UC Merced Magazine | Volume XIX, Issue V

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Each year, more than 20,000 cases are reported in the United States, but UC Merced researchers estimate the fungus is infecting more than 150,000 people. Many cases go undiagnosed because people don't seek to nd the cause of their illness. Most people who contract Valley fever don’t know they have it. “It presents like the everyday u,” said molecular and cell biology Professor Clarissa Nobile. And even its symptoms can be misleading — for example, nodules that form on the lungs can show up on an X-ray looking like lung cancer. O en, doctors will rule out other illnesses before concluding the patient has Valley fever — and during that time the fungal infection can spread. “It can take weeks, because there isn’t a de nitive diagnosis for it,” Nobile said. Her lab is working on diagnosing Valley fever. Speci cally, Nobile’s research is focused on identifying proteases, enzymes that cleave other proteins, that are produced by the Valley fever fungus when it infects the human body. Using this information, Nobile’s lab is developing uorescent reporter substrates, which would then light up when they are cleaved speci cally by the fungal proteases. “ e idea is you would take blood from a patient and run it through our kit, and you’d be able to de nitively diagnose within seconds,” she said. “ e work is still in the research and development phase. We’ve started designing our substrates; the next step is to test them.” Early detection can be crucial. Because Valley fever is a fungal infection, and there are only four major classes of antifungal drugs used to treat such infections, Nobile said, if the infection is resistant to one, there aren’t many others to choose from. And when it’s misdiagnosed, the treatment can actually make the patient sicker, explained immunology Professor Katrina Hoyer. If a doctor assumes that the respiratory problems a patient has are caused by something like pneumonia, antibiotics might be prescribed. ose do nothing to ght a fungal infection, and can cause rash, nausea, vomiting and diarrhea, and occasionally severe allergic reactions. And in the meantime, the fungal infection is not being treated,

and can spread systemwide. ough most people do clear the infection on their own without treatment, in some cases it can make a patient sick for six months to a year, and in others it can cause lifelong complications. Hoyer’s research is focused on understanding how the host responds to the fungus, and whether there is a way to predict if a patient will develop acute or chronic illness. “ en clinicians can use that information to inform treatment strategies,” Hoyer said. “Do they want to be aggressive, or take a watch-and-monitor approach?” e work Nobile, Hoyer and their fellow researchers are doing is only becoming more important, as Valley fever is outgrowing its name, and cases are spreading outside of the area where it’s typically seen due to climate change. ough the infection is not contagious from person to person, the conditions where it can thrive in the dust are becoming more prevalent. is also has led to an increase in awareness of Valley fever, and in turn of more funding from the National Institutes of Health. Hoyer, who moved to the area 11 years ago, said living in an area that’s impacted by Valley fever makes her work that much more personal. ough Kern County has the highest rate of infection in California, Merced County reported 81 cases in 2021, the most recent year data is available, according to the CDPH. “It’s relevant to my local community,” she said. “It has a direct impact on the people I’m friends with. “Everyone who grew up here has a family member or knows someone who has had Valley fever.”

Visitors tour the new BSL 3 lab.

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