Rick Parker - Valley Fever

Rick Parker, a Southern California resident who was infected with valley fever while visiting the Mojave Desert, was misdiagnosed by doctors at least twice before they made an accurate diagnosis. 

Olivia Henry / Center for Health Journalism

Rick Parker knew he had valley fever, but his doctors wouldn’t test him.

The 48-year-old was prospecting gold in Mojave in 2013 when he inhaled some dirt. Not long after, he became fatigued, developed a cough, felt some lung pain and experienced chills.

The Phoenix native had heard all about valley fever while living in Arizona, where the disease infects thousands annually. But when he asked his doctors in Torrance to test him, they refused.

Emergency room doctors at Torrance Memorial Medical Center told him that nobody in Los Angeles develops valley fever and diagnosed him with tuberculosis. Then his general practitioner said he had pneumonia, then tuberculosis again. Parker said she was about to begin treating him for lung cancer when he locked himself in her office and demanded that she test him for valley fever.

“I knew what I had, and I wasn’t going to put up with a lung cancer misdiagnosis and have them remove a lung for no reason whatsoever,” Parker said. After his tests came back positive, his general practitioner called to apologize, he said, and admitted he was her first valley fever patient.

“It’s frustrating, and it’s even more frustrating when you know what you have and nobody will listen,” Parker said.

Parker faced one of the most challenging aspects associated with valley fever: a lack of awareness among physicians, the very people patients tend to trust the most.

Valley fever, or coccidioidomycosis, is caused when fungal spores common in the southwestern United States get released into the air and inhaled. Most people don't develop symptoms, but others come down with a fever, cough, extreme fatigue and a rash, among other symptoms. In rare cases, the fungal spore can spread to the bloodstream, infect other organs and cause cocci meningitis, leading to a lifetime of health issues and potentially death.

Cases have spiked recently, with infections in California last year reaching the highest number ever recorded.

All local doctors in California’s Central Valley and Arizona’s valley fever corridor, through Maricopa, Pinal and Pima counties, should recognize valley fever symptoms, public health officials say. But that’s challenging in a medically underserved region known for having a revolving door of new doctors. Once those doctors begin to understand the disease and become good at diagnosing it, they often relocate for new career opportunities, public health officials say.

Despite the high infection rate in Kern County and throughout Arizona, there’s no mandate that all new doctors undergo training on valley fever and how to diagnose it. There are no agreed-upon best practices for raising awareness among doctors. And it’s unclear whether medical professionals even know when valley fever cases are surging because counties have no uniform guidelines for when to declare an epidemic and are not equipped to disseminate the message effectively.

When cases spike, or when labs receive more requests for valley fever tests, the Kern County Public Health Services Department issues bulletins to hospital systems and health insurers. Whether they in turn notify other medical professionals is a mystery.

Health Net and Blue Shield in California — which insure roughly two-thirds of the Kern County market — did not respond to repeated requests for comment. Kaiser Permanente declined to comment for this story, providing only a prepared statement affirming its commitment to continuing physician education on relevant clinical issues, including infectious diseases such as valley fever.

House Majority Leader Kevin McCarthy, who formed a Congressional Valley Fever Task Force in 2013, said in an August interview that educating doctors in areas where the disease is endemic could lead to the greatest improvement in reducing the toll.

“Where do we go when we don’t feel good? The medical community,” McCarthy said. “They have to have the awareness programs to educate the medical doctors.”

When asked whether he would push for legislation that would mandate training for doctors new to areas where valley fever is endemic, he instead urged insurers to put pressure on health plans. Insurance networks, McCarthy said, need to do more to educate their doctors.

“A dream scenario would be every local physician being fully aware of valley fever as they’re incoming and new to our area, and that’s something we’re always working diligently on,” said Michelle Corson, a public relations officer for Kern County Public Health Services.

Dr. John Galgiani, director of University of Arizona’s Valley Fever Center for Excellence, recommends going even further, with regular briefings for doctors in endemic areas.

“Going to a course sounds good, but that information gets cataloged in the backs of doctors’ minds and doesn’t necessarily come bubbling up to the surface if the next patient in their clinic has valley fever,” he said.

Instead, repetition is key, Galgiani said.

“Changing practices requires constant and repetitive attention to staying on message and telling people this is important,” Galgiani said.

The Californian's Harold Pierce can be reached at hpierce@bakersfield.com or 661-395-7404. Follow him on Twitter: @RoldyPierce.

(3) comments

JDugan27

I live in Arizona and I contracted Valley Fever 3 years ago camping during a dust storm. I had all the symptoms. It started with a cough that got worse, then fever and night sweats with the worst headache ever. I couldn't turn my head. then I broke out in painful red lumps on my legs. you could feel heat rising off of them. I was diagnosed as having an allergic reaction. I was given steroids and antibiotics (which feed the fungus). when I told the Doctor I thought I had valley fever I was told no people rarely get that. A week later the bumps on my legs spread and every step was painful. I went back to the doctor and was given more steroids and stronger antibiotics. My cough got worse so I went to another Doctor and ones again said I thought I had valley fever. He said it was bronchitis and prescribed more antibiotics. At this point my legs are covered in inflamed raised painful red lumps. A week or so later on my way to work I felt stabbing pains in my chest. I could hardly breathe it just caused more shooting pain. I went to a nurse practitioner who suggested it was all in my head and I was having panic attacks. I started to question everything. I had been sick for over a month, close to two. I was so tired and in pain. I went to another Doctor and begged her to test me for Valley Fever. She thought I had Lyme's Disease because I had hiked in Iowa. She agreed to send out test for Valley Fever as well. it takes 8 to 10 days for VF test to come back. I could hardly walk from my couch to fridge my legs were in so much pain. Before 10 days was up I was told I didn't have Lyme's but I was so desperate for an answer she sent me to a Dermatologist. The dermatologist took one look at my legs and said ,"I don't need to ask you anything you have valley fever. I can tell from just looking at you." I had been sick for almost 3 months! I had been put through so much by doctors who dismissed me and all he had to do was look at me. My VF test was positive and I have scars on my lungs. When I asked my doctor about treatment she said oh your body will fight it off. Seriously?! I still could barely walk. I ended up taking Pau D'Arco a herbal medicine locals swear by and within 2 days my legs started to clear up. I went on anti candida diet and slowly gained back my energy. Doctors need to be educated. The wrong diagnosis and antibiotics/steroids which feed the fungus cause so much damage and worsen symptoms could be avoided. PS sorry this was so long.

JDugan27

I live

SMGB1

My mother has been suffering the last 2 years from Mucormycosis which closely resembles Valley Fever. It’s a fungal spore that is in soil, rotting wood and compost. It’s a rare fungal disease and seen mostly n the states where there are a large number of tornados and hurricanes but she was living in Bakersfield close to the new Westside Freeway was being built. The doctors dismissed it as bronchitis and continued to administer prednisone until she fell and an crest of her shoulder showed spots in her lungs. After a biopsy it was confirmed she had Pulmonary Mucormycosis, a rare fungal disease with a 90% mortality rate. If you’ve ever watched the TV show The Walking Dead and seen the zombies, this is what the fungus does to your body. She’s had a year of intravenous Amphotericin treatments and 2 years of oral Posaconazole medication. Her Infectious Disease Doctor Soe Soe Win at Kaiser said she is a medical miracle because when she first contracted the disease at age 80 she didn’t know if she would pull thru. There is nothing in the medical books about length of treatment but it’s usually 12 months because the patient is well or deceased. My mother has been treated for a little over 2 years and just recently was removed from her fungal meds because it’s pretty much gone. This is what you need to educate people on because this can happen anywhere.

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
PLEASE TURN OFF YOUR CAPS LOCK.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.