A recent study indicates that awareness of Valley fever, or coccidioidomycosis, may not be keeping pace with its expanding geographic reach. Researchers surveyed 640 veterinarians across the United States and found significant knowledge gaps regarding this fungal infection that affects both animals and humans. This raises concerns about potential missed diagnoses, especially as the disease's distribution evolves beyond its traditional areas.
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Valley fever is caused by two soil-dwelling fungi, Coccidioides immitis and Coccidioides posadasii, and is typically contracted by inhaling airborne fungal spores. While historically associated with the southwestern U.S., changing climate conditions and activities like construction and agriculture are shifting its geographic distribution.
Conducted in June and July 2024, the survey targeted 45,240 Veterinary Information Network subscribers, with a response rate of 640 eligible veterinarians. Among those who completed the knowledge assessment, only 27% correctly identified both fungal species, and just 6% recognized all four states where human cases are documented. Awareness scores remained low, with median scores of 25% for veterinarians in endemic regions and 0% for those in nonendemic states. Diagnostic knowledge was better, with 86% identifying at least one appropriate serologic testing method, although only 8% correctly chose all relevant testing categories.
Interestingly, the survey revealed that veterinarians in nonendemic states also reported Valley fever cases, often linked to travel histories indicating prior exposure to endemic regions. Eight canine cases in these states underscored the importance of considering travel history when diagnosing respiratory or other unexplained clinical signs, as infections can manifest long after initial exposure.
The researchers stress that local transmission of Valley fever in nonendemic states has not been established, yet the findings highlight the need for veterinarians to maintain Valley fever on their differential diagnosis lists, with a focus on patient travel histories.
Additionally, the study suggests that dogs might serve as early warning signals for emerging cases of coccidioidomycosis in humans. Given their environmental exposure and behavior, canine infections could indicate changes in the distribution of the fungus. Past studies involving nearly 900,000 dogs over ten years have identified potential new endemic regions, creating opportunities for integrated public health surveillance.
The survey also points out that most veterinarians received Valley fever education primarily in veterinary school; about 63% learned about the disease only during training. The findings highlight a need for ongoing education, particularly as environmental conditions change.
The researchers noted limitations in the study, including a low response rate and reliance on self-reported information. However, the results emphasize the importance of accurate knowledge and proactive measures in veterinary practices regarding Valley fever, benefiting both animal and public health. The study was published in the Journal of the American Veterinary Medical Association.