Arizona is a hotspot for valley fever. Here's what you need to know

If you live in Arizona, it's possible to inhale a minuscule fungal spore that causes a potentially deadly disease called valley fever at any time of the year. Valley fever was the subject of the May 18 Valley 101 podcast hosted by Arizona Republic columnist Bill Goodykoontz, who had a bout of valley fever in 2013. Goodykoontz sought medical help when he couldn't stop coughing and an urgent care doctor took X-rays of his lungs. The doctor initially told Goodykoontz that he had pneumonia, which is a common valley fever misdiagnosis.

Fortunately for Goodykoontz, the doctor was aware of valley fever and gave him a test for it at the end of the visit "just in case." The test came back positive a few days later and Goodykoontz was placed on an anti-fungal drug called fluconazole. He was sick for two to three months and describes the illness as "not fun." Among people who have never had valley fever, the chance of infection in Arizona and other endemic areas is about 3% per year, but the longer one resides in an endemic area, the greater the risk, according to the University of Arizona Valley Fever Center for Excellence. Goodykoontz said he'd been living in Arizona for 23 years when he contracted valley fever and almost all of that time was in Maricopa County, which is part of Arizona's "valley fever corridor." The disease is not contagious. Rather, it is caused by inhaling a Coccidioides fungal spore, though not everyone who inhales one of the spores get sick.

During the podcast, Goodykoontz interviewed Dr. John Galgiani, who is director of the UA Valley Fever Center for Excellence. Galgiani, who is also director of the Banner University Health Valley Fever Program, shared data that shows over a four-year period between 2021 and 2024, 12% of people with pneumonia symptoms who sought treatment at a Banner Urgent Care in Maricopa County tested positive for valley fever. Galgiani has been working with Banner Health, which is the state's largest health system, to ensure that providers test patients with pneumonia symptoms for valley fever.

Historically, that has not always been happening, partly because many Arizona health providers received training or grew up in other parts of the country, where no one has heard of valley fever. The state Health Department reported 12,423 cases of valley fever, also known as Coccidioidomycosis or "cocci" for the 2025 calendar year. Arizona typically accounts for a majority of the valley fever cases reported in the United States, national data from the U.S. Centers for Disease Control and Prevention says.

Galgiani and other health experts say the reported numbers of valley fever cases likely are a significant undercount because the illness is often misdiagnosed and also because about 60% of cases show no symptoms or only mild symptoms. In instances where people do become ill, there's a range of severity. Former Arizona Diamondbacks first baseman and outfielder Conor Jackson lost playing time because of valley fever in 2009 and UA football alumnus Sterling Lewis died of it at the age of 32 in 2020. When the fungus spreads outside the lungs it can break bones and cause dangerous neurological issues.

The most recent data on valley fever deaths from the Arizona Department of Health Services say that in 2024, there were 86 deaths attributable to valley fever. Here are nine things Arizonans and people who visit Arizona need to know about valley fever: Symptoms may resemble COVID-19, the flu or pneumonia Valley fever is often misdiagnosed or the diagnosis is delayed because some of the symptoms are so similar to other respiratory illnesses such as COVID-19, the flu or pneumonia. The symptoms may include fatigue, cough, fever and headache, shortness of breath, night sweats, muscle aches or joint pain and a rash on the upper body or legs. Though many cases of valley fever will go away on their own, the valley fever test and diagnosis is important to avoid getting treated "for everything you don't have," Galgiani said.

He's seen patients with valley fever who have endured needless brochoscopies, CT scans and invasive lung biopsies, among other things, he said. "It should be a commonly done test for people who are sick longer than two to three weeks," Galgiani said. "Insurance companies would save money if they tested patients for valley fever." Arizonans with a lingering respiratory illness should ask for a test If providers don't offer it, patients with ongoing respiratory symptoms should ask for a valley fever test to rule it out, Galgiani said. Getting results after a valley fever blood test typically takes at least two days, sometimes more.

Researchers and clinicians would like to see a point-of-care test to give patients results before leaving their health provider's office, which is something that the Mayo Clinic in Arizona is working on with Arizona State University. "A faster test would be a game-changer," Galgiani said. Coccidioides fungus most common in Maricopa, Pinal and Pima counties The fungus that causes valley fever is found in the soil of arid regions. Arizona's "valley fever corridor" comprises Maricopa, Pinal and Pima counties where the fungus that causes the illness is most commonly found, though it has been found in other parts of Arizona, too, including northern Arizona.

In California, it's most common in the Central Valley and Central Coast regions. The fungus that causes valley fever also lives in parts of Washington, Mexico, and Central America. Changes in weather and climate could allow the Coccidioides fungal spores to spread and live in more areas., the CDC says. Certain populations are at higher risk for severe infection Any disturbance of the soil in endemic areas creates a valley fever risk, which is why people who do outdoor work like agriculture, construction and archaeology are more vulnerable if they work in areas where the fungal spores live and grow.

They aren't at higher risk for exposure, but people older than 60 are at significantly higher risk of getting more severe forms of valley fever, health experts say. Valley fever becomes more severe when the cocci infection disseminates beyond the lungs into other parts of the body. Others high risk factors for dissemination include: a weakened immune system (including organ transplant recipients); lymphoma; HIV+/AIDS; adrenal corticosteroid therapy; third trimester pregnancy; Male; Black; Filipino. If you've had valley fever once, you likely won't get it again Valley fever technically has no prevention and no cure.

There's no drug that gets rid of it, but the symptoms typically go away. When a fungal spore is inhaled, it changes into a larger, multicellular structure called a spherule, which grows and bursts, releasing endospores that develop into more spherules, according to the UA Valley Fever Center for Excellence. In most cases the cocci spherule or spherules will eventually go dormant. In some cases, such as when someone's immune system is wiped out, the spherules can reactivate.

But as a general rule, scientists and clinicians have found if you've had valley fever once, you aren't going to get it again. How to reduce the risk of valley fever There's no vaccine against valley fever at the moment, and in many cases, the spores are impossible to avoid. The Mayo Clinic, which has a "Cocci Clinic" in Phoenix that provides multispecialty care for valley fever, has prevention and education tips. The Mayo Clinic says anyone who lives in or visit areas where valley fever is common should be aware that a dry season following a rainy season is when the chance of infection is highest.

Prevention tips include: clean skin injuries with soap and water; wear a mask; stay clear of very dusty areas, such as construction sites; stay inside during dust storms; wet the soil before digging in it; stay away from the soil if you're at higher risk of infection; keep doors and windows tightly closed. There's no cure but there is treatment Valley fever in some cases may be treated with prescription anti-fungal medications such as fluconazole.

But the reason most people get better is that "their immune system takes care of it," Galgiani said. A vaccine against valley fever for dogs is in development Scientists at the UA discovered a vaccine against valley fever that's being developed by California-based pharmaceuticals company Anivive Lifesciences Inc. It's expected to be effective in both dogs and humans, but it will be available for dogs before humans. Dogs can and do get valley fever and while most recover if they get adequate anti-fungal therapy, some dogs can get extensive lung disease that requires hospitalization and surgery and sometimes leads to death.

If the disease disseminates in dogs it can cause other symptoms, too, such as lameness and seizures. Galgiani said it would be helpful if veterinarians were required to report cases of valley fever. Cats, horses, cattle, sheep, burros, coyotes, rodents, bats and snakes can get valley fever, too. The 'valley' in valley fever does not refer to the Phoenix area Even though Arizona typically has the most valley fever cases of any state, the disease is named for the San Joaquin Valley in California where it was first identified.

The species of valley fever-causing fungus found in California is different from the species in Arizona. Coccidioides immitis primarily is found in the soil of California’s San Joaquin Valley, as well as portions of Washington state and northern Mexico. Coccidioides posadasii is what's found in Arizona and throughout the rest of the desert southwestern United States, including New Mexico, Nevada, Utah, Texas, northern Mexico, and parts of Central and South America. The two species behave the same way if they cause a valley fever infection and the vaccine in development will work against both, Galgiani said.

Reach health-care reporter Stephanie Innes at [email protected] or follow her on X: @stephanieinnes or on Bluesky: @stephanieinnes.bsky.social.