You’ve been sneezing, coughing and feeling wiped out for weeks. You assume it’s just allergies or maybe a late-season cold, so you wait it out. But what if the real cause is something most people outside the Southwest have never heard of?
Valley fever is a lung infection that often starts with symptoms that look a lot like other common illnesses. Many people assume they have allergies, a cold, COVID-19 or the flu. But when symptoms linger, worsen or just don’t feel right, it may be time to take a closer look.
Here’s how to tell the difference and when it’s important to see a doctor.
What is Valley fever?
Valley fever (also called coccidioidomycosis or “cocci”) happens when you inhale spores from the Coccidioides fungus. These tiny fungal spores live in the soils of parts of Arizona, California, New Mexico, Nevada, Texas and other areas of the Southwest. Spores can become airborne any time dirt or dust is stirred up by wind, construction, gardening, hiking or other outdoor activities.
Not everyone who breathes in the spores gets sick. Many people never show any symptoms. But when symptoms do appear, they can be easy to mistake for other illnesses.
Valley fever is not contagious from person to person. Most of the time, if you’ve had Valley fever once, you won’t get it again. If you have a compromised immune system, though, your original infection may recur or you could be reinfected.
Why is Valley fever often missed?
Valley fever is often mistaken for other illnesses because its symptoms are so similar to other respiratory illnesses like colds, the flu, COVID-19 or pneumonia.
According to John Galgiani, MD, an infectious disease physician with Banner - University Medicine, another reason it’s often missed is that many health care providers were trained or practiced in areas of the country where Valley fever doesn’t exist.
“Historically, not everyone thought to test for Valley fever because many providers grew up or were trained in places where they’ve never heard of it,” he said.
Experts also believe the actual number of Valley fever cases is much higher than reported because the blood test needed to diagnose Valley fever is not ordered.
Symptoms that may point to Valley fever
Symptoms usually develop one to three weeks after exposure but many people don’t recall a specific dust exposure.
Possible symptoms include:
- Cough that doesn’t go away
- Feeling very tired (fatigued)
- Fever or chills
- Chest pain
- Shortness of breath
- Headache
- Night sweats
- Muscle aches or joint pain
- A rash on the upper body or legs
- Symptoms that last longer than expected
You can see why this can be confusing. A cold causes coughing and stuffy noses. Allergies lead to sneezing and a runny nose. The flu causes fever and body aches. Valley fever can seem like any of these.
So what sets Valley fever apart?
Time is the biggest clue.
“Colds and mild flu usually go away in one to two weeks,” Dr. Galgiani said. “Allergies often follow seasonal patterns. Valley fever symptoms tend to last longer or get worse over several weeks, even if you rest, take allergy medicines or use over-the-counter (OTC) cold remedies.”
Other red flags:
- You recently spent time in a dusty area (construction site, hiking, yard work).
- You were in the Southwest and your symptoms haven’t gone away after several weeks.
- You have a fever and feel very tired, along with a long-lasting cough that has no clear cause.
- Your symptoms feel worse than a normal cold or keep coming back.
A quick guide: Valley fever vs. allergies vs. colds
Allergies are more likely when:
- You have sneezing, itchy eyes or a runny nose
- Symptoms come and go with pollen, dust and seasonal triggers
- Allergy medicine helps
A common cold is more likely when:
- You have a sore throat, congestion or a runny nose
- Symptoms improve within about a week
- Fever is mild or absent
- Other people around you are sick
Valley fever may be more likely when:
- A cough, fatigue or chest symptoms linger
- You have fever, night sweats, a rash or joint pain
- Your symptoms started after dust exposure, construction, yard work, hiking or a dust storm
- You recently traveled to Arizona or another part of the Southwest
- You have been treated for pneumonia but are not getting better
When should you talk to a doctor?
You don’t need to rush to urgent care or the ER but here are signs it’s time to get checked by a health care provider:
- Symptoms last more than one to two weeks with no improvement
- Fever won’t go away, especially when combined with a cough or fatigue
- Chest pain or shortness of breath that wasn’t there before
- Night sweats alongside other symptoms
- You visited Arizona or the Southwest and got sick shortly after your trip
- You’re in a higher-risk group, including adults over 60, people with weakened immune systems or those who are pregnant
If your doctor doesn’t mention Valley fever, feel free to ask about it. You can say, “I’ve had these symptoms for awhile and I want to check for Valley fever.”
A blood test can check for it. It usually takes a couple of days to get the results. This simple step can save you weeks or months of guesswork and save you from getting other tests or treatments for things you don’t have.
What happens if you test positive for Valley fever?
Many people with Valley fever get better on their own. “Most of the time, your immune system takes care of it,” Dr. Galgiani said.
If symptoms are worse, doctors might prescribe anti-fungal medicines like fluconazole. Most people recover well with treatment but the illness can last from weeks to months.
In rare cases, Valley fever can spread from the lungs to other parts of the body, leading to serious health problems. This is more common in people with weak immune systems, those over 60 or people with certain health conditions.
Talk with a health care provider who is familiar with Valley fever to help you with next steps.
Can you prevent Valley fever?
Where Valley fever is common, it’s not possible to completely avoid getting it. You can, however, take steps that might reduce your risk by:
- Staying indoors during dust storms
- Keeping windows closed during high winds
- Wet soil before digging or yardwork when possible
Bottom line
Valley fever can look like allergies, a cold, the flu or pneumonia at first. The key difference is what happens next. If your symptoms linger, worsen or include fever, fatigue, chest pain, shortness of breath, night sweats, a rash or joint pain, don’t assume it’s just a stubborn cold. Testing for Valley fever is very reasonable in these situations and should be an option.
If you live in or recently visited Arizona or another part of the Southwest, talk to your doctor or a Banner Health specialist. Ask if Valley fever testing is a good idea. Banner Urgent Care can also test for and diagnose Valley fever.
Frequently asked questions
How can I tell if I have Valley fever or allergies?
Allergies usually cause itchy eyes, sneezing and congestion without fever. Valley fever is more likely when cough, fatigue, fever, chest pain, night sweats, rash or joint pain linger or worsen.
Can Valley fever feel like a cold?
Yes. It can start with symptoms similar to a cold or flu, such as cough, fever, tiredness, headache and body aches.
How long do Valley fever symptoms last?
Symptoms can stick around for weeks or even months. If your symptoms persist or worsen, see a health care provider.
Can you get Valley fever from someone else?
No. Valley fever does not spread from person to person. It happens when you breathe in fungal spores from soil.
Should I ask my doctor about Valley fever testing?
Ask about the test if you have a lingering cough, tiredness, fever, chest pain or shortness of breath, especially if you live in or recently traveled to an area where Valley fever is common.
