VALLEY FEVER CASES SURGE
November saw highest numbers in two years
The number of valley fever cases reported in Arizona last month reached the highest monthly total in more than two years. The Arizona Department of Health Services reported 926 cases in November — the highest since September 2015. The monthly surge means the total number of cases this year will likely eclipse the 2016 total of 6,101, though it will fall well short of the 2015 total of 7,622. “We did notice the spike in November cases but we are not sure why we saw that spike,” said Cara Christ, director of the Arizona Department of Health Services. What is valley fever?
Valley fever is caused by breathing airborne fungal spores, called Coccidioides, or cocci, found in Arizona soil.
Experts believe the disease is under-reported in Arizona, California’s Central Valley and in other states where the disease-triggering fungus spores exist.
Individuals with valley fever have flu-like symptoms such as fever, cough, fatigue, shortness of breath and rash. More people recover on their own, but some require more intense medical care. In some cases, the infection can spread beyond the lungs into other parts of the body.
In 2016, 705 people with valley fever were hospitalized at a cost of $55 million, according to the Arizona Department of Health Services’ annual report.
Arizona has had wide swings in the number of reported valley fever cases in past years because of a change in laboratory reporting and testing procedures, but Christ said there have been no reporting changes that influenced the number of cases this year.
Dr. John Galgiani, director of the University of Arizona’s Valley Fever Center for Excellence, said medical professionals need greater awareness of the risk factors for valley fever.
He cited a state health department study that found only a small percentage of people diagnosed with pneumonia are tested for valley fever.
Galgiani said doctors should nearly always orders tests for valley fever when patients show signs of pneumonia.
“Many doctors who practice in Maricopa County trained where the disease is rare,” said Galgiani, adding that doctors may never have learned about valley fever in medical school or in postgraduate training.
But the medical community will soon have another tool in their efforts to combat the disease.
A tool for earlier detection
A Utah company gained Food and Drug Administration clearance to sell a molecular-based test for the disease that backers say can quickly deliver results.
The company, DxNA LLC, developed the test based on technology licensed from Phoenix-based Translational Genomics Research Institute (TGen) and Northern Arizona University.
The company said the test can deliver accurate results more quickly that the existing laboratory test used to confirm valley fever. The lab tests involve growing a culture from a sample of mucus or blood.
DxNA CEO David Taus said his company’s test can deliver results within one hour; it can take a lab up to three weeks to complete the existing test.
“With this disease, early detection is critical to have a positive impact,” Taus said.
Labs and medical practices that use the test will need to purchase the company’s $16,000 instrument. Each test requires a cartridge, and the company would not disclose the cost of the testing cartridge. Private labs or doctors practices would set the price of the test for insurers and consumers.
Michael Saubolle, a clinical microbiologist with Sonora Quest, said the test has the potential to deliver results more quickly. He expects Sonora Quest could begin offering the DxNA test in early to mid-2018.
“There are a couple of components you have to look at,” Saubolle said. “What is the overall cost of getting the equipment? What will the cost be? You also have to look at what the reimbursement is. All of that is still up in the air.”
Sonora Quest already sells the blood test directly to consumers for $35. The lab recommends consumers order the test only if they have experienced symptoms for two weeks or longer.