Editor's Note: The Illness We Never Saw Coming

A microscopic spore led to her wife’s unexpected illness. Working@Duke Editor Leanora Minai helps raise awareness of Valley Fever and Duke’s research to better understand and treat it

Leanora and Heather hiking in Scottsdale, Arizona.
Heather, at left, and I hike on Oct. 18, 2024, in Scottsdale McDowell Sonoran Preserve in Scottsdale, Arizona. I look at this photograph and wonder: was this the day she inhaled that fungus spore?

Have you heard of coccidioidomycosis?

I wish I had when I visited Scottsdale, Arizona, last year to hike, play golf and gaze at the stars in a certified Dark Sky Zone. Little did I know a wedding anniversary trip would land my wife, Heather, in a Florida emergency room a few weeks later.

She was first misdiagnosed with bacterial pneumonia, then returned to the ER a few weeks after that before finally being admitted for several nights just before Thanksgiving.

This all unfolded while I was working remotely from Florida for Duke, before we moved back to Durham earlier this year.

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Doctors eventually discovered the cause was a microscopic fungal spore Heather inhaled as we hiked side by side on a windy day in the McDowell Sonoran Preserve.

That particle, unearthed from the dusty desert soil, set off an illness that left Heather battling Valley Fever, or coccidioidomycosis, an infection found most often in Arizona and California.

Each year, roughly 20,000 cases of Valley Fever are reported to the Centers for Disease Control (CDC) in the United States, a figure expected to climb as climate shifts push the disease into new regions.

When Valley fever strikes, it can bring crushing fatigue, a relentless cough and fever. Some people develop chest pain and aching joints, and in certain cases, tender red bumps flare across the skin. Heather experienced all this.

Heather on a trail in the McDowell Sonoran Preserve.
Heather on a trail in the McDowell Sonoran Preserve.

In most cases, according to the Valley Fever Center for Excellence, the body fights it off, but Heather fell into the 5% to 10% who develop pneumonia with lung nodules and cavities.

Valley Fever is largely overlooked and little studied, which is why federally funded clinical research is so important.

Saved by Duke Research, the cover story for the October-November 2025 issue of Working@Duke, shows how Duke’s research is not only advancing medicine but also helping Duke employees when they need it most.

Dr. Susanna Naggie, Director of Infectious Diseases at the Duke Clinical Research Institute, with colleagues and collaborators, recently led an observational Valley Fever study in Arizona and California that enrolled nearly 500 patients with pneumonia. Testing confirmed a high prevalence of Valley Fever.

The study also showed wide variation in treatment, underscoring the need for clearer guidelines and earlier testing.

“Ultimately, the reason for research is to improve human health and to impact the outcomes for patients that we take care of,” Naggie told me. “Without research, frankly, we will not be able to take as good a care of patients, and ultimately patients will suffer from that.”

Heather’s diagnosis was delayed because few clinicians recognized what to look for.

I am grateful to the infectious disease doctors and researchers whose care and discoveries not only support Heather’s recovery but also expand the knowledge that will guide treatment for patients in the future.

I hope sharing Heather’s story helps others recognize Valley Fever sooner and remember that awareness and research together can save lives.

Leanora Minai serves as the Editor for Working@Duke and Executive Director of Communications in Duke Human Resource's Office of Communication Services. She may be reached at leanora.minai@duke.edu.