Arizona’s a Hotbed for Valley Fever

Mature spherule with endospores of Coccidioides immitis
August 02, 2014

Valley Fever can lay you low. Diamondbacks outfielder Conor Jackson missed most of the 2009 season because of valley fever – the same disease that weakened the bones of basketball pro and former Wildcat Loren Woods, resulting in injury and surgery.

Of the 150,000 people in the United States who are infected with the valley fever fungus each year, most are in Arizona. Many go undiagnosed because valley fever is not widely known and its initial symptoms can be minor, similar to the flu. Yet in 2007 the hospitalization costs for valley fever patients totaled $86 million, according to the Arizona Department of Health Services.

Promising drugs that could cure valley fever risk being abandoned (the FDA calls them orphan drugs) because they may not be sufficiently profitable given the relatively few number of infections compared to other world-wide diseases.

Now University of Arizona researchers have “adopted” one of these orphan drugs called nikkomycin Z – or Nik Z. They’ve raised more than $3 million and restarted clinical trials. A spinoff startup company, Valley Fever Solutions, Inc. has received nearly $4 million in NIH grants to continue the drug’s development with the goal of bringing the drug to market by 2017.

John N. Galgiani, M.D. directs the Valley Fever Center of Excellence at the Arizona Health Sciences Center. He said, “This is so intensely an Arizona problem. If we don’t do it, who would? It makes perfect sense that this center supports that drug.” There is no other valley fever center in the world. It was established by the Arizona Board of Regents in 1996.

“We think this drug has a profitable business model. Investors will profit from taking the risk of developing this drug,” Galgiani said. Nik Z could be the first drug to actually cure valley fever – not just control the symptoms. The center also is researching valley fever vaccines and better diagnostic tests.

The fungus that causes valley fever is endemic in semi-arid areas of the Southwest. It normally lives underground, but when soil is disturbed, the microscope spores called arthroconidia become airborne, carried by the wind. When inhaled by humans, animals and other creatures, the spores can infect the lungs and spread to joints, bones, even the spinal cord or brain. The scientific name is coccidioidomycosis.

For many people, the symptoms are mild. For those with compromised immune systems it can be deadly. Hoops star Woods underwent two surgeries requiring four screws and a plate in his back to stabilize damaged vertebrae suffered in a compression injury his junior year at the UA. Earlier he’d contracted valley fever, which had weakened his bones.

About a third of people infected, experience a pneumonia type of illness. Symptoms include coughing, severe fatigue, joint pain and rashes. Valley fever pneumonia is often misdiagnosed as a bacterial pneumonia or even lung cancer. It’s frequently treated with the “azole” family of antifungal drugs. Recent Arizona statistics indicate that those with new valley fever infections reported to the state miss an average of a month of work. Some will remain on medication for the rest of their life.

In addition to testing Nik Z, the promising valley fever cure, Galgiani’s center does substantial outreach to bring this disease to the attention of medical professionals and the general public living in the valley fever corridor spanning from Tucson to Phoenix.

“Knowledge is power,” Galgiani said. The center offers free for-credit courses for physicians and other health care professionals, as well as an on-line tutorial.

Public education and events include fund-raising walks, including the Tucson 2010 Walk for Valley Fever on Oct. 10 and the second-annual walk in Phoenix on Nov. 7, which last year attracted 280 participants, including 60 physicians. On January 11 a volunteer team called The Valley Fever Spores will participate in the PF Chang Rock ‘n’ Roll Marathon.

Funding for the center comes entirely from grants and charitable donations. A recent seed grant from the Critical Path Institute and BIO5 allowed the center to lay the foundation that attracted a $3 million from National Institutes of Health this spring, Galgiani said. The JT Tai & Company Foundation also has donated $1.2 million over the past four years.

To learn more about Valley Fever, to become a volunteer or donor, visit the website at http://www.vfce.arizona.edu or call (520) 626-6517.