Cases of coccidioidomycosis, a dangerous infection also known as Valley fever caused by inhaling fungal spores, have been on the rise for decades. Experts are pointing the finger at climate change for expanding the fungus’ range and exposing more people to the illness.
Rob Purdie was diagnosed with Valley fever in 2012 after a persistent headache that was initially brushed off as a sinus infection by doctors. While Valley fever usually presents primarily in the lungs, Purdie’s infection traveled quickly into his brain, causing meningitis.
The first several anti-fungal pills he was prescribed failed, so he was put on Amphotericin, a powerful anti-fungal medication injected directly into Purdie’s brain through a hole drilled into his skull. According to Purdie, the side effects of the drug are debilitating.
“It’s a drug that’s so bad that they give you other drugs to counteract the side effects,” Purdie said. “When they administered the drug, I could feel it circulating through my body. I could feel it going down my neck, going into my spine and my body tensing up, my stomach clenched up, and I got violently ill. I still get violently ill every time. If you’ve ever thrown up so hard you blacked out, that’s what I mean when I say 'violently ill.'"
At first, Purdie received that treatment twice a week, but now he only has to endure the intense medication every 12 weeks. Like most other Valley fever patients, Purdie will receive treatment for the rest of his life.
Dr. Royce Johnson is the medical director of Valley Fever Institute in Bakersfield, where Purdie receives his treatment. In his four decades of work in the area, Johnson said he has seen the number of Valley fever cases skyrocket.
“When I came to Bakersfield many, many years ago, the average number of cases was about 250. In recent years, there are about 2000,” Johnson said. “The incidence of the disease is clearly drastically increased.”
That trend is not unique to Bakersfield. According to CDC data, the number of cases across the country has increased from 2,865 in 2000 to over 20,000 in 2019, with a majority of those cases coming from California and Arizona. The CDC also said those numbers are likely huge under counts with 10,000s of cases being misdiagnosed as other illnesses.
Valley fever cases have historically been almost exclusive to the Southwest because of its hot and dry climate, but as temperatures increase across the country, experts like Morgan E. Gorris expect the endemic regions of the fungal infection to spread. In a study published in 2019, Gorris estimates that by 2,100, the area affected by Valley fever will more than double and the number of people who will become ill will increase by 50%.
According to Johnson, the fungal spores responsible for causing Valley fever can travel more than 70 miles in the air. So, while the infection is often associated with people who spend time outdoors and near the kinds of soil and dirt where the fungus thrives, unsuspecting city dwellers are also at risk. So, Johnson suggests airing on the side of caution and getting tested for Valley fever if you show any telltale signs of the illness.
“If you have a respiratory illness that is not getting better by 10 days to two weeks, you need a chest X-ray and in the appropriate circumstance you need to be tested for Valley fever,” Johnson said.
Valley Fever Institute has partnered with other institutions to better understand the fungal infection. Johnson said that though some folks like Purdie develop life-threatening illnesses, other infected patients barely get ill at all. Experts hope that continued research into the disease will lead to better therapeutics and prognoses for patients.
Purdie is encouraged by all of that research and he now dedicates much of his time as the patient and program development coordinator at Valley Fever Institute to helping others navigate the disease that has changed his life forever.