Tucson teens work to save lives by spreading Valley fever awareness

In February 2023, my Uncle Clem spent a month in Tucson fixing up his new second home. He worked in the yard, watched plumbers trench a new line, hiked Sabino Canyon and cheered at the Tucson Rodeo. He flew home to Virginia healthy.

By March, he was tired, weak and losing weight, with a slight cough and aching muscles. His Virginia doctor diagnosed a urinary tract infection. Back in Tucson in May, he grew worse, with a stiff neck and hearing loss in one ear. Then he collapsed at home.

At the hospital, scans showed large masses in his lungs, and doctors suspected Stage 4 lung cancer. The biopsy came back negative. Only then did a doctor start him on fluconazole, an antifungal used when Valley fever is suspected.

By then, the infection had spread beyond his lungs and throughout his body. Uncle Clem died days later. A final biopsy found no cancer, only dead tissue where the fungus had grown.

Looking back, the signs were so clear: an older visitor to the desert, digging in the dirt, with an immune system weakened by cancer treatment years earlier. Yet over a three-month period, in two states, seeing multiple medical professionals, no one connected the dots.

A name to know, not to fear

Valley fever, or coccidioidomycosis, is caused by Coccidioides, a fungus that lives in desert soil. When construction, yard work, or wind disturbs that soil, spores float into the air and are inhaled. Most people have no symptoms, or only mild ones. However, in roughly 1% of cases, the fungus can spread to other areas of the body, a condition known as Disseminated Valley fever, which can be fatal.

It is important to note that some groups have a higher risk of developing Disseminated Valley fever, including older adults, women in the third trimester of pregnancy, people with diabetes, people who are Black or Filipino, and people who have other health conditions that weaken their immune system.

State health officials reported more than 14,600 cases in 2024, and the CDC estimates Valley fever causes 15 to 30% of community-acquired pneumonia in the Phoenix and Tucson areas. Yet testing lags. A recent study at Banner-University Medical Center Phoenix found that only about one-third of hospitalized pneumonia patients were tested for it.

Valley fever looks like the flu or an ordinary pneumonia. Unless someone thinks of it, no one orders the test.

That is especially true for visitors like my uncle. Symptoms usually appear one to three weeks after exposure, so many of the millions who visit Arizona each year are already home, where doctors rarely see the disease, before they feel sick.

What we're doing about it

That is why my friends Jeffrey Cai, Ryotaro Ishii and I, students at University High School, have spent the past year volunteering under Dr. John Galgiani, who founded and directs the University of Arizona Valley Fever Center for Excellence.

With a grant from the Valley Fever Americas Foundation, we designed and printed bookmarks listing symptoms, who is most at risk, and when to ask for a test. They were approved by and are being distributed through the Pima County Public Library system and Biosphere 2. We also developed a Valley fever awareness page for the Pima County Health Department.

We’ve met with other community leaders to discuss how to further share awareness about Valley fever with other key groups, including out-of-state students at the University of Arizona and winter visitors who come to stay seasonally.

We don’t want to spread fear or scare away tourists; rather, we want to get the word out. Above all, just knowing the name Valley fever makes all the difference.

What you can do

There may be a vaccine in the future, but it isn’t here yet, so knowing about Valley fever is your best defense. Accurate early diagnosis allows for precise management of the condition with established life-saving remedies, avoiding unnecessary tests and ineffective treatments. For Uncle Clem, that would have allowed him to start effective treatment when it could still have saved his life.

If you live in or have visited Southern Arizona and have a cough, fever or exhaustion that won’t go away or pneumonia that isn’t improving on antibiotics, ask your doctor: Could this be Valley fever?

Nov. 14-22 is Valley Fever Awareness Week, though awareness events are held all month long. Learn about it. Uncle Clem chose Tucson as his second home. One question, asked early enough, might have given him more time to enjoy it.