# data[].attributes.body
The disease that I decided to focus on is valley fever caused by a sporadic fungi infection incited by Coccidiodes immitis.

Common Name: Rift Valley Fever

Scientific Name: Coccidioidomycosis

# data[].attributes.body
Valley fever was first detected in Buenos Aires, Argentina, in 1892, originally thought to be a protozoan disease, hence the name Coccidioides immitis was given. However, between 1896-1900, researchers discovered that the infectious agent was a fungus, later adding -mycosis to the name to indicate its infectious agent. It is an endemic disease, meaning that it is consistently present in a region, in this case, the northwestern region of Mexico and the southwestern region of the United States. It is spread via inhalation of fungal spores.

# data[].attributes.body
After initially being discovered in Argentina, C. immitis was thought to be "imported" from somewhere else. C. immitis is native to the southwestern region of the United States, hence why it is endemic to the region. Originally thought to be a rare disease, in the 1930s, it was discovered that it was actually widespread among farmers in California. After skin tests were developed, hundreds of patients were diagnosed, and thousands of people were found to be infected.

# data[].attributes.body
According to the Merriam-Webster Medical Dictionary, virulence is defined as the capacity of a pathogen to overcome a host's defense and cause injury or damage. C.immitis is has a high infectivity rate, as few as 1-10 organisms can cause infection. However, the virulence of C.immitis depends on the host's ability to fend it off. In healthy individuals, the virulence of C.immitis is dramatically reduced; the individual may be infected but experience mild to no symptoms. However, patients who have a weakened immune response can experience severe symptoms and even death. Over time, cases of valley fever have increased, but this may be due to many contributing factors, such as climate change and advances in medical technology, where it is easier to detect C.immitis in patients. Research shows that the fungus has had a stable virulence overtime the past few decades.

# data[].attributes.body
The healthcare community's approach to Valley Fever underwent dramatic change over time as they learned more about the disease. Originally thought to be a protozoan infection, Valley Fever was initially treated with nitric acid, mercury, and potassium iodide, with no signs of improvement. In 1931, the California Department of Public Health reported that X-ray therapy showed improvement in skin lesions and vaccines were ineffective, but no effective treatment was discovered. For about 65 years, either patients improved on their own or they died, showing how limited the healthcare response was. A major medical advancement came in 1951, when Amphotericin B from Streptomyces nodosum was found, and it showed antifungal properties. And in 1957, it was administered intravenously to human patients. More recently, new diagnostic technologies have been developed to detect valley fever, such as PCR testing and coccidioidal antigen testing. And treatment has seen major advances, a canine vaccine is set to be approved by the end of 2025, and a human vaccine is still in development. The combination of fungal detection and improved antifungal treatments has transformed how Valley Fever is identical and managed.

# data[].attributes.body
Valley Fever poses a significant and growing public health challenge in the southwestern United States. One major challenge is the massive underreporting of the disease, so we don't really know the full impact of the disease. Leadership/governmental bodies have handled this disease in various ways. For example, at the state level, many states' health departments, including those of Washington, California, and Arizona, have attempted to increase awareness of valley fever and have provided recommendations for the prevention of infection. However, on the federal level, while the CDC and CSTE have considered valley fever as a "notifiable" disease, this classification does not mandate reporting, meaning that many states do not report cases of valley fever, leading to the challenge of underreporting mentioned earlier. Some innovative initiatives that have been taken in order to combat the disease are the development of vaccines, for example, at the University of Arizona through some NIH grants. A vaccine is being developed, and it is promising, providing some protection to canines. Crozet Biopharma is working on developing a vaccine for humans. Better treatments are in the process of clinical trials, such as nikkomycin Z. What the US Government could have done better to help combat this disease is to require Valley Fever to be reported in all states and implement some public campaigns informing the community of Valley Fever and what residents may do to prevent Valley Fever.

# data[].attributes.body
Valley fever had profound societal and sociological impacts. In counties where the rates of valley fever were high, those same counties had the highest rates of poverty in the country. As a result, many people who were infected were not treated, allowing their symptoms to worsen and have more severe effects. Workers in construction, agriculture, and archaeology were even more susceptible to the disease. For example, in 2016, a group of construction workers working in Monterey County were being diagnosed at 62 times more than the normal rate, according to a report from OSHA. These increased rates of infection also put strain on the healthcare system. These effects made way for improvements in societal behaviors; today, high-risk workers are advised to wear face masks, and indoor air filtration is advised. Awareness campaigns have also seen an increase; public health advisories in California have put out notices for people to stay indoors during dust storms. Even clinical education has changed, training health care providers to better detect and diagnose valley fever. As a whole, society is still learning from the physical effects of valley fever, and funding for research and vaccination efforts may see a decrease in funding due to federal cuts. Experts believe that the economic impact of valley fever may experience a steep increase as a result of climate change. Societal learning has been incomplete, while some progress has been made, funding and policies may greatly impact our ability to tackle the broader societal and sociological impacts of valley fever.