Aug. 11: Promising New Drug Offers Treatment For Valley Fever Infections

Support for this podcast comes from the Central Valley Journalism Collaborative, connecting communities with the resources, infrastructure, and networks to ensure a vibrant local free press. From KVPR in Fresno, this is Central Valley Daily. It's Tuesday, August 11th. I'm Sarithauk. A promising new drug hopes to treat some of the most severe cases of Valley fever. is a totally different option for patients and could be a life-changer for them. We speak with a doctor helping research this new development and an over-the-counter method to diagnose the illness sooner. That conversation in just a moment, but first, these headlines. Fresno Mayor Jerry Dyer on Monday clarified why the city moved forward with a half-cent sales tax measure last week. It happened after state lawmakers pushed to put up a county sales tax on the November ballot. I don't want anybody in this city to see that as an opposing measure. They complement one complements the other. Dyer said he still supports the county tax, which is aimed at funding transportation projects. But a critical deadline was missed last Friday, so the city decided to put up its own tax on the ballot as a precaution. The measure has been opposed by members of the Fresno County Board of Supervisors. Some supervisors threatened legal action against the state after it stepped in to move the tax effort forward. The supervisors will meet today to decide on next steps. A year's long effort to bring new housing to downtown Fresno is one step closer to reality. KVPR's Israel Cardona Hernandez reports on a groundbreaking ceremony that took place on Monday. One, two, three. The park! The housing project is called The Park at South Stadium. It will soon provide more than 170 housing units in downtown Fresno. 70 will be affordable to lower income tenants. Fresno Mayor Jerry Dyer says the new housing will help make a quote, vibrant downtown. Why? Because we all know that great cities have great downtowns, and we are well on our way in Fresno to having a great downtown. He hopes the housing attracts young people in particular. Imagine watching a Grizzlies game or a concert from your own home. That is exactly the kind of urban living experience we have envisioned for downtown Fresno for many years. The project is worth more than $80 million. It should be completed by the summer of 2028. For KVPR News, I'm Israel Cardone-A-Landes.

A former nonprofit executive in Fresno will spend nearly three years in prison after she was convicted of stealing from her employer. Suliana Caldwell was the former operations manager at the Fresno Arts Council. Earlier this year, the nonprofit reported it was missing roughly $1.5 million in taxpayer funds. An investigation later found Caldwell had taken the money and spent it on vacations and other personal expenses. A man from Porterville was one of the pilots killed over the weekend in a helicopter crash in Utah. News reports say the man identified as Miles Elliott was helping fight a wildfire when the helicopter went down. Elliot was one of two pilots aboard, both died. The pilots were employed by a company that was contracted by the U.S. Forest Service. Congressman Vince Fong called Elliot a selfless servant. KVPR's $10,000 drawing is underway. Support KVPR by purchasing your $100 ticket for a chance to win the grand prize of $10,000. Only 800 tickets will be sold. Purchase tickets now at kvpr.org slash 10K. And now to our main story. In recent years, cases of valley fever have been climbing by the thousands in California and Arizona. Valley fever is an infection that can happen from breathing in fungal spores found in dry soil. The disease is considered endemic in arid and rural landscapes like the Central Valley. Symptoms can range from mild to severe and sometimes have lifelong impacts. But researchers are hopeful a new drug can help fight the world. worst cases. To find out more, I spoke to Dr. Fariba Donovan. She works at the Valley Fever Center for Excellence and is an associate professor of medicine at the University of Arizona College of Medicine. So usually when you inhale the spores, it takes about two to four weeks, the incubation period for people who get sick to develop this flu-like symptoms, cough, fever, chills, night sweats, extreme fatigue. Sometimes people develop rash. So it resembles to a lot of other respiratory symptoms, such as community-acquired pneumonia, which is bacterial pneumonia. So it's very hard to distinguish the initial presentation from other respiratory infections. And then I have to add this, that about 60% of people who get exposed to it, they never have any symptoms. So at what point is it that that can be distinguished? Because you said it gets to a point where it looks very similar to other illnesses. And you're talking specifically about... a fungal infection versus a bacterial infection too. So can you talk about the difference?

You know, generally speaking, patients go to their primary care physician to urgent care to emergency room and say, I have this cough that has been going on for several weeks now. And in these cases, usually patients have received a course or two courses of antibiotics and didn't respond, didn't get better. In that case, usually we tell our providers here in Arizona area or even in California, please, please, please consider. Valley fever as your second diagnosis, please test for the disease because in those cases we can eliminate a lot of morbidities that come with the misdiagnosis or delay diagnosis of patients. As you said, and as I just earlier said, this has overlapping symptoms that mimics a lot of other diseases. You know, if people have rash, they think they have allergic reaction to something, they go to dermatologist. So we send our flyers to our dermatology offices and say, please keep valid fevering your differential diagnosis and test the patients, which helps a lot of people to actually not have a delay in diagnosis, and hopefully we can prevent a lot of complication that comes with them. And you're actually working on a, essentially, a rapid test that might be able to find out that information even quicker. Is that right? Can you tell us more about what you're working on? Absolutely. And the rapid test actually was originally marketed by EMI company, which is based in Oklahoma. And that is a blood test. We tested that test that is... supposedly takes only 30 minutes. It's a great test because it's very rapid turnaround, has very high specificity, but the sensitivity didn't exactly pan out the way we wanted it to be. So we took that test and we wanted to actually improve it by using a different kind of antibody understrip. And now, hopefully this new test that we are working on can detect the antigen in the urine so it's non-invasive and it could be just like a pregnancy test that you put a dipstick in the urine and within 15 minutes you can read it either positive or negative now this may not be the only test that we do for a patient but at least it keeps us in the ballpark of okay this is positive so let's go and do some confirmatory blood test to confirm the diagnosis And when would this be available? Where are you on the research on that? Well, my goal is tomorrow morning, but I hope that soon. We are actually putting a proposal together to see if we can actually test this test here in real life to identify the sensitivity, to specificity, the real life performance of the test before it can be marketed. And now that, you know, we've talked about a way to test for it, there's also a treatment that we're also discussing today. It's a drug that's being researched right now called Allorophym. Can you talk about how that works and who is an ideal patient to receive it?

This is a fantastic medication. As you mentioned, olorophym is a medication that blocks a specific enzyme that blocks DNA and RNA synthesis in fungus. The studies in animal model actually proved that. Inhuman, we had a clinical trial that was just published. We enrolled 41 patients. Our center had the highest enrollment of 14 patients. These were people who truly had no other alternative option. They were extremely ill. Most of them, almost half of these people, as you see in the paper, had CNS involvement, meningitis form of the disease. And as you know, meningitis can be fatal if it doesn't get treated. And with current treatments that we have in the market is lifelong treatment. So having a medication that potentially could be used and eliminate the disease. And hopefully in very near future, we have enough data to say that it can be only given for a limited period of time is a totally different option for patients and could be a life changer for them. We are actually trying to expand this clinical trial. And then the second study that hopefully will be started enrolling very soon is a double-blind study with olorophym and the standard of care, whatever antifungal medication they are on, or a placebo with a standard of care. So I'm hoping that we can start enrollment in that study. And by having all these results, I'm hoping that FDA actually get satisfied with all the questions they had and we can get it approved to be in the market for everybody who needs it. Wow, that sounds like a lot of progress, a lot of trials you're still doing. It is not FDA approved at this point. What needs to be done before we might be able to see FDA approval? One of the trials that right now I'm enrolling, as I mentioned earlier, is acute valet fever meningitis. And the criteria for that trial is that patients only go on allotaphim. So by doing so, we can actually show that patient respond to the treatment. And hopefully, as the study goes on, we can show that patient did not develop all those complications. That would hopefully answer a lot of questions that maybe FDA has in next reviews. The next studies, they wanted us to compare and see that if we have the olorophym.

arm-to-arm comparing with the standard of care what happens in those cases. So hopefully with these two, we can satisfy all those questions for FDA. And my goal is that perhaps they will approve the medication. So as I said, if it is in the market, then all patients have access to it, not only patients who are in the clinical trial. Yeah, so much work ahead. And, you know, right now we are seeing some of the hottest and driest conditions so far this year. What do we need to know to protect ourselves from potential infection from valley fever? Great question. You know, patients always ask me, should I not come out? Should I not do activity? Well, you know, this is in air. So, say, in our area, you could walk. walk out your dog and you could expose to it. So really be cautious when it is a storm, when it is dust storm, maybe wear a mask. And beyond that, you really have to monitor for symptoms. If you have a cough, a cold, a fever or chills that for some particular reason doesn't want to go away and is lingering around, it's unusual. You never had that before. Just ask your doctor. And I always tell my patients, just ask your doctor, could you please test me for valley fever? Now, again, going back to the testing of the disease, the blood tests we have right now in the market is not the most sensitive test. So if it is negative and you do have the symptom, I don't say you don't have valuable. I say maybe my test was not sensitive enough. Let's just repeat that test for now. Let's see if we can repeat it, we can increase the yield of the diagnosis. Well, lots of great advice. Dr. Fariba Donovan, Associate Professor of Medicine, College of Medicine, the University of Arizona, and Valley Fever Center for Excellence. Thank you so much for taking the time to speak to us. Thank you, and I truly appreciate efforts you make to raise awareness for this very important disease that has been forgotten for many years. And that's today's show. Today's episode was produced by Jonathan Linden and KVPR. I'm Sarith Hawke. Find the latest local news anytime at kvpr.org.

The fatal shooting of a teenager at a protest in Seattle has gone unsolved for six years. This is open in your face. How are there no answers? Our investigation has uncovered new evidence and witnesses who say they've never talked to police. Did police ever call you? Not once. Listen to We Keep Us Safe, a new true crime series on the Embedded podcast from NPR.