Source: XL Group, Construction Insider, March 2014
The fungus that causes Valley Fever (coccidioidomycosis) is a found in the soil of dry, low rainfall areas. It is endemic (native and common) in many areas of the southwestern United States (See Figure A. below), Mexico, Central and South America. Valley Fever is a common cause of pneumonia in endemic areas. At least 30% – 60% of people who live in an endemic region are exposed to the fungus at some point during their lives. In most people the infection will go away on its own, but for people who develop severe infections or chronic pneumonia, medical treatment is necessary. Anyone can get valley fever, but people who live in California, New Mexico, and Arizona are at increased risk (see Figure A). Certain groups of people are at higher risk of developing severe respiratory problems. It is difficult to avoid exposure to the Coccidioides i. fungus, but people who are at higher risk should try to avoid breathing in large amounts of dust if they are in endemic areas.
Valley Fever is a potential source of worker’s comp claims, especially in Arizona and
California. The main source of exposure to Valley Fever on construction sites is disturbing the soils (e.g. grading cut/fill, drilling piers, etc.) but personnel can be exposed to the fungus during high wind events or from fungal spores transported
on dust from adjacent sites, e.g. agricultural activities.
Most people who are exposed to the fungus do not develop symptoms, or have very mild flu-like symptoms that go away on their own. Some people may develop a more severe infection, especially those who have a weakened immune system, are of African-American or Filipino descent or are pregnant in their third trimester.
Valley Fever Symptoms
Common symptoms of coccidioidomycosis include:
Symptoms of advanced coccidioidomycosis include:
Symptoms may appear between 1 and 3 weeks after exposure to the fungus. Some patients have reported having symptoms for 6 months or longer, especially if the infection is not diagnosed right away. If symptoms last for more than a week, it is recommended to contact a healthcare provider.
Treatment of Valley Fever
In many cases, treatment for coccidioidomycosis is not necessary, as symptoms can resolve on their own. Many healthcare providers still prefer to prescribe antifungal medications, such as fluconazole, to prevent a more severe infection from developing. It is especially important for people at risk for severe disease, such as people infected with HIV or those with weakened immune systems, to receive treatment as quickly as possible. It is extremely important for people with severe infections to be treated with antifungal medications because advanced coccidioidomycosis can be fatal if not treated.
Controlling/Monitoring Potential Exposures
The first step to protect personnel and avoid potential exposures is to have everyone on the project trained in the hazards related to Valley Fever, and the steps required to mitigate the hazards. This starts with a notification to project personnel of the hazard during orientation. Contractors using this approach, including the steps outlined below, have recently shared their process with Cal OSHA consultation, which has not offered any additions.