The dust-borne disease has plagued residents of the Southwest deserts for thousands of years and is believed to strike as many as 60,000 Arizonans each year, most of them in metropolitan Phoenix and Tucson.
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Reported cases have nearly tripled since 1999, victims suffer symptoms for an average of six months and miss an average one month of work, and they racked up $86 million in hospitalization charges last year.
Still, state health officials say valley fever is being misdiagnosed, or missed altogether, by Arizona doctors. Patients are waiting weeks before seeking medical care and then wait an average of five months before being properly diagnosed.
New data shows that Sun City and the northwest Valley appear to be hot spots for valley fever, or coccidioidomycosis, and scientists from the U.S. Centers for Disease Control and Prevention are in the midst of a three-week stay here to find out why.
Arizona is entering peak season for valley fever, which has reached epidemic proportions. Though seniors are the most prone to complications from the disease, public health officials say everyone is at risk.
"We know that the reported rates of valley fever are about twice as high over (age) 65," said Dr. Rebecca Sunenshine, deputy state epidemiologist. "But we have cases from newborns all the way up to 98 years old. It affects everyone."
The state Department of Health Services and the University of Arizona's Valley Fever Center for Excellence have launched a campaign to raise awareness of the disease among the public and the medical community. Gov. Janet Napolitano has proclaimed this week Valley Fever Awareness Week.
A recent study of Arizona physicians found that one in three did not know they were obliged to report the disease to public health officials and many failed to test pneumonia patients for valley fever, as recommended by DHS.
The disease generally is confined to Arizona and Southern California, with a smattering of cases in Nevada and New Mexico. Since most Arizona physicians received their medical training out of state, Sunenshine said, it's likely they just don't know about valley fever.
But the lack of diagnosis, or misdiagnosis, can be costly.
"Not only are you giving them the wrong diagnosis, you're also giving them the wrong treatment," Sunenshine said.
In addition, she said, patients wrongly diagnosed with a bacterial or viral infection will have the mistaken belief that their symptoms will subside in a week or two. Valley fever symptoms last an average of six months.
Valley fever is caused by a fungus that grows in arid climates under about six inches of topsoil. The fungus is nourished during the rainy season and then disrupted when the ground dries out, by things like wind, construction or farming. Its spores take to the air as thread-like filaments that, when inhaled by people and animals, can cause infection in the lungs.
Most people will never know they had valley fever. For every 100 people who contract the disease, Sunenshine said, 60 will have no symptoms and 37 or so will become mildly or moderately ill.
The remaining two or three will develop a severe illness that can spread throughout the body and lead to lifelong treatment or death. People with compromised immune systems, the elderly and pregnant women are most at risk. In 2006, there were 36 deaths attributed to the disease.
In Mark McNeil's case, it went to his brain.
McNeil acquired valley fever in the summer of 1980 while working at an equipment rental company in Mesa. Until then, he'd been a healthy husband and father of two.
"I woke up with a headache, tired, joints hurting," he said. "I just kept pushing myself. Days became weeks and weeks became months."
He went into the hospital the day after Thanksgiving and, three brain surgeries, 137 spinal taps and 28 years later, is holding the disease at bay with daily medication.
McNeil, 65, speaks publicly about valley fever whenever he gets the chance, figuring that he came back from death's door for a reason.
"Make sure your doctor has some kind of working knowledge of valley fever. Too many of these doctors have no idea," he said.
"There are medicines out there that can help," he said. "You don't have to go through all that suffering. Don't ignore it."
Valley fever was added to the list of reportable diseases in 1997 and state health officials started sounding the alarm when they saw the number rising steadily.
So far, the peak was in 2006 with 5,535 reported cases, followed by 2007 with 4,832. As of Oct. 31, the state reports 3,564 cases of valley fever. But that's just the ones confirmed by the state laboratory.
"It's the tip of the iceberg," Sunenshine said.
"It's OK to ask your doctor if it might be valley fever," Sunenshine said. "We're really encouraging patients to bring it up to their doctor."