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Valley fever, also called coccidioidomycosis, is an infection caused by the soil-dwelling fungus Coccidioides. The fungus is commonly found in the arid soil in the southwestern US and parts of Central and South America, as it is dependent on both weather patterns and soil composition for growth. It has also recently been found in south-central Washington. Humans and animals contract the infection by breathing the fungal spores from the air, often after disturbance of contaminated soil. In the US, highly endemic areas include southern Arizona and California’s southern San Joaquin Valley. Notably in Washington, 12 human cases with suspected exposure in Washington have been reported since 2010, all from south-central Washington.

Changes in healthcare have caused a shift of care to outpatient settings and specialized services. This has not lessened the complex needs of some patients, however. These individuals rely on frequent and intensive use of outpatient care to maintain and improve their health. They are vulnerable to infection from the increased frequency of invasive procedures, use of antibiotics, immunocompromise, age, and multiple co-morbidities, such as diabetes, advanced renal disease, and obesity, to name a few.

Lyme disease is rarely acquired in Washington state, and when it is acquired in-state, it is almost always west of the Cascades. If a healthcare provider suspects a person has been exposed to Lyme disease in an endemic area, such as the upper Midwest region, Eastern US, or the West Coast, or to an animal from these regions, the CDC currently recommends a two-tiered process for testing. Both can be done using the same blood sample.

Ticks are a frequent source of conversation and irritation during summer months in the Inland Northwest. In Washington state, ticks carry few diseases and reported cases are few, as compared to other states. In the Spokane-area, only three tick-borne diseases are rarely locally-acquired: tickborne relapsing fever, tularemia, and tick paralysis. However, other diseases are noted.

June 27 is National HIV Testing Day