I am very closely acquainted with a person who was found to have this infection by culture of a biopsy sample during the 1980s. The person I know has never been to the parts of the United States mentioned in this article. The examination finding that prompted the biopsy was persistent cough and general fatigue accompanied by an abnormal chest X-ray. (The chest X-ray, in turn, was follow-up to a course of preventive treatment for tuberculosis, medically indicated for a foreign person who arrived in the United States Mantoux-positive for tuberculosis, perhaps from having had the BCG tuberculosis vaccine overseas. The X-ray finding was nothing at all like the chest X-ray of someone with a tuberculosis infection, but quite unusual, prompting many other diagnostic tests, including repeated biopsies.)

The good news is that the patient I know recovered fully after surgery. The bad news is that the patient had to have major surgery. Moreover, we are unsure to this day what the actual diagnosis was. The surgery was curative, as the patient's complaints and disabilities all went away after it was over, but the lung infection was never definitively diagnosed. (Another infectious agent was cultured after a different biopsy.) Slow-growing lung infections are very hard to diagnose. Fortunately, most people have a lot of spare lung tissue, so even removal of a whole lobe on one lung does not impair future aerobic exercise.

Developing better diagnostic procedures for this illness will not be easy at all, but seems well worth doing. Antifungal drugs are very hard to develop, because fungi are very biologically similar to animals, and thus a drug that works on fungi has a high probability of being toxic to human patients if taken internally.

http://www.mayoclinic.com/health/valley-fever/DS00695/DSECTI...

The article is actually a little sensationalist. Because Coccidioidomycosis is actually ENDEMIC to the western region of USA and Mexico.

The rates do usually go up after earthquakes and storms that can lift up large amounts of dust up in the air.

In most people the infection resolves itself (much like TB in healthy people). Some people might get pneumonia and rarely do healthy people get meningitis. The disease is severe in immune-comprised but any disease can be severe in that case (eg: simple thrush - candida albicans infection)

simple anti-fungals eg: fluconazole is effective is most cases

Also, a new coronovirus in France and the middle east, which although it's killed 50% of the people who've caught it so far is probably not going to kill us all[1].

Also H7N9 (a new bird flu), although it's a bit of a lightweight having killed a mere 20% of sufferers. It may not spread human to human, although we don't know that, and this one hasn't yet reached "the West".

[1] http://www.bbc.co.uk/news/health-23179570

[2] https://en.wikipedia.org/wiki/H7N9

As an Arizona native, both my best friend and one of my college professors acquired the disease and became seriously ill. My professor had to miss most of the year of the class I signed up for, and my best friend was down for an entire year with weakened lung capacity, as well as not being able to drink an ounce of any sort of liquor while taking the medication she needed to fight it. These are probably 5s on a scale of 1-10 with how bad this disease is.

It's horrible, and I wouldn't wish it on anyone. I'd say be careful when you visit AZ or CA, but there's not really anything you can do except avoid the dusty areas entirely.

The problem also is that you have people who are constantly getting exposed to anti-fungal medications without their knowledge. E.g. almost all supermarket lemons/limes/oranges are coated in anti-fungal cream before being coated with another thin layer of wax, so when you make zest from them (or order a drink with zest at a bar) then you are probably reducing your body's ability to fight off things like this. So much better to avoid things like that entirely I think, as fungal infections are often not possible to cure.

Swell. I write this from the Sacramento area (yeah, "the other valley" - Central, not Silicon) as somebody who was born by Bakersfield.

OTOH - doesn't every place have its own local diseases and parasites???

We have recently been dealing with this not even knowing it existed prior. We adopted a flat-coated retriever from Kingman, AZ and he was soon diagnosed with a blown-out knee that required radical surgery. Luckily, my wife did some research and cancelled the morning of the surgery as his behavior was not consistent with a bad knee (lame sometimes, run like crazy others). Almost a year later, still lame off and on, my wife felt odd swelling on his leg bone. A new vet took more x-rays and found large lesions just above his ankle. We are lucky it did not affect his lungs, but it settled in his bones which seems painful. He has been on fluconazole for a couple of months and the masses on his leg are shrinking. He has not limped for a couple of weeks now, but I still have to carry him up and down the stairs because the weak leg could break and it would not heal. Treatment will take at least one year.

Arizona was on the top of our list for our next home. Not anymore.

Interesting to see this link about Bakersfield. I grew up there (15 years). I remember every year knowing people that got sick from it. It was kind of like the chicken pox where you'd just have to stay home for a week. From that perspective, this article feels completely blown out of proportion. But maybe we as locals all underestimated it.

Well that article makes you feel horrifyingly hopeless.

Somewhat related I've read that people who visit other countries for weeks at a time can also get all kinds of illnesses their immune system isn't familiar with, like Americans visiting Japan for a few weeks can catch all kinds of stomach viruses.

This is very common where I currently reside - Phoenix. It happens most often during dust storms, when soil is kicked up into the air. This is really terrifying though; I had no idea it was so serious.

My mom lives in Bakersfield and our family own a ranch in the valley (north of Bakersfield). My mom's neighbor had a bad case last year and she said most people know someone who has/had it.

Out where the ranches are, everything is dusty. Much more so than you see to the west in the Salinas valley or where I live (Paso/San Luis/Santa Maria). They built several prisons there years ago. It's pretty much the only lights you can see at night.

Looks like a hoax for me. Fungal infections are medically treated, even if your lungs are affected with, say, Candida after sharing some shisha in a dirty moroccan place.

There is utterly no epidemiological evidence that eating zest has anything to do with any kind of fungal infection.

Almost all fungal (few exceptions) infections are 100 % curable and treatable in most healthy individuals !!

Lethal fungal infections (such as Aspergillous and Mucormycosis - flesh eating fungus) are common in immune-comprimised individuals (Diabetics, HIV+ , Organ Transplant Recipients, etc) and very un-common in healthy individuals.

Come on, do you have any references or sources for any of these claims? That seems a very flimsy inference.

Do you have any more information about that?

I zest the peels often and enjoy a gin and tonic with lime, would buying organic or from a specific producer help avoid it? The cost should be minimal for these items.

Drinks at a bar would be using unwaxed lemons.

It's possible to buy organic unwaxed lemons, so people who worry about what's put on lemons and sealed in with wax can still enjoy zest.

For this post let's assume that all lemons are sprayed with pesticides and fungicides, and then they're waxed. And that the wax is removed by alcohol, allowing the pesticide and fungicide to come off into the drink.

A slice of lemon in a gin and tonic is going to give you a tiny dose. I'd be interested to see if there's any evidence that the pesticides and fungicides are doing any harm. (Especially in comparison to the alcohol.)

Any authoritative reference on the type of antifungals that are used? Do they inhibit fungi specific to citrus fruits or also fungi that infect humans?

>doesn't every place have its own local diseases and parasites?

Exactly. This whole article feels like the sort of ego piece you only get out of places like LA or NYC. Every place on earth has diseases and other medical problems caused by local environmental factors. To give it that a name like "valley fever" is to trivialize the fact that the exact same phenomenon occurs everywhere else in the world too.

>doesn't every place have its own local diseases and parasites???

You're right. I live in the mid-Atlantic region of the country. Two months ago, we went hiking in the woods and my wife and I forgot to check our three kids for ticks until the next day. My 4 year old son had two ticks on him. A week later, bulls-eye rash about 5 inches in diameter appeared on his back around one of the tick bites.

Three weeks of antibiotics later, he was fine but there are a lot of people that get Lyme's Disease without even knowing that they had a tick bite, or the rash that appears in the majority (but not all) is in their hairline so they don't see it. Untreated, it can have a lot of the same effects the article attributes to this fungal infection.

Where I grew up (Darwin, Australia), gardening can kill you with a flesh-eating bacteria.

http://en.wikipedia.org/wiki/Melioidosis

Luckily, it's treatable with very high doses of antibiotics. It mostly kills the already infirm or elderly.