April 24, 2019

New Study Works to Understand the Prevalence of Valley Fever

Fungi Coccidioides immitis, saprophytic stage, Pathogenic fungi that reside in soil and can cause infection coccidioidomycosis, or Valley fever

DHVI Communications | Published April 24, 2019

DURHAM, N.C.-- Coccidioidomycosis, also known as “Valley Fever” is an infection caused by Coccidioides, a fungus commonly found in the southwestern region of the United States. Coccidioides resides in the soil and can cause infection when its microscopic spores are released into the air because of disturbances. Residents who are infected with Valley Fever can develop pneumonia like symptoms, such as fever and cough, and in more severe cases, can lead to meningitis and bone and joint infections. Most of the time infected residents will get better on their own, but in some cases specific medication is needed to treat the infection.

Valley Fever is often underdiagnosed or late to be diagnosed. In endemic areas it is believed that Coccidioides accounts for 15-29% of all community acquired pneumonia and there is concern that the vast majority of cocci-positive cases remain unknown. A new study at the Duke Human Vaccine Institute aims to better understand the frequency of this infection and raise awareness of the disease in regions where disease prevalence is highest.

Over the next three years Dr. Chip Walter, Director of the Vaccine and Trials Unit at the Duke Human Vaccine Institute and Dr. Susanna Naggie, Director of Infectious Diseases at the Duke Clinical Research Institute, will coordinate enrollment of up to 1,000 people with pneumonia in south-central California and southern Arizona. Patients will be observed to determine how frequently they have Valley Fever, the factors that lead to severe infections, and how specific antifungal treatments can lead to more rapid improvement of symptoms.

This multisite study will be the first to enroll patients across the Southwestern United States allowing researchers to observe the differences in the regional clinical management of primary pulmonary coccidioidomycosis, as well as the clinical, laboratory and demographic predictors of Valley Fever.

 “We hope that better data describing disease prevalence will improve disease awareness,” said Dr. Walter. “With improved awareness, it is hoped that more providers will test and potentially treat infection earlier.”

By bringing awareness to this disease and learning the factors that contribute to its severity, providers will be able to appropriately diagnose Valley Fever at earlier stages of infection, and in turn provide better treatment plans for patients.

The Duke Human Vaccine Institute will work in collaboration with the following sites: 1) Southern California Permanente Medical Group - Antelope Valley, Lancaster, CA; 2) Southern California Permanente Medical Group – Kern County, Bakersfield, CA; 3) Kern Medical Center, Bakersfield, CA; 4) UCSF Fresno, Fresno, CA; 5) Banner -University Medical Center Tucson, Tucson, AZ and 6) Banner University Medical Center Phoenix, Phoenix, AZ.  Laboratory Site: University of California, Davis. This project is supported by the Division of Microbiology and Infectious Diseases (DMID), National Institute of Allergy and Infectious Diseases (NIAID) of NIH through the Vaccine and Treatment Evaluation Units (VTEU), and the US Department of Health and Human Services under contracts HHS (Duke University HHSN 272201300017I). The study is registered on clinicaltrials.gov (NCT03908632).