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Valley fever or coccidioidomycosis is a fungal disease native to the arid regions of the North American Southwest and select areas of South America. The disease derived from the air born spores of the mold Coccidioides, which will enter the body of it's host though often the mouth into the lungs to grow it's spores. Valley fever if entering the mouth can cause fatigue, coughing, fevers and headaches, muscle pains, rashes, and night sweat. Valley Fever can affect both humans and animals and is a particular threat to pregnant women, sufferers of diabetes, and suffers of Hiv/aids.

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Coccidioidomycosis

1. Where was your disease of study first detected? Valley fever was first detected in the Sonoran Desert between Southern Arizona and Northern Mexico, with the fossil record showing that the disease has existed in animals for 2 million years.

2. What was the suspected infectious agent (e.g., bacteria, virus, fungi, or parasite)? The viral agent of valley fever is the fungal mold Coccidioides.

3. What type of disease was it (e.g., zoonotic, emerging infectious disease, etc.)? Be sure to include the definition of the disease type in your post. Valley Fever is an airborne and formite-borne (can be transfered from interacting with inorganic molecules) fungal pathogen which is spread through inhaling the organism's spores. The disease is not infectious with the exception of being transferred through an open cut.

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1. Where (e.g., what geographical regions) did the disease spread to? Valley fever is primarily native the Americas, with most cases present in arid regions of Western North America. The contagion has spread into south America as well and has adapted into what was once inhospitable regions. The disease was likely spread by travelers since there is little geographic connection to. the fungal populations  between even the Californian and Sonoran populations.

2. What was the timeline of the spread? Although evidence shows the presence of valley fever for 2 million years, the first case was reported in Argentina in 1892, with the infection being present in California in 1901, in Arizona in 1932, Washington state in 2014.

3. Approximately how many people were affected (illness and/or death)? Cases of valley fever have been increasing to 20,000 just in 2019 in the United States, with the majority of cases coming from Arizona. Despite the high number of cases only a 0.07 percent death toll mostly affecting the elderly, with 200 deaths per year.

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1. How virulent is your disease? Virulence refers to how easily the agent of your disease spreads within the body and beyond. The virulence factors of valley fever is not well know however, scientists have noted that the spores do show signs of glycoprotein which attacks the protein and carbohydrate chains, and produces ammonium.

2. Did the virulence change over time? Valley fever has been more infectious and cases reaching 20,000 a year which likely due to the greater adaptability of the mold's spores.

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1. How was the disease handled by the health care community? Unless the disease shows immediately shows dangerous symptoms the disease usually goes away without medication within a few months. However if symptoms worsen or the infected are in the dangerous age range they will be prescribed anti-fungal medication ranging from 3-6 months. If the disease develops into meningitis the medication may be prescribed for possibly years.

2. What medical advances were used in combatting the disease? Because fungal organisms are so close to animals evolutionarily speaking anti fungal treatment must have specified targets and alter specific attributes of the fungus' biology. Scientists often use chemical compounds that target the fungus' membrane such as in the case of polyenes or allyamines which target the enzyme of the infection.

3. Were any new technologies applied to this disease? What were they? More recent cases of valley fever have proven the effectiveness of the drug Dupilumab in supplementing the immune system if it is short on interferon gamma an anti infective agent.

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1. How was the disease handled by the leadership and/or governmental bodies to the disease? Valley fever and other fungal disease outbreaks are incredibly rare due to it's complicated transmission rates, however annual infections do occur which generally leads city and state governments to isolate individuals and to order investigations into any potential origins.

2. Were any innovative initiatives used in combatting the disease? What were they? Because it is a fungus rather than a bacteria or virus, epidemiologists will often work with ecologists to take samples of soil and water and to quarantine areas where the fungus is active.

3. What could leadership have done better in response to this disease? Will valley fever can be contained, it can be a challenge to locate valley fever samples especially when people are traveling. Lack of insight has allowed it to spread without detection when people are traveling to hotspots such as Mexico which could have been avoided with greater health enforcement and regular check ups of people and environments.

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1. Beyond the physical effect, what was the societal and sociological impact of this disease? Valley fever is an incredibly expensive disease to medicate with recent numbers placing a cost of medicinal treatment being around 700 million dollars in the state of California. Because it is a fungal medication treatment is often more expensive and requires careful examination to avoid dangerous side effects. With the disease often hampering low income communities such as farmers it is often used as an example for policies of more affordable caring. https://poverty.ucdavis.edu/policy-brief/reducing-impact-valley-fever-low-income-communities

2. Did any society behaviors change? With valley fever and other fungal diseases, local medicinal communities had to work with ecological scientists to examine the soil for potential spores. Because the disease can affect pets veterinary and animal care became more prevalent in the south west.

3. Did society “learn” from the physical effect of the disease? Unfortunately there is a rising number of cases of valley fever, partially because the effects of valley fever was mistaken for different diseases such as pneumonia causing many deaths. Doctors are now advised to run more critical tests to distinguish between the diseases.

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Center for Poverty and Inequality Research

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Reducing the Impact of Valley Fever in Low-income Communities - Center for Poverty and Inequality Research

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By Sarah M. Rios, University of California, Santa Barbara