All That Rain Is Driving Up Cases of a Deadly Fungal Disease in California

All That Rain Is Driving Up Cases of a Deadly Fungal Disease in California

What the spores really love is exactly the type of rain-drought cycle that California is caught in. Until last year’s series of drought-busting atmospheric rivers, California was in the throes of a long-term drought pattern; 2000 to 2021 was the driest two-decade stretch in the Southwest in 12 centuries. Climate models predict the Golden State will endure more droughts in the future. Rising global temperatures fuel dry conditions by sucking moisture out of the soil and depleting California’s water reserves. Meanwhile, the warmer atmosphere is also supercharging atmospheric rivers as they move from the tropics to the West Coast, causing the “rivers in the sky” to unleash more rain than they would on a planet untouched by human-made warming.

The oscillation between extreme dryness and extreme wetness causes Coccidioides to flourish. During rain events, flushes of fungi colonize the soil. As the ground dries out, the invisible spores can be lifted out of the soil by a bulldozer, a rake, a hiking boot, an earthquake, or even a strong gust of wind. When those flying spores land in soil, they begin to reproduce. If they’re sucked through an open mouth or nostril, they colonize the lungs.

The progression of the illness in humans depends on the strength of the individual’s immune system: The majority of people who contract valley fever—some 60 percent—will never know they crossed paths with killer spores, because their immune system is able to rapidly vanquish the fungal intruder. But quashing valley fever isn’t always a given, even for healthy individuals. The disease disproportionately impacts Latinos, Filipinos, Black people, Native Americans, and pregnant people for reasons researchers and physicians are still trying to puzzle out.

When it causes symptoms, valley fever starts with a fever, headache, or cough—similar to the symptoms of Covid-19, a disease it is often confused with. If the immune system can’t fight off the Coccidioides spores, the illness can move past its initial phase and become a chronic condition that produces a severe cough, chest pain, weight loss, pneumonia, and nodules in the lungs. This stage, known as disseminated valley fever, can also cause skin lesions and ulcers, swollen joints, meningitis—swelling of the membranes surrounding the spinal cord and brain—and even death. Between 1 and 5 percent of valley fever cases reach the disseminated stage. Antifungal medications can help hold valley fever at bay, but recovery ultimately depends on the individual’s immunological defenses. There is no cure for the disease, and approximately 200 people in the United States die from disseminated valley fever every year.

Researchers surveying for Coccidioides collect samples from rodent holes in the Carrizo Plain National Monument in Santa Margarita, California.

Photograph: Carolyn Van Houten/The Washington Post/Getty Images
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