It is a given that in the landscaping business you and/or your employees are going to disrupt the soil to get the job done.
What you may not be aware of is the inherent risk this creates if you are working in the southwestern United States. A spore known as Coccidioides lives in the soil and can be breathed in when dirt is moved. Around 60 percent of people who are exposed will never experience symptoms, but for those who do, the effects can be life-threatening.
The infection is called coccidioidomycosis but is better known as Valley fever and the Centers for Disease Control (CDC) has called it a “silent epidemic.”
What is Valley fever?
So, what is Valley fever exactly? It is a fungal infection caused by spores that thrive in soil where there is low rainfall, high summer temperatures and moderate winter temperatures.
Coccidioidomycosis was first discovered by a medical student in 1892 in Argentina, according to Clinical Infectious Diseases. Clinical investigations conducted in the San Joaquin Valley during the 1930s is where the disease gets its name from.
The geographic range for this fungus is mostly in the Southwest, with 70 percent of cases occurring in Arizona and nearly 30 percent in California.
However, it is suspected the range could be larger, as it has been found in Washington State as well. Spikes in incidences of Valley fever in Arizona and California in recent years are suspected to have been caused by favorable environmental factors such as precipitation following high temperatures and drought.
According to the University of Arizona Valley Fever Center for Excellence (VFCE), Valley fever is more prevalent during certain seasons. In Arizona, the highest number of infections occurs during June through July and October through November. In California, this period is from June to November.
Valley fever can affect people at any age, but adults 60 or older are particularly vulnerable, along with people who have weakened immune systems or diabetes. African American or Filipino individuals are also particularly susceptible, according to the CDC. The disease is not contagious.
In 2017, there were 14,364 cases of Valley fever reported to the CDC. Yet, it is suspected that this number is underestimated do to misdiagnosis. This is due to the fact that the disease’s initial symptoms can easily be mistaken for those of the flu, causing the doctor to prescribe antibiotics instead of antifungals to treat the problem.
The University of Arizona VFCE has been working on creating a clinical practice guide to help physicians detect and treat Valley fever earlier on.
The symptoms of Valley fever tend to appear between one and three weeks after breathing in the spores. They include fatigue, cough, fever, shortness of breath, headache, night sweats, muscle aches and a rash on the upper body or legs.
These symptoms can last anywhere from a few weeks to a few months. Nearly 75 percent of people miss work for about two weeks and 40 percent of those infected with Valley fever need to stay in the hospital.
Anywhere from five to 10 percent of the people who get Valley fever will develop serious or long-term issues in their lungs. In some rare cases, the disease can spread from the lungs to the central nervous system, which is known as coccidioidal meningitis. This form is fatal if left untreated.
On average, there are 200 Valley fever-related deaths every year.
How to treat it if infected?
If someone on your landscaping crew is experiencing Valley fever-related symptoms, they should seek medical attention. If the fungal disease is suspected, specialized tests can be conducted to confirm this.
Antifungal medication can be prescribed to prevent the symptoms from getting worse. Treatment tends to last three to six months.
Currently, there is no vaccine for Valley fever, but there have been ongoing efforts to make on since the 1960s. The VFCE is one organization that has been focused on research to speed the development for a vaccine in recent years.
How to prevent it?
When it comes to protecting your crews from Coccidioides, it can be a tricky business since most advice on preventing getting Valley fever is to avoid activities that stir up dust and dirt.
Although you can’t stop having to work in the dirt, you can minimize worker exposure. Check out the following best practices to follow.
Because there is no reliable way to test for the spores before working in a particular area, contact your local health department to determine the risk in your region.
Train your workers on endemic areas for Valley fever, how to recognize the symptoms and encourage them to report respiratory symptoms lasting for more than a week to a crew leader or supervisor.
One way you cut down on exposure is to suspend work during heavy wind or dust storms. When the soil is being disturbed by heavy equipment, wet the soil to keep dust levels down. Make sure vehicles working in dusty situations have enclosed, air-conditioned cabs. Cabs should be equipped with high efficiency particulate air filters.
When crews are digging a trench or other soil-disturbing tasks, strive to place them upwind when possible.
Ultimately, when exposure to dust is unavoidable, the best option is for crews to wear NIOSH-approved respiratory protection.
Another element to consider is preventing the transport of spores. It is important to clean tools, equipment and vehicles before driving them offsite so the spores won’t be inhaled at a later time.