The HBO series “The Last of Us” has raised awareness about the growing threat of yeast infections. While no fungus is known to turn humans into porous zombies, health experts say a pathogen may become more prevalent due to climate change.
Valley fever is an infection caused by coccidioides, a fungus that generally prefers hot, arid climates and lives predominantly in the soil of the southwestern United States, according to the Centers for Disease Control and Prevention.
The CDC reported over 20,000 cases of valley fever in 2019. Although most cases are mild, the fungus spreads in a fraction of patients, causing severe illness and death.
Studies show that variable weather caused by climate change could spread the fungus to other parts of the country, said Dr. Paris Salazar-Hamm, a researcher at the University of New Mexico School of Medicine.
A 2019 study found Valley fever endemicity could range from 12 to 17 states and the number of cases could increase by 50% by 2100 in a “high warming scenario.”
“Fungal pathogens are a largely overlooked group and valley fever is an interesting model because it is associated with weather,” Salazar-Hamm said.
Here’s what we know about valley fever.
How do you get valley fever?
A person contracts valley fever by inhaling fungal spores from the soil that are normally raised into the air, according to the University of Arizona Valley Fever Center of Excellence.
What are the symptoms of valley fever?
Symptoms usually occur within three weeks of exposure, according to the Valley Fever Center for Excellence.
The CDC says symptoms include:
- Difficulty breathing
- Night sweats
- Muscle aches or joint pain
- Rash on the upper body or legs.
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Is valley fever a serious illness? What is the survival rate?
Yeast infection is endemic in the Southwest, with most people experiencing mild or no symptoms, said Dr. Manish Butte, professor and division chief of immunology, allergy and rheumatology in the department of pediatrics at the University of California , The Angels.
But there is a small subset of people in whom the fungus “spreads rapidly and destructively throughout the body,” and eats meat for nourishment, he said.
“If it spreads to the brain or spinal cord, about 40% of people die,” he said. This process can take up to two weeks from exposure. About 200 people die from valley fever each year. CDC reports.
It’s unclear why only a fraction of people exposed to fungal spores develop severe illness, but Butte’s research suggests it may have something to do with an individual’s immune system.
“We still find a number of patients that we don’t have a good clue about, and that’s where immunologists like myself try to get involved and try to understand from genetic testing,” he said.
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Can valley fever be cured?
Most acute infections can be treated with antifungal medications, most commonly fluconazole, Butte said, but the hard part is knowing when to use it.
Fungal infections are difficult to detect using plain X-rays, he said, and the only available diagnostic test is a blood test that detects antibodies.
Some doctors confuse fungal infections with viral or bacterial infections and use antibiotics to treat patients, Salazar-Hamm said.
“The bacterial flora is eliminated (with the antibiotic), which allows the fungal infection to grow and make it worse,” he said.
Antifungal medications are also “intense,” Salazar-Hamm said, and can have negative side effects. The Mayo Clinic says some rare side effects include:
- Hives, chills
- Chest tightness
- Rapid heartbeat, etc.
“Fungi are more closely related to humans than they are to bacteria,” he said. “Fungal drug targets have negative side effects for human cells.”
About 1% of patients in whom the fungus spreads throughout the body also receive another antifungal called AmBisome, but Butte said many patients still die. His research focuses on how immunomodulation, or manipulation of the immune system, could help these selected patients fight off the fungus.
Is valley fever very contagious?
Several people in a household can contract the fungal disease by breathing in the spores that are in the air around them, but valley fever is not “contagious” in the sense that it cannot be spread from person to person.
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