by An outbreak of Valley fever among attendees of an outdoor music festival in California’s Central Valley highlights the growing threat of the fungal infection.
There have been five confirmed cases among people who went to the Lightning in a Bottle festival in Bakersfield in May. Three of them were hospitalized.
“About a week after coming back from the festival, I was just hit with crazy body aches and a crazy fever,” said Eric Mattson, 33, a musician in San Luis Obispo, who said he attended the festival this year. . He tested positive for Valley fever last month.
His symptoms progressed to pain in the joint that made it difficult to move, accompanied by night sweats, Mattson said: “I would wake up, like, two or three times a night, sweating. I would have to change my bed and change my pajamas when I was in pain. It was pretty terrifying.”
The fungus that causes Valley fever, called coccidioides, thrives in hot, dry climates, so most cases are found in Arizona and California. But climate change is creating more opportunities for it to increase, and Valley fever cases are climbing in California as a result.
The state’s annual number of infections rose from less than 1,000 in 2000 to more than 9,000 in 2019. According to a recent report from the California Department of Public Health, there have been 5,370 suspected or confirmed cases so far this year. Department officials did not respond to questions about the escalation of cases.
In San Joaquin County, the total number of suspected and confirmed cases is already over 200 this year, compared to a total of 47 last year and 59 in 2022.
Valley fever does not spread from person to person – instead, the lung infection results from inhaling spores in dust or soil. The name is a reference to California’s San Joaquin Valley, where coccidioides was discovered.
The actual number of cases related to the music festival could be higher than the state’s account. Mattson said he has not been contacted by the health department, which has not released the names of the confirmed cases, so it is unclear if Mattson is included. NBC News reviewed the medical record showing his positive test result.
Mattson estimated he lost 20 pounds in four to five weeks.
He said he suspected Valley fever, since he had heard reports that some fesivalgoers had been infected in recent years, but he was initially diagnosed with pneumonia. Eventually, his primary care doctor ordered a blood test, which came back positive early last month.
Cases like Mattson’s are common, said Dr. Geetha Sivasubramanian, assistant clinical professor of medicine at UCSF Fresno: “Often, patients with Valley fever are misdiagnosed as bacterial pneumonia.”
That’s because many doctors aren’t aware of the illness or test for it too early or confuse it with another respiratory infection, she said. Such errors can lead patients to take antibiotics they do not need, rather than the appropriate antifungal medications.
About 60% of people with Valley fever have no symptoms, while others develop a cough, fatigue, fever, shortness of breath, night sweats, muscle aches, joint pain or a rash on the legs or upper body. People with diabetes or weakened immune systems or who are pregnant are at risk of serious lung infections. In very rare cases – around 1% – a lung infection could spread to the bones, joints or brain, which could be fatal.
A great location to spread Valley fever
Sivasubramanian said she was not surprised by the cluster of cases among more than 20,000 people presenting at a music festival.
“We live in a high endemic area for Valley fever, so anyone who comes to visit, who lives in these areas, is at risk,” she said.
In the Central Valley, heavy rain in winter helps the fungus to grow in the soil. Then, as the temperature gets warmer and the soil gets drier, the dust carries the spores into the air.
Activities that generate a lot of dust — such as construction or farming — increase the risk of exposure. In 2014, the Centers for Disease Control and Prevention linked five confirmed and five suspected cases of Valley fever to dry, dusty conditions on outdoor film sets.
Lightning in a Bottle seemed to be in the right place at the right time, said Dr. Arturo Casadevall, chair of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health.
“You need two things: You need a spore cloud, and you need people,” he said.
Mattson said the wind during the festival kicked up dust near some of the stages and on campus where many attendees stayed.
“When there are a lot of people dancing, it’s bound to get a lot of dust,” he said.
Valley fever may be spreading to new areas
As climate change encourages heavier rainfall and higher temperatures, it is fostering conditions that favor the coccidioides fungus. More frequent and more intense wildfires may carry spores to surrounding areas.
Outside of California and Arizona, a 2019 study estimated that Valley fever may already be endemic in some counties in 10 other states as far east as Kansas and Oklahoma.
“As the deserts expand, we will see situations outside of historical regions,” Casadevall said.
Some researchers also suspect that rodents could help spread the fungus as climate change alters their migration patterns, although others don’t think that’s common. A 2022 study found coccidioides among rodents in Kern County, where the Lightning in a Bottle festival is held.
Mattson said he doesn’t regret attending the festival but wants others in the area to be aware of the illness and its symptoms.
“You really need to recommend getting tested if you’ve been in the valley or if you’ve been in a place where there’s a lot of dust in the air,” he said.
This article was originally published on NBCNews.com
