July 2025
Welcome to the Valley Fever Center for Excellence’s website. Here we try to provide reliable and timely information about coccidioidomycosis, the medical name for Valley fever.
Today, think about Valley fever not just as a major public health problem for parts of the Western United States. It certainly is that for Arizona, where over the past five years Valley fever has averaged 10,990 cases annually. It is the most frequently-reported reportable disease to the state’s department of health other than sexually transmitted diseases. Moreover, the economic impact to the state was $750 million1 in 2019 dollars. These statistics are likely a 10- to 18-fold underestimate according to a just-published analysis from the Centers for Disease Control and Prevention.2 As large as these numbers are, the impact of Valley fever on individual Arizonans or others who visit our state is far greater. Moreover, it has ongoing economic consequences for many aspects both personally and for the communities we live in. Here are some stakeholder groups impacted:
College and Professional Athletes
• Baseball. Valley fever was the reason Johnny Bench needed chest surgery in 1972. In 2009, the Arizona Diamondbacks’ Connor Jackson lost 30 pounds, slept 12 to 15 hours a day, and missed most of that season because of pneumonia due to Valley fever. Ike Davis contracted Valley fever in 2012, and it affected his performance for many months if not years.
• Basketball. Johnny Moore (Figure 1), while playing for the San Antonio Spurs, contracted Valley fever meningitis in 1986 which interrupted his career for three seasons. Loren Woods, while playing center for the University of Arizona, did not complete the NCAA Tournament in 2000 because he needed back surgery to manage his Valley fever infection. In 2013, Jermaine Marshall transferred from Penn State to Arizona State University to play guard. Shortly thereafter he was sidelined for a period of time because of Valley fever.
• Football. Sterling Lewis, after completing a successful college career at the University of Arizona, died of Valley fever in 2020 at age 32. Michael Bates, three decades after completing a successful collegiate and professional football career and winning a bronze medal in the 1992 Barcelona Summer Olympics, developed Valley fever in his back.
• Soccer. John Sternberg, in 2023, while playing for the Phoenix Rising, contracted Valley fever and was still recovering during the 2024 season.
• Golf. Gregory Kraft, who lived in Florida, competed in the PGA Tucson Open in 2002. Upon returning home, he developed an illness thought to be cancer, but surgical biopsies revealed that his illness was due to Valley fever. Shane Prante, a collegiate golfer and on his way to being a member of the PGA, in 2007 contracted Valley fever, lost 40 pounds, and was incapacitated for a significant period of time. Charlie Beljan in 2011, as he was trying to become a PGA member, developed Valley fever which eventually spread to his hand and required surgery for its management.
It would be reasonable to assume that athletes who compete outdoors might be at increased risk for Valley fever. In fact, a study conducted at the Valley Fever Center for Excellence demonstrated U of A scholarship athletes are diagnosed four times more frequently than other students.3 However, the same study showed the primary reason for this difference was that the athletes were tested five-fold more frequently. Thus, the impact of Valley fever on athletes is quite similar to everyone else.
Arizona Tourism
A study from the CDC identified patients diagnosed with Valley fever outside of its endemic regions and then examined the endemic regions to where those people had recently traveled (Figure 2).4 As shown, most infections diagnosed outside of the Valley fever endemic regions contracted their infections from travel to Arizona. For this reason, the CDC advises travelers to know about this risk.
While this is a significant problem for Arizona visitors, what should the state’s department of tourism tell people what the risk is for each individual visitor? To estimate this, a couple of statistics are useful. First, a 2010 study conducted by the Arizona Department of Health Services found the median years of residence in Arizona for people to contract Valley fever was 12 years,5 or approximately an annual risk of 5%. Second, the average length of stay for overnight visitors to Scottsdale, Arizona in 2023 was
5.1 days or 1.4% of a year. These figures lead to the estimate that only 7 out of every 10,000 visitors to Arizona will contract Valley fever. Thus, the risk to an individual tourist is small.
However, since Arizona annually has 45.7 million overnight visitors, the estimated total number of clinical illnesses exported from the state is 32,000. In my opinion, these estimates suggest that the Arizona Department of Tourism should acknowledge the risk of contracting Valley fever - just as it does for heat-related illnesses and snake bites - while at the same time emphasizing that the individual risk is small.
Real Estate
In “How to Know If You’ll Regret Moving to Arizona,” Money, Inc., listed nine reasons someone might regret moving to Arizona. Of those nine, No. 1 was Valley fever (Figure 3). This exemplifies the need to both manage information about Valley fever and support a program to actively do something about it.
The Valley Fever Center for Excellence is nearly 30 years old. During that time its physicians and scientists have built the plan to manage this disease. It starts with advocating for diagnosis as early as possible. Once diagnosed, infected people need to be provided with the best medical care possible. Now affiliated with Banner Health, the Valley Fever Center is developing the program to do just that. Finally, research into better diagnostics, curative therapies, and preventative vaccines will reduce the overall impact of Valley fever. The Valley Fever Center is doing that as well. There is no other center in the country that has been doing all of this for so long. The Valley Fever Center for Excellence needs the support from stakeholder groups, such as those listed here, to continue its work.
John Galgiani MD
Cited References:
1. Grizzle AJ, Wilson L, Nix DE, Galgiani JN. Clinical and Economic Burden of Valley Fever in Arizona: An Incidence-Based Cost-of-Illness Analysis. Open Forum Infect Dis. Feb 2021;8(2):ofaa623. doi:10.1093/ofid/ofaa623
2. Williams SL, Benedict K, Jackson BR, et al. Estimated Burden of Coccidioidomycosis. JAMA Network Open. 2025;8(6):e2513572–e2513572. doi:10.1001/jamanetworkopen.2025.13572
3. Stern NG, Galgiani JN. Coccidioidomycosis among scholarship athletes and other college students, Arizona, USA. Emerg Infect Dis. Feb 2010;16(2):321–3. doi:10.3201/eid1602.090918
4. Benedict K, Ireland M, Weinberg MP, et al. Enhanced Surveillance for Coccidioidomycosis, 14 US States, 2016. Emerg Infect Dis. Jul 2018;24(8):1444–1452. doi:10.3201/eid2408.171595
5. Tsang CA, Anderson SM, Imholte SB, et al. Enhanced surveillance of coccidioidomycosis, Arizona, USA, 2007-2008. Emerg Infect Dis. Nov 2010;16(11):1738–44. doi:10.3201/eid1611.100475