Pooja Gandhi/Centers for Disease Control and Prevention

Medical illustration of coccidioides, the fungus that causes Valley fever (coccidioidomycosis).

Through KJZZ’s Q&AZ reporting project, a listener asked: If you get Valley fever once, can you get it again?

The short answer is, most likely, no. Immunocompromised people are at more risk to get it again, but most people have immunity from Valley fever once they’ve had it.

Valley fever — also known as desert rheumatism, San Joaquin Valley fever and cocci — is a microscopic fungal infection prevalent in the American Southwest. But cases have also been documented in northwestern states like Washington, according to the Centers for Disease Control and Prevention.

"It’s that outlier on the map," said Jennifer Vanyo-Novak, medical director at Neighborhood Outreach Access to Health, known as NOAH. "It’s in the drier, more rural portion of Washington and actually Oregon, as well. And so there’s areas with more farmland, much like the areas of California and Arizona that are affected."

Valley fever affects about 150,000 people a year, and two-thirds of infections are contracted in Arizona, according to University of Arizona Health Sciences.

This fungal infection usually peaks around June through July and October through November in Arizona, according to University of Arizona College of Medicine Tucson Valley Fever Center for Excellence. People become infected by inhaling the spores that get kicked up from farming, construction, gardening or dust storms. Being outside near these environments does raise the likelihood of becoming infected.

Only about 40% of those infected show symptoms, Vanyo-Novak said. When symptoms develop, they usually manifest about seven to 28 days after exposure, according to UA.

"Oftentimes, people find out they’ve had Valley fever because they get a routine chest X-ray for something else, and they find out there’s a nodule," Vanyo-Novak said.

Common symptoms are fever, coughing that last for weeks, shortness of breath and fatigue. Headaches, night sweats, joint and muscle pain and upper-body rashes are also symptoms, according to the Centers for Disease Control and Prevention.

While most cases clear up on their own, some severe cases need antifungal medication, according to the CDC. Though rare, Valley fever can spread from the lungs to other parts of the body, called dissemination. The most common places are the skin, bones, joints and brain, according to UA.

"The few most common forms of disseminated, or outside-of-the-lung Valley fever, are cutaneous Valley fever where you get a rash that looks like really bad eczema or psoriasis — red, scaly, lumpy, bumpy. It doesn’t get better with all the cream," Vanyo-Novak said. "And then cocci meningitis. So, that’s when it actually gets into the brain fluid and around the spinal cord."

Vanyo-Novak said if cocci meningitis is identified early enough, it can be treated with life-long antifungal medication and therapy.

However, most people recover from Valley fever in a few weeks and develop immunity. A relapse is rare but can occur if a person’s immune system has changed.

"Certain groups of people, such as people who are immunocompromised, like they’re on medication that lowers their immune response," Vanyo-Novak said. "You see commercials for medications for rheumatoid arthritis or psoriasis where they always say, ‘if you live in an area where fungal infections are endemic,’ they’re referring to us."

Misdiagnosis is also another issue, as Valley fever’s symptoms can mimic other diseases, such as tuberculosis, chronic obstructive pulmonary disease or cancer. To combat this, chest X-rays and blood tests can be taken to determine if someone has Valley fever.

Valley fever is not contagious and cannot be transmitted from person to person, animal to person, or vice versa. So if your dog gets Valley fever, you will not get Valley fever from your furry friend. Dogs do make up the majority of domestic animals that contract Valley fever, according to the UA.

There is no vaccine for Valley fever, but Arizona Sens. Kyrsten Sinema and Mark Kelly have advocated for the development of a vaccine for dogs as a precursor. Meanwhile, people can take precautions, like avoiding areas that kick up dirt, i.e. construction sites, and wearing masks around such areas.