contact reporter Carla McClain at 806-7754 or at

cmcclain@....