Coccidioidomycosis (Valley Fever)


Cause: Fungus Coccidioides.

Illness and treatment: Symptoms can include fever, fatigue, cough, dyspnea, headache, night sweats, myalgias, and rash. Typical presentations are shortness of breath and pneumonia. Disseminated disease may also occur, with bones/joints, soft tissues, and meninges most commonly affected. Infection may be asymptomatic. Treatment is with antifungals.

Sources: Coccidioides sp. are environmental fungi that have been isolated from the soil in south-central Washington; cases are most common in the southwestern United States. Exposure is through inhalation of the organism, generally from dust or disturbed soil.

Prevention: There are no specific precautions.

Recent Washington trends: Since 2010, sixteen human cases of coccidioidomycosis with suspected exposure in Washington have been reported, all from south-central Washington. Animal cases with presumed in-state exposure have also been reported. C. immitis was found in soil from south-central Washington, including in Benton, Yakima, and Kittitas counties.

Purpose of Reporting and Surveillance

  • To track the emergence of Coccidioides in Washington.
  • To differentiate between infection acquired in Washington versus disease acquired outside of Washington.
  • To monitor trends in the epidemiology of disease due to Coccidioides.

Legal Reporting Requirements

Human or animal infections with Coccidioides are reportable in Washington State.

  • Health care providers and Health care facilities: Coccidioides infections notifiable to local health jurisdiction within 3 business days. 
  • Laboratories: notifiable to local health jurisdiction within 2 business days; submission required – isolate, within 2 business days; if no isolate available, on request specimen associated with a positive result, within 2 business days.
  • Veterinarians: animal cases notifiable to Washington State Department of Agriculture (see:
  • Local health jurisdictions: notifiable to the Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (OCDE) within 7 days of case investigation completion or summary information required within 21 days