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Valley Fever

Valley Fever . Edward Moreno, MD, MPH Director and Health Officer Fresno County Department of Public Health David Luchini, PHN Division Manager of Community Health Fresno County Department of Public Health. Overview. What causes Valley Fever What are the symptoms Should I get checked

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Valley Fever

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  1. Valley Fever Edward Moreno, MD, MPH Director and Health Officer Fresno County Department of Public Health David Luchini, PHN Division Manager of Community Health Fresno County Department of Public Health

  2. Overview • What causes Valley Fever • What are the symptoms • Should I get checked • Who gets it • What is being done about Valley Fever • Can I protect myself

  3. What causes Valley Fever • Cause • Coccidioides immitis is a mold that grows in the dirt during the wet season and spreads through the air during dry warm season • Exposure • People inhale the spores of the fungus

  4. What are the symptoms • Disease • Most people have no symptoms • 40% have flu symptoms including pneumonia • 1% have disseminated infection • Bones, skin and brain • Valley Fever is not contagious

  5. What are the symptoms • Treatment and recovery • Treatment is available • Most individuals recover over several weeks • Few develop chronic illness • Rarely leads to death • Lifelong immunity

  6. Should I get checked • Healthy individuals • No need to be checked • No vaccine or medicine to prevent valley fever • Individuals with symptoms • Tell health provider that you live in endemic area

  7. Who gets Valley Fever • Endemic regions • San Joaquin Valley • Sonora Desert • South America

  8. Who gets Valley Fever • Risk factors for severe or disseminated disease • Age, gender, race, chronic disease, prior exposure

  9. Valley Fever in Fresno County

  10. Coccidioidomycosis in S/W Fresno County Coalinga PVSP

  11. Coccidioidomycosis Cases and Incidence Rates in Fresno

  12. Total Cases of Coccidioidomycosis in Fresno County/Coalinga for the last 5 Years Year Fresno County Coalinga

  13. County, Coalinga and PVSP Coccidioidomycosis Total Cases by Year

  14. County, Coalinga and PVSP Coccidioidomycosis Incidence Rates by Year

  15. Outbreak Investigation • Several agencies involved • Fresno County Department of Public • California Department of Corrections and Rehabilitation • California Department of Public Health

  16. Investigation Findings • Clinical Epidemiology • 60% Pulmonary Disease • 7% Disseminated Disease • 24% Hospitalized • 4 Deaths

  17. Investigation Findings • Environmental considerations • Construction of facilities and housing • Wet winters followed by arid summers

  18. Investigation Findings • Health considerations • Growing population • Individuals with no prior exposure • Enhanced screening by physicians

  19. Department of Public Health Recommendations • Mitigate environmental factors • Relocate high risk inmates • Enhance surveillance and epidemiology • Continue vaccine research

  20. CDC Findings • MMWR February 13, 2009 • Increase in Valley Fever cases in CA • 2000-2006 Incidence rate tripled • Highest incidence rate in Kern County • Highest hospitalization rate among non-Hispanic blacks • 76% of California’s cases were reported from San Joaquin Valley

  21. CDC Findings • People at risk for severe or disseminated disease • Older persons • Pregnant women • Immunocompromised persons • African American • Filipino ancestry

  22. People living in endemic areas Avoid exposure to outdoor dust as much as possible Wet soil and use masks Close windows and use air conditioning People traveling to endemic areas Tell physician that you will visit or live in endemic area Learn about the disease Avoid exposure to outdoor dust Close windows and use air conditioning CDC Recommendations

  23. Thank You

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