Valley Fever – more prevalent after Thomas Fires?

Dr. Brugman is a leading pulmonologist in Ventura.

by Jennifer Tipton

Native to the San Joaquin Valley (hence the name “Valley Fever”) this airborne fungal infection dates back as far as 1892 and may also be referred to as Desert Fever or Desert Rheumatism.

Valley Fever is due to the coccidioides fungus which enters the body through the respiratory tract when inhaled. The fungus is found in soil and is endemic or limited to certain regions such as Bakersfield or other desert areas along with the San Joaquin Valley.

I asked Dr. Brugman, a leading pulmonologist in Ventura, how the Thomas Fires contributed to the recent outbreaks of Valley Fever and he emphasized that the Santa Ana winds really perpetuated the problem but, “the fires were helpful in aerosolizing the fungus because the chaparral that burned had kept the dust on the ground”. He added, “the low humidity and the winds kicking up the dust are what really get it going”. He’s seen 15 cases of Valley Fever in the last few months where he usually sees 2-3 in a year. “A lot of people are coming in with pneumonia after inhaling the spores from the soil”, he reported.

Diagnostics may include a bronchoscopy where he can see the spores in the lungs and the treatment is most commonly an antifungal medication, some needed for up to 6 months.

The good news, most of the population have been exposed and aren’t even aware of it, while many others may have mild symptoms that usually go away on their own in a week or two. The bad news, the symptoms can progress to pneumonia or worse, disseminated cocci.
According to the C.D.C (Center for Disease Control), Valley Fever causes 15% to nearly 30% of community acquired pneumonias and time from contact until symptoms start is usually 1 to 3 weeks.
Symptoms such as fatigue, fever, headache, muscle aches, chills, sore throat, cough, and even weight loss or chest pain may occur.

If a case of Valley Fever becomes as serious as disseminated cocci, Dr. Brugman refers his patients to the dynamic infectious disease specialist, Dr. Gail Simpson.

Dr.Simpson tells me the organism that causes Valley Fever “is a dimorphic fungus and the spores can live in the soil for years and years until something stirs up the dust and puts it in the air”. She remembers a huge outbreak after the Moorpark fires when “even young, healthy people were in the I.C.U. (Intensive Care Unit) because the smoke causes stuff to sit in the air longer”.

Dr. Simpson reports she has seen a lot of cases since the Northridge earthquake in January 1994, “cocci just wasn’t that common before the earthquake, what happened is a lot of dirt from the cocci belt got redistributed all over the place”.

Valley Fever is not contagious and there is no medication to prevent it. Dr. Brugman’s advice for prevention, “if it’s dusty out, wear a mask, but it can’t be the cheap painter’s mask, it needs to be an N95 to filter out the dirt and particulate”. Good advice for anyone digging through the dirt and ash left by the Thomas Fires!

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