Coping with Valley Fever Information for Families

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Coping with Valley Fever Information for Families Valley Children s Healthcare & University of California, Merced 9300 Valley Children s Place Madera, CA 93636 Social Worker: Margie Arreguin-Zarate, LCSW Infectious Disease Doctor: Fouzia Naeem, MD Health Psychologist: Erin M. Gaab, PhD

What You Need to Know About Valley Fever What is Valley Fever? Valley fever is an infection caused by coccidioides, a fungus that grows in the soil of hot, dry climates that have little rain. Fungus grows naturally and is common in the Central San Joaquin Valley. People can be infected by breathing in the fungal spores, and it becomes more prevalent when wind blows the spores into the air or when dirt is moved for other reasons, like construction. Valley fever is not contagious and cannot spread from one person to another or animals.

Where is Valley Fever Most Prevalent? The southwestern United States Arizona, California s Central Valley, Nevada, New Mexico, Texas and Utah and parts of Mexico and Central and South America are hotbeds for Valley fever because of their natural climates. What Are the Signs of Valley Fever? Symptoms can include fever, cough, chest pain, headaches, muscle aches, tiredness, joint pain in the knees or ankles, or rashes on the torso, arms and legs. About 40 percent of people who come in contact with fungal spores will develop symptoms that may require medical treatment and will not go away on their own. Symptoms can appear 1-3 weeks after contact with fungal spores. These symptoms can last for a month or more, and the majority of people fully recover. Valley fever usually infects the lungs but it can spread outside of the lung and infect the brain, joints, bones, skin or other organs. This is called disseminated disease. It is rare but can be very serious and fatal if not treated. In severe cases, Valley fever can develop into chronic pneumonia (lung infection) or meningitis (spine or brain infection) or infect bones and joints. How is Valley Fever Diagnosed? Talk to your healthcare provider if you have symptoms. Your provider can order blood tests, chest x-rays or other tests to help diagnose Valley fever.

How is Valley Fever Treated? Many patients won t need medicine and will benefit from education and deconditioning therapy, but patients with symptoms and those with disseminated disease will need medicine. Antifungal oral medicine is used for mild to moderate disease, intravenous medicine for serious disease and in rare cases surgery may be needed. How Can I Prevent Valley Fever? It is difficult to avoid contact with the fungal spores, but people who live in endemic regions like the Central Valley should avoid dusty areas and activity on windy days, if possible. Stay indoors and close windows and doors during times of increased dusty winds. It can help to wear a mask when exposed to dusty winds while doing yard work, sports or other outdoor activities. When dust is unavoidable, the California Department of Public Health recommends NIOSH approved respiratory protection with filters rated as N95, N99, N100, P100 or HEPA. Can I Get Valley Fever More Than Once? Usually not. If you ve already had Valley fever, your immune system will most likely protect you from getting it again. Some people can relapse from the initial infection, but this is very rare.

Frequently Asked Questions About Valley Fever in Children? Is there a Cure for Valley Fever? No. Researchers in the U.S. are currently working on vaccines. How Long Are Children on Medication? It depends on the severity of the disease and your child s response to medication. Children with central nervous system involvement will stay on medications for life. Children with vertebral (spine) disease will stay on medications until they are adolescents (teens) or longer. Your doctor will let you know which medication is best for your child depending on the severity of their disease and how your child s body might react to medication. Will There Be Side Effects? This depends on the medication your child is taking. If your child is on fluconazole, please look out for hepatic dysfunction (rare liver problems) and dryness of lips. Please consult your doctor if you are unsure if these symptoms exist.

How Does Valley Fever Affect My Child s Development? How your child s body is affected depends where the disease starts. When the disease affects the central nervous system, the child s neurological system may be damaged by Valley fever. Does Valley Fever Affect My Child s Ability to Have Children or Pregnancy? This is still an unknown. The medication used to treat Valley fever, fluconazole, can affect the baby of pregnant women who take it. Children taking fluconazole should not get pregnant while on the medication and should follow safe sex practices. More information for sexual health can be found at cdc.gov/ sexualhealth. Valley fever in newborns is rare. Most babies who acquire it do so by inhaling the spores from the environment. The disease is not contagious person to person or from mother to newborn. Should My Child Move Out of the Area? This depends on the severity of the disease and many other factors. Please ask your doctor.

What if Medication Does Not Work? Symptoms should improve while your child is on medication, but if they do recur, please inform the doctor who tested your child for Valley fever. Also, if your child changes doctors, you should tell your new pediatrician about their Valley fever. Are There Different Types of Valley Fever? Yes. Valley fever affects different body systems in different patients. There are two different fungi that cause Valley fever, with the most common in California being coccidioides immitis. The fungus that causes infection in most places outside California is called coccidioides posadasii.

What Are the Long-Term Effects? Since we have not known about Valley fever for very long, we do not have information about the long-term effects of childhood Valley fever. Your continued participation in research projects like this one will help us help families in the future. Please continue reading this brochure for information about staying healthy, along with financial, transportation and other support resources. Online Resources: valleyfever.ucmerced.edu cdph.ca.gov/programs/cid/dcdc/pages/ Coccidioidomycosis.aspx cdc.gov/fungal/diseases/coccidioidomycosis/index.html

You Are Not Alone In This Valley fever can be scary, but you are not alone. There are other parents of children with Valley fever that understand what you are going through, and there are resources that can help you, your family and your child as you go through this together. Counseling Services: Valley Children s Healthcare Behavioral Health Services (559) 353-6735 Kern County Mental Health (661) 868-8300 Tulare Youth Services (559) 688-2043 Visalia Youth Services (559) 627-1490 Your social worker can give you information about other counseling resources if needed.

Resources for Families Physical Therapy: Delano Medical Therapy Unit (661) 725-6452 McKinley Medical Therapy Unit (661) 868-7270 Riverbend Medical Therapy Unit (559) 730-7762 Ronald McDonald House: (559) 447-6770 Open from 8 a.m. to 8 p.m. for day use while families are at Valley Children s Hospital or surrounding facilities. A food pantry, kitchen, meals, and even beds are available. Talk with your social worker about referring you. Financial Resources: There are programs that provide financial support for medical coverage for serious medical problems. Your child may be eligible for one of these programs. Supplemental Security Income (SSI): Children with the diagnosis of Valley fever may be eligible for SSI if their condition is disabling. Your social worker can give you information about how to apply or call 1-800-772-1213. Transportation Resources: Sometimes your child s insurance covers non-emergency medical transportation. If you have trouble getting to and from medical appointments, talk with your social worker, who can provide information about available transportation assistance, including limited financial help.

Resources for Families Continued Services in Kern, Kings and Tulare Counties: CommuteKern: (661) 832-7433 When two or more people commute in a car for work or other purposes, it s called a carpool. CommuteKern offers ridematching; it may be possible to get matched with a ride to Valley Children s. Kings Area Rural Transit (KART): (559) 584-0101 Kern Transit: 1-800-323-2396 Tulare County Area Transit (TCaT): 1-877-404-6473 Visalia Transit: (559) 713-4100

Support Services for Families: Coping with Valley fever is not easy. Many families haven t even heard of Valley fever until their children are diagnosed. Help is available. To access a social worker, please call: (559) 353-5270 Please feel free to add notes and questions for your doctor or social worker here: