Term Paper on “VALLEY FEVER

Course Name: POP-202

Course Title: Introduction to Public Health
Section: 01
Date of Submission: 07-09-2023

Submitted By:

Mahbub Hasan Ullas

ID:2021-2-80-027
Submitted To:

Mohammad Bellal Hossain

Professor Department of Population Sciences
Title: "Uncovering the Challenges and Solutions: A Comprehensive Analysis of
Valley Fever (Coccidioidomycosis)"

Introduction:
Coccidioidomycosis, colloquially known as Valley Fever. This is a fungal ailment
resulting from exposure to Coccidioides immitis. This often-overlooked disease
predominantly afflicts individuals in arid regions of western United States, with
California and Arizona being notable hotspots, where infection rates are steadily
increasing. The disease's clinical introduction changes broadly, extending from
asymptomatic cases to serious pneumonic conditions, and in a few occurrences, it
can spread, influencing differing body frameworks such as the brain, skin and
bones. Alarmingly, later estimates show a yearly frequency of up to 350,000 new
coccidioidomycosis case within the United States, underscoring the critical need
for the improvement of compelling immunizations and novel restorative drugs to
combat Coccidioides contaminations. 
Coccidioidomycosis, or Valley Fever, is mostly asymptomatic which is nearly 60%
but about a third develop pulmonary illness ,a leading cause of community-
acquired pneumonia in endemic areas. Rarely in o.5 to 2 % of cases it spreads to
extrapulmonary sites, mainly in immunocompromised individuals like transplant
recipients, HIV, pregnancy and African Americans, Filipinos. Diagnosis relies on
clinical suspicion and lab results. Prevention includes education, dust avoidance,
mask use, antifungal prophylaxis and testing because there is no vaccine available
right now.

Literature Review
1-Disease Overview:
Causative agent of Valley fevers are Coccidioides immitis, a soil-dwelling
fungus.Scientifically Valley Fever is a fungal infection caused by inhalation of
spores from the soil-dwelling fungi Coccidioides immitis.Primarily it was endemic
to the arid southwestern United States that includes Arizona and parts of Central
and South America. Valley Fever Presents as a respiratory illness and can range
mild to severe with symptoms like fever,cough,fatigue and chest pain.Some cases
it can lead to severe lung infection and even disseminate to other organs with
significant health risks.
Climate and Valley Fever:

The relationship between Valley Fever and climate components, especially

temperature and precipitation, has been a subject of intrigued within the scientific
community. The content highlights a few key discoveries from the consider:

1. Rainfall:
Research shows that higher rainfall, especially during winter and early spring, is
positively correlated with increased incidence of valley fever. This suggests that
wetter soil conditions may favor Coccidioides growth.

2. Temperature:
The analysis indicates that high temperatures, especially during the summer
months, are associated with a higher incidence of valley fever in the fall and
winter of the following year. High temperatures can increase fungal dispersal by
promoting the release of spores from the soil. 3. Palmer's Drought Severity Index
(PDSI):
PDSI, a measure of soil moisture, was also considered in the study. It showed that
dry soil conditions, expressed as a negative PDSI value, were associated with an
increased incidence of valley fever. This suggests that humidity plays an important
role in the life cycle of fungi.

2-Important review:

1. Data quality:
The text acknowledges concerns about the quality of incidence data because
reporting standards change over time. This can cause bias and affect the reliability
of the results. In addition, the lack of data on fungal numbers in soil or in the air
limits the ability to directly link climate changes to fungal activity.

2. Time considerations:
The study explores the lagged effects of climate changes on valley fever incidence,
recognizing the time lag between exposure to environmental conditions and the
onset of the disease. This approach makes sense because of the complex
pathogenesis of the disease.
3. Modeling strategy:
Utilizing numerous straight relapse models to foresee month to month impacts
based on climate factors could be a profitable explanatory strategy. In any case, the
generally tall base cruel square blunder (RMSE) values recommend that the
models may not completely clarify the complexity of the disease-climate
relationship.

4. Multidisciplinary investigate needs:

Valley fever is affected by numerous variables, counting climate, soil
characteristics, changes in arrive utilize, and human behavior. Future investigate
ought to consider a multidisciplinary approach that coordinating extra-climate
components to move forward prescient models. 3-Document outline:

The investigate displayed in this content is steady with existing investigate

emphasizing the significance of climate in valley fever the study of disease
transmission. This bolsters the finding that wetter conditions, regularly related with
El Niño occasions, can lead to expanded horribleness. In expansion, the think
about highlights the part of temperature, particularly extraordinary warm, in
advancing parasitic dispersal and contamination.
Be that as it may, impediments of the think about, such as issues with information
quality and the avoidance of short-term climate occasions, highlight the require for
assist investigate. Future inquires about ought to investigate the intuitive between
climate, soil dampness, arrive utilize alter, and financial variables in forming the
the study of disease transmission of valley fever. In rundown, Valley fever could be
a complex infection impacted by numerous variables, in which climate plays a
prominent part. In spite of the fact that the investigate displayed within the content
gives profitable data, a comprehensive understanding of Valley fever requires
intrigue inquire about endeavors to superior educate avoidance procedures.
anticipate and moderate this possibly unsafe malady.

 Method:

Problem:
Coccidioides fungus exposure may not cause symptoms in some people, while
others may experience symptoms that can resolve on their own in a few weeks to
months. If symptoms persist for over a week, it’s advisable to contact a healthcare
professional.
Valley Fever symptoms include fatigue, cough, fever, shortness of breath,
headache, night sweats, muscle aches, joint pain and occasionally a rash on the
upper body or legs. Fungal spores can enter the skin infection.
Symptoms of Valley fever typically appear 1 to 3 weeks after inhaling the fungal
spores and usually last for a few weeks to several month. However, in severe
Cases, symptoms may persist longer. Around 5 to 10% of individuals with Valley
Fever may develop serious lung problems and infection can spread narrowly in
some cases to the central nervous system, skin, bones, or joints.

Valley Fever is an infection that is caused by breathing in the fungus Coccidioides.

People and animals can get sick when they breathe in dust that contains the Valley
Fever fungus. Costs of diagnosis and initial treatment can be substantial, with
costs rapidly increasing for more severe infections requiring lifetime antifungal
treatment and recurrent hospitalization. Occasionally, the pulmonary infection
becomes chronic or the fungus spreads to other parts of the body, most typically to
the skin, bones, and brain disseminated infection, leading to significant morbidity
and economic burden. In 2019, there were 20,003 cases of Valley fever reported to
CDC these cases were in people who live in Arizona or California. This case is
highest among people age 60 and older.  The Highly endemic areas such as the
Phoenix and Tucson metropolitan areas of Arizona, Valley fever causes an
estimated 15% to nearly 30% of community-acquired pneumonias, but low testing
rates suggest that Valley fever is probably under-recognized.

Etiology:
Valley fever is a fungal infection caused by Coccidioides organisms. Two
Coccidioides fungi species cause valley fever includes Coccidioides imitis and
Coccidioides posadasii. These fungi are commonly found in soil in specific
regions, such as parts of Arizona, Nevada, Utah, New Mexico, California, Texas,
and Washington. The fungi's spores can be stirred into the air by anything that
disrupts the soil, such as farming, construction, and wind. People can then breathe
the fungi into their lungs. Environmental factors play a significant role in the
occurrence and distribution of Valley Fever. The spores can survive through heat
and drought, lingering in the soil. When the dirt is disturbed through construction,
wind or even walking — the spores can be lofted into the air. The Coccidioides
fungus breaks apart into microscopic reproductive parts (spores) that travel through
the air you breathe. They settle into the airways in your lungs where they grow into
larger clusters of more spores (spherules).
The spherules can break apart and send more spores out into other parts of your
lungs and sometimes other parts of your body. Those spores can grow into
spherules of more spores and keep spreading the fungus in your body. The spores
of the fungus can be stirred into the air by anything that disrupts the soil, such as
farming, construction, and wind. People can then breathe the fungi into their lungs.

Recommendations:
Valley Fever is often mild, with few or no symptoms. Signs and symptoms occur
one to three weeks after exposure and tend to be like flu symptoms. Symptoms can
range from minor to severe and include fever, cough, tiredness, shortness of breath,
headache, chills, night sweats, joint aches and muscle soreness, and a red spotty
rash mainly on lower legs but sometimes on the chest, arms and back.

Valley Fever is difficult to diagnose based on signs and symptoms alone because
they are usually vague and like those that occur in other illnesses. Even a chest X-
ray can't help doctors see the difference between Valley Fever and other forms of
lung infection such as pneumonia. To diagnose Valley Fever, doctors may order
one or more tests such as a sputum smear or culture to check for the presence of
Coccidioides organisms or blood tests to check for antibodies against the fungus.

Most people with acute Valley Fever don't require treatment. Still, doctors carefully
monitor people with Valley Fever. If symptoms don't improve or become worse or
if you're at increased risk of complications, your doctor may prescribe an
antifungal medication such as fluconazole. Antifungal medications are also used
for people with chronic or disseminated disease⁷.

There is currently no vaccine to prevent infection with Valley Fever. That’s why
knowing about Valley Fever is one of the most important ways to avoid delays in
diagnosis and treatment. People who have symptoms of Valley Fever and live in or
have visited an area where the fungus is in the environment should ask their doctor
to test them for Valley Fever.
The following are some common-sense methods that may be helpful to avoid
getting Valley fever. It’s important to know that although these steps are
recommended, they haven’t been proven to prevent Valley fever.

People who live in these areas can try to avoid spending time in dusty places as
much as possible. People who are at risk for severe Valley fever (such as people
who have weakened immune systems, pregnant women, people who have diabetes,
or people who are Black or Filipino) may be able to lower their chances of
developing the infection by trying to avoid breathing in the fungal spores. There is
no vaccine to prevent Valley fever.

Implementation:
1. Try to avoid areas with a lot of dust like construction or excavation sites. If you
can’t avoid these areas, wear an N95 respirator face mask while you’re there.

2. Stay inside during dust storms and close your windows.

3. Avoid activities that involve close contact to dirt or dust, including yard work,
gardening, and digging.

4. Use air filtration measures indoors.

5. Clean skin injuries well with soap and water to reduce the chances of developing
a skin infection, especially if the wound was exposed to dirt or dust.

6. Take preventive antifungal medication if your healthcare provider says you need
it.

Implementing recommended interventions in healthcare settings involves careful

planning, considering various factors like feasibility, acceptability, and
sustainability. The RE-AIM framework provides a structured approach to consider
these factors. Let's see each component of the framework in the context of
implementing interventions:

Target Population:
Recognize the population or understanding bunch that will advantage from the
intercession. Guarantee that the intercession is planned to reach and address their
special needs. For case, in case the mediation points to decrease childhood weight,
it ought to target children and their families.
Setting:
Decide where the intercession will be executed. It might be in a clinical setting,
community center, school, work environment, or online stage, depending on the
target populace and the nature of the mediation.
Staff:
Recognize the healthcare experts, teachers, or community laborers who will
provide the mediation. Guarantee that they are prepared and prepared to work with
the target populace viably.
Assets:
Apportion the fundamental assets, such as subsidizing, materials, and innovation,
to bolster the reach of the intercession to the planning group of onlookers.
Evidence-Based:
Guarantee that the intervention is based on sound logical prove and includes a
demonstrated impact on wellbeing results. Thorough assessment through clinical
trials or investigate thinks about is regularly fundamental to set up viability.
Result Measures:
Characterize clear and quantifiable result pointers that will survey the affect of the
intercession. This might incorporate changes in wellbeing status, behavior, or
information among the target populace.
Adequacy:
Evaluate the worthiness of the intercession to both the target populace and the staff
who will convey it. Consider their inclinations, convictions, and social standards to
guarantee the intercession is well-received.
Integration:
Decide how the mediation fits into existing healthcare frameworks or community
programs. Guarantee that it adjusts with the values and needs of the organizations
or communities where it'll be executed.
Achievability:
Assess the common sense of conveying the intercession. Consider variables like
time, assets, and coordinations. Make any fundamental alterations to streamline
usage.
Preparing and Back:
Give preparing and progressing back to the staff dependable for conveying the
mediation. Guarantee they have the vital abilities and assets to carry out their parts
viably.
Quality Confirmation:
Execute instruments for monitoring and keeping up the quality of the mediation
conveyance. Routinely survey constancy to the intercession convention and make
improvements as needed.
Supportability:
Create a arrange for maintaining the intercession over time. This may include
securing long-term subsidizing, joining the mediation into standard hones, and
guaranteeing staff progression.
Long-Term Affect:
Persistently survey the long-term affect of the mediation on the wellbeing results of
the target populace. Alter and progress as vital to preserve positive comes about.

In summary, actualizing prescribed intercessions in healthcare settings requires a

comprehensive approach that considers the RE-AIM system. By addressing reach,
adequacy, selection, execution, and support whereas too considering the target
populace, setting, staff, and assets, healthcare organizations can maximize the
success of their intercessions and eventually improve the health and well-being of
their communities.
 
Evaluation:
Those who already had Valley fever, your immune system will most likely protect
you from getting it again. Some people can have the infection come back again (a
relapse) after getting better the first time, but this is very rare.

Addressing the health problem of Valley Fever comes with several gaps and
challenges, which can be evaluated using the RE-AIM framework:

Challenges:

1. Constrained mindfulness and instruction around Valley Fever, particularly in

districts where it is less common, can ruin the reach of mediations. Numerous
people may not recognize the side effects or the require for preventive measures.
2. The viability of intercessions may shift depending on the populace and
geographic locale. What works in one range may not be as successful in another
due to contrasts in parasitic strain predominance and nearby natural conditions.
3. Healthcare suppliers in locales with moo Valley Fever predominance may have
constrained involvement in diagnosing and overseeing the malady, driving to
delays in conclusion and suitable treatment.
4. In a few regions, there may be challenges in getting to demonstrative testing and
antifungal drugs, which can lead to delays in treatment.
5. Supporting endeavors to address Valley Fever over the long term can be
challenging, particularly in locales where the illness is scattered and not reliably a
open wellbeing need.
6. Helpless populaces, such as low-income communities or those without get to to
healthcare, may confront incongruities in Valley Fever determination and
treatment.
7. There's a require for progressing investigate to superior get it the the study of
disease transmission, transmission, and clinical administration of Valley Fever,
especially in locales where it is less common.
Crevices:

1. There's a require for focused on open wellbeing campaigns and educational

programs to extend mindfulness approximately Valley Fever, its hazard
components, and preventive measures.
2. More inquire about is required to create region-specific mediations and
treatment rules to guarantee that they are viable in zones with changing levels of
Valley Fever predominance.
3. Preparing and instruction endeavors ought to target healthcare experts,
especially in non-endemic regions, to move forward the selection of best hones for
Valley Fever determination and treatment.
4. Guaranteeing the accessibility of demonstrative devices and antifungal solutions,
indeed in low-prevalence districts, is pivotal for compelling usage. Making strides
get to to these assets can diminish delays in determination and treatment.
5. Creating feasible financing instruments and joining Valley Fever avoidance and
treatment into schedule open wellbeing hones can offer assistance keep up
endeavors to address the illness.
6. Tending to wellbeing value issues is fundamental. Endeavors ought to center on
guaranteeing that all people, notwithstanding of their socio-economic status, have
get to to early conclusion and suitable treatment.
7. Proceeded venture in inquire about is basic to fill information crevices and
create more successful intercessions and treatment techniques.

Conclusion:

Valley Fever may be a parasitic infection caused by the Coccidioides organism that
can run from mild to extreme. It can be troublesome to analyze based on signs and
side effects alone and may require tests such as a sputum spread or culture or blood
tests. Most individuals with intense Valley Fever do not require treatment but
antifungal drugs may be endorsed for those at expanded chance of complications.
There's as of now no antibody to avoid contamination with Valley Fever. By
tending to the wellbeing issue of Valley Fever presents different challenges and
crevices, counting constrained mindfulness, territorial varieties in adequacy,
selection issues, get to to diagnostics and medicines, supportability concerns,
wellbeing value abberations, and the require for continuous investigate. Tending to
these challenges will require a multi-pronged approach including open wellbeing
instruction, healthcare supplier preparing, progressed get to to assets, and
maintained endeavors to prioritize Valley Fever as a open wellbeing concern.

References:
 Introduction:
1. Epidemiologic Reviews, Volume 41, Issue 1, 2019, Pages 145–157
Review of Coccidioidomycosis in California: Exploring the Intersection
of Land Use, Population Movement, and Climate Change | Epidemiologic
Reviews | Oxford Academic (oup.com)
2. Valley Fever (Coccidiomycosis) Awareness | CDC.
https://www.cdc.gov/fungal/features/valley-fever.html.

 Literature Review:
1. Modeling valley fever (coccidioidomycosis) incidence on the basis of
climate conditions, Korine N. Kolivras & Andrew C. Comrie
International Journal of Biometeorology volume 47, pages87–101
https://rdcu.be/dlpLp

 Method :
1. Clinical and Economic Burden of Valley Fever in Arizona: An Incidence-Based Cost-of-Illness
Analysis - PMC (nih.gov)
2. Valley Fever: Causes, Symptoms & Treatment (clevelandclinic.org)
3. Valley fever - Diagnosis & treatment - Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/valley-fever/diagnosis-
treatment/drc-20378765.
4. Valley Fever: Causes, Symptoms & Treatment - Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/17754-valley-fever.

5. Valley fever's deadly history - EARTH Magazine.

https://www.earthmagazine.org/article/valley-fevers-deadly-history.

6. Valley Fever in Dogs: Everything You Need to Know | PetMD.

https://www.petmd.com/dog/general-health/valley-fever-dogs-
everything-you-need-know