Coccidioidomycosis in Texas: Valley fever must be reportable, recognized, and taught

IntroductIonCoccidioidomycosis, better known as Valley fever (VF), is a fungal infection caused by the soil-borne Coccidioides fungi (C.immitis and C. posadasii) and is contracted through inhalation of fungal spores released into the air when contaminated soil is disturbed.The reader is directed to other sources 1,2 for detailed information on clinical aspects of its diagnosis and treatment.This article highlights important issues in the public health and public policy aspects of this emerging infectious disease and its causative agents.Historically endemic to dryland regions of the Southwest United States, particularly California (VF named after California's San Joaquin Valley) and Arizona, the borders of Coccidioides' endemic region are expanding due to climate changes, increased soil exposure, and growing populations in these dry regions.Today, VF is also prevalent in other southwestern states, including Texas.However, unlike many of these newly endemic states, coccidioidomycosis is not recognized as a reportable disease in Texas other than in El Paso County, despite Valley fever's increasing presence.Unfortunately, this infection remains underdiagnosed, misdiagnosed for other respiratory illnesses, mistreated, and is barely present in medical education, and consequently some patients suffer delayed diagnoses, failed treatments, and even death.This situation makes Valley fever an urgent public health concern in Texas.Texas must mandate reporting, increase coccidioidomycosis train ing in medical and public health education, and equip medical providers with the appropriate tools to recognize and treat this growing infection.The Southwest Journal of Medicine 2025;13(57): 30-35 Making Valley fever a reportable disease in Texas, embedding it into medical and public health education, and improving occupational and public awareness of its occurrence and symptoms, especially in highincidence areas, are necessary first steps toward earlier detection, improved outcomes, stronger preparedness and healthier communities statewide.