Some people are at greater risk to develop Cocci than others. Learn more about the risks for Cocci as well as the factors that increase the risk for severe disease.

Who is at Risk for Coccidioidomycosis?

Who is most at risk of contracting Coccidioidomycosis (Cocci)? Everyone who lives in the endemic area is at risk. But some people are more exposed to disturbed soil because of their jobs or hobbies. In the endemic area, people with a higher occupational risk include those shown in Figure 1.

Figure 1. People who live in or travel to the endemic area who are at higher risk of contracting Cocci

construction worker

Construction workers

farm worker


military personel

Military personnel





correction officer

Officers in correctional facilities

In addition, certain activities and hobbies are associated with increased risk, as shown in Figure 2.

Figure 2. Activities associated with increased risk of Cocci.

horseback riding

Horseback riding



mountian bike

Mountain biking


Dirt bike riding, or use of off-road vehicles

Other factors that increase the Cocci risk include increased time spent in the endemic area, particularly during the hottest and driest times of the year (seasonality).

Valley Fever Outbreaks

Outbreaks of Valley Fever can occur. Most of these cases are associated with environmental exposures such as

Natural Events

  • Wind storms
  • Earthquakes
  • Wildfires

Man-made Events

  • Large-scale construction projects
  • Excavation projects

These outbreaks can occur in the endemic area, but up to a third can be in new areas that were not recognized as endemic.

Key Term:

Outbreak is an occurrence of disease cases in excess of what is normally expected.

Who is at risk for severe or disseminated Cocci?

Some people have a harder time fighting off the fungus. Often, these people have immune systems that are not working well or they were exposed to a large quantity of Cocci. People at greater risk for getting very sick from Valley Fever or developing disseminated Cocci are listed in the Table.

Table. Groups of people who are at high risk for severe or disseminated Cocci

People exposed to a large quantity of Cocci (e.g., during an archaeologic dig or laboratory accident)
People who are Black or Filipino
Pregnant individuals (particularly when infected during the late stage of pregnancy). Pregnant individuals who get infected with Cocci require expert care.
People with diabetes
People with weakened immune systems who have:

  • Cancer
  • Human immunodeficiency (HIV) infection
  • Had an organ transplant
  • Taken medications that suppress the immune system (drugs used to manage conditions such as psoriasis, rheumatoid arthritis, and ulcerative colitis).

Frequently Asked Questions

There are some steps everyone can take to reduce their exposure to Cocci

  • Avoid dusty places where Valley Fever is common
  • Stay inside with windows and doors closed during dust storms
  • If driving, keep car windows closed and use recirculating air, if possible
  • Avoid yard work and digging if you are at risk for severe or disseminated Cocci
  • Cover dirty areas with ground cover to reduce dusty, open areas
  • If you can’t avoid dusty areas, wear a N95 respirator or other type of face mask*
  • If you have to dig
    • Stay upwind
    • Wear a mask
    • Wet the soil
    • Change your clothes as soon as possible and wash them

*While N95 masks are recommended, recent recommendations include any available covering to reduce inhaled dust and possible spores.

Some clinicians consider providing preventative antifungal therapy for patients who are at very high risk for severe Cocci disease (e.g., patients undergoing organ transplantation in the endemic area who don’t have active Cocci). If you are in a very high-risk group, you may want to discuss this with your healthcare provider.

Yes, animals can get Valley Fever. The majority of Valley Fever cases in animals occur in dogs. But other animals, such as horses, can get Valley Fever. For more on management of Valley Fever in dogs, see guidance from the Valley Fever Center for Excellence.

More often than not, once you are exposed to Cocci, you will develop life-long immunity and will be protected from developing the symptoms again. However, some people whose immune systems are weakened by cancer or certain medications can have their symptoms return.