I received this question yesterday, pertaining to a potential therapy dog.

Valley Fever, also known as coccidioidomycosis, is a fungal infection caused by Coccidioides immitis or Coccidioides posadasi. These fungi live in the soil and are most common in the southwestern US, northern Mexico, and parts of Central and South America. They are part of an unusual group of fungi called "dimorphic fungi," meaning they exist in two forms. One form in found in the environment (soil). This arthroconidial form is the infectious form. The other yeast-like form is present in the body tissues during infection, but is not (or at least is very minimally) transmissible.

Disease from Valley Fever is rare in healthy people.  These fungi are mainly a concern in people with compromised immune systems. When illness occurs, flu-like disease, respiratory disease, rash and joint pain are the most common signs, but disseminated infection (i.e. infection throughout the body) is a much more serious form of the disease that can occur.

Valley Fever is similar in dogs, with most dogs have mild to inapparent disease, and most sick dogs having vague signs and respiratory disease. Cats often develop skin lesion. Disseminated disease can also occur.

While coccidioidomycosis can occur in both humans and animals, the risk of transmission between humans and animals is extremely low. The fact that it occurs in both humans and animals is because both humans and animals get exposed to the same sources, not because they spread it between each other.

However, there is a slight risk that shouldn’t be ignored. There are two situations that are of concern.

• Bites: There is one report of a bite-associated infection in a veterinary technician. The risk of infection after a bite from an infected animal isn’t known, but anyone bitten by an infected animal should seek medical advice. Presumably, nothing would be done initially but there could be close monitoring for disease so that it can be treated early if problems develop.
• Veterinary procedures: Infection has been reported in a person performing a necropsy (autopsy) on an infected horse. It was thought that infectious endospores were aerosolized when an infected area was cut with a saw as part of the procedure, and inhalation of the fungus lead to disease.

There’s also a theoretical concern with handling bandage material from infected animals. While the active infection would be caused by the minimally infectious tissue form of the fungus, it’s possible that infectious arthroconidia could develop in a bandage.

People with infected pets have little about which to be concerned. The main risk (which is also very low) is infection from a bite from an animal with disseminated disease. Basic bite avoidance should minimize this risk, however medical care should be sought following any bite and people at high risk of serious infection (e.g. people with compromised immune systems) should take particular care when interacting with infected animals. If a pet owner has to change a bandage on an infected animal, they should wear gloves, double bag and immediately dispose of the bandage, avoid contamination of the environment during bandage changing and thoroughly wash their hands after completing the task.

Image: The infectious arthroconidia of Coccidioides immitis (source: CDC Public Health Image Library #476).