Valley Fever Update

Nov. 12, 2008

Transcript:

Ted Simons
>> Coming up, a warning about Valley Fever. But first here's how to read a transcript and watch video of this and other Horizon programs online.

Ted Simons
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Ted Simons
>> Cases of Valley Fever are on the rise. And here to tell us more about this disease is Dr. Rebecca Sunenshine, the state's deputy epidemiologist. Thanks for being on Horizon.

Rebecca Sunenshine
>> Thanks for having me.

Ted Simons
>> Let's get to the basics here. What is Valley Fever, how do you get it?

Rebecca Sunenshine
>> Valley Fever is a fungal disease. It's predominant in the southwestern United States and also part of Central and South America. You get it by inhaling the fungal spore from the soil. So on a dusty or windy day you can inhale the fungus into your lungs and that's what typically causes Valley Fever.

Ted Simons
>> Is there a cure for Valley Fever?

Rebecca Sunenshine
>> There actually is no cure for Valley Fever. We do have treatment available. There are some drugs that treat it. Unfortunately, they cannot completely get rid of the disease. And folks who have severe Valley Fever or disseminated Valley Fever that spreads to all over the body, those folks need to be on medication sometimes lifelong.

Ted Simons
>> Was going to ask, I've heard that Valley Fever can spread throughout the body. You're saying that indeed happens.

Rebecca Sunenshine
>> Absolutely. So out of about 100 infections of Valley Fever, about 60% of people will have absolutely no symptoms at all or very mild symptoms and not even know they have the disease. But the other 40% will have symptoms like fever, shortness of breath, cough, and especially prolonged fatigue. Of those, about three or four of them actually have severe disease which spreads throughout the body and those are the ones that require therapy and sometimes for the rest of their lives.

Ted Simons
>> Do those symptoms come on fast? They come on quickly? Are they the kinds of things where you just notice that you've been tired lately or your cough won't go away?

Rebecca Sunenshine
>> It really is a continuum. Some people will say I feel like I have a flu-like illness. But what we're hearing from a lot of people is that they'll complain of fatigue and maybe cough and shortness of breath for many months. In fact, when we looked at our enhanced survey in state which we did in 2007, we found that average amount of time that people we interviewed reported symptoms was six months. So it's not just a cold or the influenza. It lasts a lot longer.

Ted Simons
>> Can you have a low-grade version of it? Not feeling yourself but not feeling so bad that you think you need to see a doctor or you think you have to go to the emergency room?

Rebecca Sunenshine
>> Probably those folks fall somewhere in the -- sorry, the 60% that we would consider asymptomatic so. People who don't really even know sick at all are probably in that 60%. And we know for sure that we don't capture any of those people at the health department. The people that we capture feel sick enough for long enough that they go to the doctor and they're lucky enough to get tested by their doctor for Valley Fever. And health department. So we know that numbers that we have are far less than the actual number of cases out there.

Ted Simons
>> Let's talk about those numbers. How much of an increase are you seeing?

Rebecca Sunenshine
>> Well, what we saw back in 1997 when only doctors were reporting were just a couple thousand cases a year approximately. And what we had in 2006 at our peak was 5,535 cases. And last year we had almost 5,000 cases. So that is a lot of Valley Fever. And what we know is that's just the tip of the iceberg. It's estimated that there's actually about 90,000 case of Valley Fever in Arizona per year.

Ted Simons
>> The reason that people wait so long or the reason that it's misdiagnosed, is it because they think it's something else? Doctors think it's something else?

Rebecca Sunenshine
>> You know, it's really hard to know. What we do know is that patients wait an average of 45 days. So about a month and a half. Before they even go to seek care for their Valley Fever. And we also know that it takes about three visits to a health care provider before physicians actually test them for the disease. So that's why the Arizona department of health services is launching a huge educational campaign to get doctors to test earlier, to think of Valley Fever when folks come in with respiratory symptoms, cough, fever, fatigue. And also to get patients to think of it. And when they have those symptoms, ask to get tested for Valley Fever.

Ted Simons
>> Impact on the health care system. It sounds like a lot of patients, sounds like it's growing, sounds like a pretty big impact.

Rebecca Sunenshine
>> Well, we had like I said about 5,000 cases in 2007. And we were able to interview every tenth case. What we learned was that almost half of those patients actually had to go to the emergency room for their illness at some time during their illness. So that's a lot of the E.R. visits for Valley Fever. About 40% of them actually were hospitalized overnight for the disease. And about the same number had to see their doctor more than 10 times for the illness, which is just a tremendous impact on the health care system as you can imagine.
Ted Simons
>> With all this in mind, is there anything you can do to avoid getting Valley Fever if you live here in the Valley?

Rebecca Sunsenshine
>> That's a great question. And that's something that we're really working on. Right now if you live in Arizona, you are at risk for potentially getting the disease. So what we really want folks to do is know the symptoms, know what they are, and if you feel like you've had prolonged cough, fever, fatigue, for more than a week or two, ask your doctor to test you. What we are doing is working with our partners at T-Gen and university of Arizona and they're working on treatment and vaccine for Valley Fever. That is the ultimate prevention. We're hoping that eventually we will get a vaccine and that way we can prevent it in Arizonans.

Ted Simons
>> Very quickly I understand if you get Valley Fever you're not likely to get it again but you can.

Rebecca Sunenshine
>> Exactly. The vast majority of people that get Valley Fever get over it and never get it again. But there's a very small percentage that if later in life their immune system is depressed that it may come back.

Ted Simons
>> All right. Well, excellent information. Thank you so much for sharing with us on Horizon.

Rebecca Sunenshine
>> Thank you.