Moving to a Drier Climate to Improve Asthma? Look out for Valley Fever

One of the questions I get asked often in my work is “Will moving to another state help my asthma?” The answer is, maybe. When I moved to California from Washington, DC I was lucky that my asthma improved dramatically. Others may find their asthma and/or allergies get worse, or end up with new respiratory infections. Case in point, my colleague Joni.

Joni recently moved to the central valley of California from the mid-west. She said “I think I have asthma now and it stinks. My doctor doesn’t think it’s asthma, so my friends are helping me manage it with teas and the neti pot.”

Joni did not have lung function testing, but met with her doctor three times. Based on her symptoms, a recent move to the central valley and work taking water and soil samples, Joni’s doctor diagnosed her with valley fever.

So, what is valley fever and how does it impact asthma?

Valley fever is a fungal, respiratory infection caused by a fungus in arid desert soil called coccidioides (kok-sid-e-OY-deze), or cocci (kok-si) for short. This soil is found in southern Arizona, Nevada, New Mexico, Utah, northern Mexico, central and South America, and California’s central valley. These states are often where people with asthma move to in an effort to improve their disease.

How do you get valley fever?

When the soil containing the Cocci fungus is disturbed, the fungus becomes airborne and is breathed into our lungs. The soil becomes disturbed during wind storms and by farm or construction equipment. All-terrain vehicles or just walking across the soil can also disturb the fungus. Valley fever is not contagious.

What are the symptoms of valley fever?

Common symptoms mimic the flu; headaches, fever, chills, fatigue, cough and chest pain, but may also include a red, bumpy rash. These symptoms and the infection will normally go away on their own in a few months, according to the CDC. Anti-fungal medications can be prescribed to keep the infection from getting worse.

People with weakened immune systems (along with pregnant women and older adults) are at risk for the infection to worsen. Long term, chronic symptoms include low-grade fever, weight loss, cough, pneumonia , chest pain or nodules in the lungs. These nodules don’t typically cause problems but can look like cancer on an X-ray. In severe cases, the infection spreads beyond the lungs to other parts of your body, like the spine, liver and brain.

Not everyone will experience symptoms, and for some, the symptoms may be so mild they don’t seek medical attention. It’s common that you won’t even know you had valley fever until you have a positive skin or blood test.

How do I know if I have valley fever?

If you live or have traveled to any of the areas where Cocci is found or have symptoms, talk with your healthcare provider. Valley fever is often misdiagnosed but is easily diagnosed with a simple blood test, which is recommended over the skin test.

Valley fever and asthma.

This infection can worsen asthma, increasing symptoms and making them harder to treat. Additionally, chest tightness and cough caused by valley fever may be misdiagnosed as asthma. Only lung function testing such as spirometry can officially rule asthma out/in, or determine how severe your asthma is and which medications are best for you.

If you think you may have come in contact with Cocci or have valley fever symptoms, talk to your health care provider.