Fellowship Story Showcase
Just One Breath: Valley Fever Science Catches Up with the News
A group of Southern California researchers tallied up every death certificate that mentioned valley fever over a nearly 20-year period. They found more than 3,000 deaths from the disease.
By William Heisel
Contributing Editor, ReportingonHealth.org
The study only covered trends through 2008, and Amaro has been working with reporters throughout California as part of the ReportingonHealth Collaborative to describe the more recent rise in valley fever cases. The collaborative found that cases of valley fever are increasing at a very rapid clip, that the disease causes a huge financial burden for patients and taxpayers and that policymakers and potential funders for a vaccine have mostly ignored the problem.
In addition to the study’s vintage, the researchers seemed to be saying things that the collaborative already had told readers many times over the course of the past two months in its Just One Breath series. Here are the first two lines in the teaser for the study:
Coccidioidomycosis is a fungal disease that is contracted by inhaling spores, which are carried in dust. Therefore, the disease, which typically affects the lungs, occurs most commonly in dry areas and in persons who work in dusty conditions (such as agricultural workers, ranchers, construction workers, military personnel, and archeological site workers, especially those located near deserts).
And, besides, there were other, much sexier studies in the same issue of Emerging Infectious Diseases, including one about the link between cows and MRSA.
But this is what happens when you master a topic or a beat in a short period. Amaro has been talking with scientists, public health officials, patients, and patient advocates since June. So when she saw the boringly titled, "Coccidioidomycosis-associated Deaths, United States, 1990–2008," she knew that there likely was something new and interesting to be found.
Indeed there was, but only for those paying attention.
Researchers know so little about valley fever that they can’t say with any precision how many people suffer and die from it every year. They generally agree that there likely are more than 150,000 cases of the disease, most of which go undiagnosed. As for deaths, they estimate about 100 annually. The Centers for Disease Control and Prevention has not even provided a death count since 2008.
But a group of Southern California researchers tallied up every death certificate that mentioned valley fever over a nearly 20-year period. And they found more than 3,000 deaths from the disease.
The study doesn’t say how many deaths this translates to annually. But do the math and you find that about 170 people on average die from valley fever. That’s 70% more than the number everyone uses, and it’s more than twice the number the CDC reported for most years between 2002 and 2008.
That death toll puts valley fever in a very elite category of infectious diseases. Of all the diseases tracked by the CDC, only AIDS, tuberculosis, and hepatitis cause more deaths annually. West Nile virus, influenza, salmonella poisoning, Lyme disease, hantavirus, even the scary disease of the moment – fungal meningitis – cause fewer deaths.
Cook and Plevin quickly called tracked down experts in valley fever and fungal diseases, sharing with them the study’s findings and asking smart questions. For a piece that ran this past weekend, they highlighted the chronic conditions that tend to complicate the disease and lead to more deaths.
Amaro wrote an accompanying story about the former mental health director for several California counties who died from a combination of valley fever and diabetes. And Cook and Plevin explained some of the questions that can’t be answered by the study.
For example, they wrote:
The research is limited by the fact that valley fever is often not diagnosed or misdiagnosed as another disease. Researchers noted in the study that the death certificates their data were drawn from "probably underreport causes of death and can contain errors."
"I think what we’re demonstrating is really the lower end of the reality,” said one of the study’s authors, Benjamin Bristow. "My guess is there are a lot more valley fever deaths and cases that we’re not finding in the data."
So, the next time a sleepy-sounding study lands on your desk, don’t assume there isn’t any news in there. If you’ve been doing your job, you may spot something that the scientists themselves didn’t see.
Photo Credit: The Modesto Bee / Jeff Jue, pictured, served as the director for the Mental Health Department in Merced, Sonoma, and San Francisco counties. He was considered a leader in social services by those familiar with his work before dying of valley fever at the age of 62 in 2005.