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Valley fever (coccidioidomycosis) is caught by breathing in spores of the fungus Coccidioides, which lives in soil and dust in the southwestern United States; 97% of U.S. cases are reported from Arizona and California. In California, cases rose 213% from 2014 to 2018.
It's usually a self-limited illness with cough, fever, chest pain or fatigue, but some people get severe disease, and rarely it's fatal. People at higher risk include adults 65 and older, Black and Filipino people, pregnant women, people who smoke, and people with diabetes or weakened immune systems. There's no vaccine, and the fungus is in the environment, so public awareness is key to catching the illness early.
The survey
In 2016, the California Department of Public Health added three questions to the state's Behavioral Risk Factor Surveillance System (BRFSS) telephone survey, asked of 3,485 adults from February 2016 to February 2017; 2,893 answered at least one:
- Have you heard of Valley fever?
- Do you live where the Valley fever fungus exists?
- Are you at increased risk for severe Valley fever?
Counties were grouped by their typical yearly case rates:
| Region | Cases per 100,000 a year | Counties |
|---|---|---|
| High | 10 or more | Fresno, Kern, Kings, Madera, Merced, Monterey, San Joaquin, San Luis Obispo, Stanislaus, Tulare |
| Moderate | 2–9 | Alameda, Calaveras, Contra Costa, Imperial, Los Angeles, Mariposa, Orange, Riverside, Santa Barbara, San Bernardino, Santa Cruz, San Diego, Solano, Tuolumne, Ventura |
| Low | under 2 | all other counties |
What Californians knew
| Statewide | High-incidence | Moderate | Low | |
|---|---|---|---|---|
| Had heard of Valley fever | 42.4% | 66.3% | 35.1% | 45.0% |
| Knew the fungus lives where they do | 6.1% | 25.0% | 3.0% | 3.0% |
- General awareness was highest among adults 65 and older (61.1%) and lowest among adults 18–44 (32.9%) and Hispanic people (26.4%).
- In the high-incidence region, knowing the fungus was local ranged from 48.6% of adults 65+ and 40.7% of non-Hispanic White people down to 10.5% of adults 18–44 and 11.3% of Hispanic people. In the moderate region — which includes southern California and more than half the state's population — under 5% of every group knew.
- Local efforts by providers, public health, media and support groups in Kern and neighboring counties may explain the high region's higher awareness.
People at higher risk
Of 2,841 respondents, 1,272 (44.7%) had at least one risk factor for severe disease. About half of them (50.8%) had heard of Valley fever — but only 3.5% knew they were at increased risk.
| Risk group | Had heard of it | Knew they were at higher risk |
|---|---|---|
| Black people | 37.1% (lowest) | 1.3% (lowest) |
| Filipino people | 61.6% | 5.9% |
| Adults 65+ | 61.1% | 3.4% |
Knowing the risk can help people avoid dust where the fungus lives and, if they get sick, recognize Valley fever and seek care sooner.
What came of it
The results helped shape a statewide Valley fever awareness campaign in 2019–2020, reaching people in high- and moderate-incidence regions and those at risk of severe disease — and could guide programs in other southwestern states. In Arizona, more education for the public and providers has been suggested to cut unnecessary treatment, ease anxiety and improve early diagnosis.
Limits: a fairly small sample; exposure may happen outside a person's home county; pregnancy and immune suppression couldn't be counted as risk factors; and statewide weights may not fit smaller areas.
Sources
Based on Glorietta Hurd-Kundeti, Gail L. Sondermeyer Cooksey, Seema Jain and Duc J. Vugia (California Department of Public Health), "Valley Fever (Coccidioidomycosis) Awareness — California, 2016–2017," MMWR, Centers for Disease Control and Prevention, as corrected by a later erratum; a work of the United States government in the public domain; rewritten in hubnx's own words.
Лицензия: CC0 1.0 (общественное достояние) · По материалам www.cdc.gov
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