Science Friday - Valley Fever, Citizen Science Month Finale. April 24, 2020, Part 1

Episode Date: April 24, 2020

When you think of fungal infections, you might think athlete’s foot or maybe ringworm—itchy, irritating reactions on the skin. But other fungal diseases can cause much more serious illness. One of them is Valley Fever, caused by the soil fungus Coccidioides. In 2018, over 15,000 people were diagnosed with coccidioidomycosis, commonly known as Valley Fever, in the United States, mainly in the American West, and in parts of Mexico, and Central and South America. But the numbers could be much higher: The disease is commonly misdiagnosed and the hot spots are difficult to pin down. Plus, the endemic region could grow with climate change.  Science Friday digital producer Lauren Young takes us into the Central Valley in California—a Valley Fever hot spot—to learn more about how the disease spreads and the people it harms. She tells the story in a new feature on Methods, from Science Friday, using video, sound, and pictures, gives you a flavor of the challenges faced by scientists working to solve big problems.  Ira brings on Valley Public Radio reporter Kerry Klein, who helped us report this story, to tell us more about the communities Valley Fever is impacting and new treatments. He also talks with UCSF microbiologist Anita Sil to dig deep into fungal pathogens and the latest research.  This year’s Citizen Science Month may be winding down at the end of April, but you can help researchers collect and analyze their data all year long.  This week, citizen science platform Zooniverse has not one, but four projects you can help with: data analysis tasks that will hopefully calm, soothe, distract, and divert you from life in a pandemic. Whether it’s identifying cute raccoons in camera trap photos, looking for seasonal wind on Mars, identifying how antibiotics kills tuberculosis in petri dishes, or even transcribing the cursive of old letters from anti-slavery activists—Zooniverse wants to help you find diversion in data. Ira talks about these projects—and how to get involved with Zooniverse—with co-lead Laura Trouille, vice president of citizen science at Chicago’s Adler Planetarium. Learn more about Zooniverse and other SciFri Citizen Science Month partners at sciencefriday.com/citizenscience. And join our citizen science newsletter for all the latest updates on our online events here! Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Ira Plato. This hour, we'll talk about an illness called Valley Fever that is caused by breathing in a soil fungus. We'll hear from patients and talk about the latest treatments. But first, we learned this week that the first death from coronavirus in the U.S. happened on February 6th. This is a big deal because before now, we thought the first death was three weeks later on February 29th. So what does this changed coronavirus timeline mean? Here to talk about that and other short stories in science. As Annalie Newitz, journalist and author based in San Francisco. Welcome back, Annali. Hey, thanks for having me.

Let's jump right into this story about a shifted coronavirus timeline in the U.S. There were two people who died before February 29th. Tell us about this. What's going on here? So this new timeline starts in Santa Clara, California, that is a city kind of in the Silicon Valley area. And what we know is that both of these deaths were originally chalked up to some kind of influenza, but a medical examiner, an intrepid medical examiner, decided to send a couple tissue samples off to the CDC.

And when we found out that indeed it was coronavirus, it completely changes our picture of how the disease was spreading, because these two people do not appear to have any connection to travelers, nor had they traveled. So it seems like these are examples of community spread. And so it means the virus was around longer than we thought, right? Much longer than we thought, potentially, and also spreading within the community. So this is not something where, you know, people were coming in from outside. So that suggests that, yeah, it had been spreading in Santa Clara County for quite a while. So why is it that we are just finding out now that the people died of coronavirus before our first

official death? So part of it is just that we didn't realize at the time. You know, doctors assumed it was something else. They thought it was flu. They thought these people were just sick with some kind of respiratory illness. And it's really only now that the CDC has been able to analyze those tissues from the patients who died and figure out that indeed it was coronavirus. So there just haven't been enough testing kits available. And particularly at that point in the timeline, people just weren't being tested for the coronavirus. And so there was just no way for medical officials to figure it out immediately.

Now, your next story is about this drug combination that President Trump had said repeatedly could be a game changer for treating coronavirus, hydrochloroquine, and xithromycin. But this week, a panel of experts put together by the government, said people should not take this. Why not? What did they find? So they found that not only is that drug combination not particularly helpful in dealing with a coronavirus, but it also can cause coronary problems, coronary failure. And what that means is that if you have any kinds of heart problems, taking this drug could actually cause major, major issues. And so who were the health experts on this panel. So this was a very diverse group of folks put together by the National

Institutes of Health, and they range from medical professionals, medical doctors who are working on the ground to professors, and they're from all over the country. You know, I know I'm going to be sorry for asking this question, but I have to ask it. And that is, do we have any idea why Trump has been so gung-ho about this combination? You know, I think this is just an example of, It's not just Trump who's doing this. You know, anytime we see a paper, a scientific paper that suggests that maybe certain drugs might turn out to be the miracle cure, it's hard not to run around like your hair is on fire saying, here it is.

We figured it out. And Trump or one of Trump's people had read a paper that suggested that this combination of drugs might be a good antiviral and just ran with it without doing any kind of checking. And so I think this is just a lesson for all of us as we're kind of sitting at home. going through social media, to really take everything you read about miracle cures with a grain of salt and wait to see, you know, what experts say before you start ordering it online. Yeah. Let's move on to a country case study. And that country I'm talking about is Singapore where the coronavirus seemed to be under control for months. But now there are reports that

cases have doubled. What's going on there? That's right. So Singapore was a huge, really shining model of flattening the curve. You know, the country had maintained a really low level of the virus. They had not had to close down their schools. They'd kept most of their businesses open. And they were doing things like just temperature checks to get into public places. And suddenly, they had this outbreak and her having to reconsider and start thinking about shelter in place. And where did these new infections come from? So this is what's interesting. The infections are coming from immigrant workers and from immigrant neighborhoods.

So not just necessarily people coming in from outside, but people who are just part of ethnic minorities who are living in the country, often doing construction work and other kinds of things. And what happened was these were people who just weren't really on the radar of place. police and government agencies who were doing things like contact tracing to try to get people to quarantine themselves if they've been exposed to the virus. None of these people were being alerted if they had come into contact with the virus. It doesn't seem like they were being tracked at all. And so this is a bit of a reflection of what we've seen in the United States where certain groups like African Americans and immigrant communities are not getting the same level of

medical attention as white people and more wealthy communities. And so in Singapore, it's a strict class divide here that we're seeing. And people who were working class or immigrants just were outside the medical system. And now it's really come back to, you know, cause a big problem. And I think the lesson here is that when you're tracking this virus and when you're providing medical attention, you have to provide it equally to everyone, you know, otherwise everyone will get sick. And that's what they did at least initially to damp down that curve, right? They did a whole bunch of stuff like contact tracing and all kinds of things to make sure that that curve went down. That's right. But contact tracing only works if you're tracing everyone. So details, details.

Yeah, exactly. So it's great if you're, you know, tracking only rich people, well, then you're going to get an incredibly incomplete picture of how the virus is spreading in your actual community, which is comprised of everyone who lives there, not just the wealthy. Okay, let's shift gears to a technology story. New research says there might be a reliable way to tell if you're talking to a human or a bot online. So this was specifically looking at bots on Twitter. This is a study that was done on a chunk of Twitter data that researchers at the University of Southern California have, and it shows an enormous number, millions of social interactions on Twitter. And I love this story because it reminds me of that scene in Blade Runner where Decker is trying to figure out if someone is a replicant and is

asking them a series of questions and getting them more and more nervous. And essentially, that's what these researchers did. They looked at how human beings interacted when they had a conversation and compared it with a human being interacting with what was clearly a bot. And so the first thing they did was actually figure out, how do humans interact? Like, what's a natural way that humans interact? And they discovered that when two people get into a conversation, and most of these conversations from Twitter that they were looking at were political. So it was people kind of getting into debates or discussions about the election. And so they found that people would, when they got excited about a conversation, they would start

sending texts to each other more and more frequently. So you would see kind of a bunching up of texts. And then as they got less interested, they would send those texts less and less and less frequently. And they would become shorter and shorter. But when a person was interacting with a bot, say the bot came around and was like, Hillary Clinton sucks, because this was the 2016 election, that bot would not have that same bunching up of excited back and forth messages. It would keep sending messages at exactly the same intervals. And the messages would stay almost exactly the same length. And so one way that these researchers suggest that you can identify a bot is if it keeps

sending you messages at regular intervals, even though you're in a conversation with them, and all of the messages, even the very last message they send, stays the same length. So beware of entities on Twitter that send you. perfectly similar length messages. Let's talk about your last stories about the unusual composition of a comet that could be seen from Earth last August, a really unusual comet. What did NASA reveal this week? So comet Borosov was spotted late last year, and as it zoomed past Earth and past our sun, scientists were able to catch a whiff of the gas coming off of it, and what they realized on looking at that gas is that this comet is coming from outside of our solar system.

So this is our second interstellar visitor in just a few years. We also had Umuamua, if you remember, which was an interstellar rock that kind of zoomed through this solar system really fast and we barely got a glimpse of it before it left. But this time with Borisov, we actually got to see what it was made of. And so it was really unusual because it had a very high content of carbon monoxide in it. That's right. And so this is what gave them the clue of where it might have come from, because it's very unusual for comets in our solar system to have such a high amount of carbon monoxide. I mean, obviously we haven't examined every single comment, so it's possible that that's more common than we realize. But knowing that it was made of carbon

monoxide allowed them to speculate that it was probably formed around a red dwarf star, because these stars are a little cooler. And so comets who are forming close to the star could conceivably be made of a gas that cools at that rate close to a star. So it's very unusual to see in a solar system like ours with a really hot sun, but in a cooler solar system

where planets and other bodies can get closer to the sun, you're going to see more bodies made of carbon monoxide. The other possibility is it came from a planet that had a ton of carbon monoxide. monoxide in its atmosphere and got bonked by another celestial body and a chunk of it flew off and then eventually made it into our solar system. So that itself would also be interesting because it would tell us that in other solar systems, there's planets that have tons of carbon monoxide, even if they don't have cars that are belting carbon monoxide into their atmosphere.

Love it, Annalie. I always love talking Starstuff with you. Annalie Newitt's science journalist and author based in San Francisco. Thanks for taking time. had to be with us today. Yeah, thanks for having me. You're welcome. After the break, we'll talk about Valley Fever, an illness that affects tens of thousands of people in the western part of the United States. We'll talk about the latest treatments and research. Stay with us. We'll be right back after this short break. This is Science Friday. I'm Ira Flato. When you think of fungal infections, you might think athletes' foot or maybe ringworm, itchy, irritating stuff on the skin. But other fungal diseases can cause much more serious illness. Consider valley fever caused by

fungi in the soil. In 2018, over 15,000 people were diagnosed with valley fever in the U.S., mainly in the West, cases in Latin America, too. And the numbers could grow with climate change. The Central Valley in California is a valley fever hotspot. Science Friday digital producer Lauren Young took her microphone or camera and recorders and went to California to capture the stories of the scientists and victims to learn more about how the disease spreads and the people at harms. She tells the story in our methods project, which using video, sound, and pictures gives you a flavor of the challenges faced by scientists working to solve big problems. And you can watch the videos and read about her trip at ScienceFriday.com slash valley fever.

And Lauren is here to tell us more. Hi, Lauren. Welcome. Hey, Ira, good to be here. Tell me about the interest. What got you interested in the first place in the story? I grew up just outside of Fresno, which is pretty much smack dab in the middle of the San Joaquin Valley Valley. It's one of the major hotspots for Valley Fever and where the disease actually got its common name. But when I moved out here to New York, I realized a lot of people didn't know about Valley Fever. I first found out about it from my mom. She had gotten it when she was just a teenager. Many of my relatives, relatives worked on farms and fields throughout the Central Valley. And so one summer she had been working on her uncle's farm in Madeira and she'd been packing dried red onions. And she was just breathing in this dust flying out from unloading bin after bin of onions. And after a week of that, she started to feel not so well. And so here's how she described it. At first I thought maybe I was catching a cold, but it was like hard to breathe. And when I would take in a breath, I could hear, you know, the wheezing part. And then, you know, I was really, you know, really, really tired. And I was going, this is not my norm. And I didn't know what it was. That was your mom, Pam, out in California. How is she doing now? She's doing well now. She's totally healthy. She got treated in time and recovered. But we also got so many listeners who just called in in our box pop app to share their stories. I was affected by Valley Fever when I was four and five years old, 1945 to 1950. When I was living in Tucson 20 years ago, I contracted Coxidiomycosis.

In 1982, when we lived in Bakersfield, they went ahead and ran a blood test, and yep, I had Valley fever. My husband, Dusty, has Valley fever. He was diagnosed in 2017. Late last year, my 83-year-old brother showed some kind of shadow, some kind of scarring in her lungs. I was really lucky. All I had was a severe chest cold, but it felt like there was an anvil on my chest.

After more tests, including a biopsy, they found that what she had was a scar that resulted from valley fever. It disseminated to his brain, and he has had four or five strokes, and we moved to North Carolina so his dad can help me take care of him. There was a lot of new construction and dust in my neighborhood. I think that made it easier for the agent to get into people's lungs. I was told to get out of the valley, so my grandmother and I went up to a family cabin in Yosemite and spent the summer-dash winter there. She lives in a northwest suburb of Phoenix. Many of her friends have been in the past diagnosed with badly fever. It seems to be endemic to that region.

It's an illness not very many people know about, but it can really have lasting effects. That was David, Marilyn from Boulder, Sue and Missouri, Rebecca from North Carolina, and Guillermo talking about his mom in Phoenix. Now tell me, are those typical symptoms of valley fever? Yeah, so the symptoms and outcomes of this disease can vary drastically from case to case. Some people just get a cough or a fever, some never recover, and some die from this disease. And scientists and doctors are really trying to figure out why this is happening. So I spoke to some of those researchers and to Art Charles, a patient in Bakersfield, California,

who's had Valley Fever turn his life upside down. I used to be pretty athletic. I played basketball at Foothillow High School, won a state championship. Growing up, Arthur Charles lived and breathed sports. But today, Arthur, who goes by art, is winded after just 30 minutes of talking. If I talk a long time, it just like,

it just kind of just takes it out of you. Art is a major league baseball recruiter in the city of Bakersfield in the Central Valley of California. When he first got sick, the doctors assumed it was pneumonia. This was two years ago, well before the coronavirus took over our lives. He had been on a morning walk with his wife when he started to feel unwell. Then over a few days, he became short of breath, dizzy, nauseous, and extremely exhausted. I didn't have a drop of energy at all.

I've never felt so weak and so beat in my life. At first, doctors gave him antibiotics, but that didn't work because Art didn't have a bacterial infection. Eventually, they figured out he had valley fever, a disease caused by a fungus called coxidiotics, or coxie, for short. Coxie grows in the soil of dusty dry regions in the southwest United States, Mexico, and Central and South America. To become infected, all you have to do is breathe. There are thousands of new infections in the United States every year. Arts family has been hit three times. Most people get flu-like symptoms and recover on their own.

But for about 40% of people, valley fever can progress into a more serious pneumonia-like condition, often misdiagnosed. If you catch it in time, you can usually treat it with antifungals and recover, like Art's son, who was infected in 2008. But then, there are the 5 to 10% of cases, like Art, who develop chronic valley fever, where the fungus just keeps growing back. And in an even smaller percent, about 1% of cases, the fungus can be deadly. That's what happened to Art's older sister. Deborah, who got sick when Art was in the sixth grade. When they figured it out, it was too late. It had pretty much taken over her whole body.

She lost her eyesight, and her weight dropped from 165 pounds to less than 80. So to watch her go from being vibrant and beautiful and as strong as ever to almost being an infant again was tough. Deborah was only in her late 20s when she passed away from the disease. Researchers have found that some people are more at risk of this deadly version of valley fever. Women in late-stage pregnancy, immunocompromise people, and some racial minorities, including African-Americans, like Art, his son, and sister. Scientists are trying to figure out why this is happening. Why do some people do just fine with this infection? They're able to control it. They don't even know they were infected.

That's Katrina Hoyer. She's an immunologist and professor at the University of California, Merced. What is different about the immune response in the people that get severe disease? And what is wrong with that immune response? Can we manipulate it? Okay. In Katrina's lab, there's a mini-fridge-sized incubator filled with petri dishes of coxidioidious fungus. But yeah, this is the coxie. Katrina's graduate student and deep shows me a plate covered with white puffy fungus. When you grow coxie, the best sign of it is the fact that you get these kind of like

fuzzy, cottony strands is what the field calls it. So they grow in the soil in these long, string-like forms that then break apart into little spores. They get airborne. And when they enter the lung, they form these spheres that grow and then eventually rupture. And so they provide this unique challenge to the immune system. It's a war. The immune system versus the fungus. And Katrina's watching out for misbehaving immune cells.

She's been narrowing in on one kind, the regulatory T cells, cells that help put the brakes on the immune system. And what it looks like is that patients that will go on to have chronic or more persistent infection, they have a higher frequency of these regulatory cells. More regulatory T cells could be dampening the immune response, allowing the fungus to run amok. Other labs have looked at different types of T cells that attack invaders. Like in 2018, doctors at UCLA,

were treating a four-year-old boy with severe valley fever that was causing painful skin lesions, and they noticed his T-cells were acting strangely. Instead of gearing up to fight a fungal invader, like Coxie, they were targeting another kind of invader, a worm or a tick. But using a new combination of drugs and proteins, the doctors actually managed to redirect the boy's cells to fight the fungus, and over the course of six weeks, his condition greatly improved. His lesions vanished.

For now, this treatment has only been tried in one patient. There are more clinical trials expected in the future, but Valley fever patients like art still have to wait for a proven cure. And in the meantime, clinicians may want to be prepared. Katrina and fellow scientists say the fungus is spreading. The past three years we've had record years for infections. Part of it is with climate change, the endemic region is expected to grow. If aerotype environments spread with climate change, valley fever territory could too. According to researchers at UC Irvine, it could spread well into the Midwest by the end of the century.

So while Valley Fever is well known in hotspots like the Central Valley, where Katrina works, it might soon be affecting many more of us. Until I moved here and interacted with this community, I hadn't talked to anybody who had ever been infected with Valley Fever or was aware of the infection. So it is definitely a regional issue, but it is a growing problem. For now, Art keeps taking his medication. an antifungal called fluconazol. It can be brutal on the body, dry skin, exhaustion.

He might be taking it for the rest of his life. But he isn't giving up. He's still running around Bakersfield as a baseball recruiter and organizing activities at the local rec center. In January, he had his first grandchild, and earlier this week, he celebrated his 50th birthday. So when it comes to Valley Fever, he's optimistic. I'm a fighter, so it's not going to get me.

It's just going to be a battle. So if I go out, I'm going to go out swinging, that's for sure. For Science Friday, I'm Lauren Young. That's a report by Science Friday digital producer, Lauren Young, for our Method series. Lauren, what else can we find in your method story? Yeah, so you can listen to more of art's story with Valley Fever and see snapshots of his life in Bakersfield. You can also go into UC Merced's fungal room and see what that fuzzy fungus looks like up close. There are so many more stories from patients and scientists that you can read.

watch and listen to on our website at Science Friday.com slash Valley Fever. Thank you, Lauren. Terrific. Thanks for having me, Ira. Now we're going to dig deeper into the current treatments for Valley Fever and talk about how different communities are being affected by the disease. Let me introduce my guests, Kerry Klein, a reporter at Valley Public Radio in Fresno, California. She covers Valley Fever and teamed up with us on this methods piece. And Dr. Anita Sill, Professor of Microbiology and immunology at the University of California, San Francisco. Welcome to Science Friday.

Hi there, thank you. Great to be here. Nice to have you. Dr. So let's start with you. Patients with Valley Fever can have a wide range of symptoms. Can you give us a sort of thumbnail sketch of what the fungus does to our bodies once you inhale it? How does it make you sick? Yeah, that's an interesting question.

So spores from the fungus can enter into the lungs, just, you know, if we're breathing in the air, especially around a region where the soil can be disturbed. And then once that spore gets into the lungs, it starts to grow. And senses the environment of the host, we think the fungus, you know, has a specific developmental program that it undergoes in response to the temperature of the host environment and other cues. and that spore will enlarge and it will generate a quite large structure called a spherial that's made up of individual fungal cells. And that spherial is really recalcitrant to being engulfed by some of the cells of the immune system that would normally take up foreign invaders. and instead the fungus is able to grow in this form, and then that large spherial structure can lice

and release small fungal cells that can then move out from that original location and cause disease. So there's a complex interplay between the fungus and the immune system that, as you say, can result in a very wide and differing range of symptoms for different individuals. Very interesting. because we had a lot of people who called in to say they had a misdiagnosis of lung cancer. Yeah, that definitely happens because one of the things that our bodies do when some of these foreign invaders come in

is there's a constellation of immune cells that make a structure called a nodule that can surround, let's say, an invading microbe. And you can see evidence of those nodules on chest x-ray, and they look, very similar to what a lesion can look like that's cancerous. And so not until you sort of go in and biopsy that area can you see, oh, this is actually a fungal infection as opposed to a malignancy. I'm Ira Flato. You're listening to Science Friday from WNYC Studios. Now, is this fungus unique to the West?

I mean, do other parts of the country not have the right soil conditions? or why do we only find it out there? There's certainly something conducive about the climate in the southwestern United States that facilitates growth of the fungus that causes valley fever, coxidioides, in the soil. But it's not just confined to California and Arizona. There was a recent outbreak in Washington State. You can find coxidioides in the soil causing disease in Mexico, Central America, South America. So it seems like there's some slow spread of the organism, but the highest, you know, regions where the fungus is really found in the soil at a higher incidence.

You know, we see that in the Central Valley of California and in Arizona as well. Harry Klein, there are certain communities and demographics who have a higher risk for contracting valley fever. Do we know why these groups have higher risks of infection? I don't think that researchers really do know why yet. It's actually interesting. There's a lot of parallels with COVID-19 right now. it's African-Americans and Filipinos seem to be more vulnerable. You know, those who are immunocompromised are more vulnerable.

Also, you know, folks over 60. You know, researchers suspect that there are maybe some underlying immune reasons or something that's working or not working properly within the body. But they, you know, they're really not sure why. And that's kind of one area of research that folks are really trying to work on. We've been seeing, you know, with COVID-19, how the populations in prisons, I mean, They're getting astronomical numbers of cases in prisons. Is that the same sort of thing that might be going on with Valley Fever? You know, the prisons that are in endemic areas, either in Central California or in Arizona,

there have been historically high cases there because people are confined there and aren't able to leave, aren't able to go somewhere else. They're not able to protect themselves. Say, if they're outside and if there's a dust storm or even just a little bit of dust in the air. You know, I think in the last couple years, case rates have actually been relatively low, but between like 2005 and 2013 or so, there was a huge spike, at least in California state prisons. And even to the point where actually a lot of inmates themselves and their lawyers were arguing that it was a human rights issue, that the state wasn't moving vulnerable prisoners out of those areas. So they finally did, and that's actually what brought the case or one of the things that brought those case rates down really, you know, really tremendously. So, you know, that's an interesting kind of story within the story of Valley Fever right there.

After the break, we'll be talking more about Valley Fever and the research behind treatments for the disease. We'll be right back. Stay with us. Hey there. Ira here. You know, as the world continues to adapt due to COVID-19, getting accurate information is crucial to protecting ourselves, our loved ones, and our communities. This is where Science Friday comes in. We are here to deliver the facts to combat misinformation, to have the right to, conversations with trusted experts who offer a unique voice in this confusing noise of news. Our goal is to get you the information you need, but you know, we can't do this alone. Science Friday depends on donations from listeners just like you. So please, if you can, I'm asking you to help to chip in a few dollars right now to support

our programming. Go to ScienceFriiday.com slash donate to make a donation. Every little bit helps. Again, that's ScienceFriday.com slash donate. Stay safe, stay healthy, and thanks. This is Science Friday. I'm Iroflato. We're talking about Valley Fever, a fungal disease, and some of the research and treatments for the illness. We're talking with Kerry Klein, a reporter at Valley Public Radio in Fresno, California. She covers Valley Fever, and she teamed up with us on this method story. And Dr. Anita Sill, Professor of Microbiology and Immunology at the University of California, San Francisco. Carrie, recently in California, there have been laws and budgets aimed at tackling the disease in California. What is the state focusing on in terms of combating valley fever? Right.

So that's absolutely true. There have been efforts in researchers and scientists working on valley fever for decades. But in 2018, outgoing governor, Jerry Brown, in his. final budget, his 2018, 2019 budget, he pumped $8 million into Valley Fever Research. And of course, that's kind of a drop in the bucket for a lot of, you know, major diseases getting research funding. But that was a lot more than had ever been put in from the state budget. And that's a lot more than a lot of researchers are seeing. The majority of that money went to the UC system, the University of California system, and also the Valley Fever Institute, which is at a hospital in Bakersfield.

And there, you know, that's kind of upping the amount of clinical work and the amount that doctors are able to see valley fever patients. But then within the UC system, they're really trying to tackle a lot of unanswered questions. So like one of the projects is to kind of investigate fundamental gaps. And so the very question that you asked, Ira, to understand why some demographics are more vulnerable than others, why the disease can be so much more severe in some people than others. One of the projects is really investigating, you know, immune dysregulation. So what kinds of problems can there be in immune systems? And then how can that, how can that

manifest in how the disease occurs in certain populations as well? And if I understand it correctly, that's where the research is sort of heading at, looking at some of the more severe cases, tackling the immune system, because right now the antifungals trying to kill the fungi, that's the main thrust of treatment, is it not? Yeah, that's correct. Yeah, these antifungal drugs, are really the first and the main line of defense that doctors have. And in most cases, they're effective. Doctors still correct me if I'm wrong, but in most cases they're effective, at least in managing the disease, if not completely wiping it out. But there are some of these really severe cases where, you know, it's apparent that more treatment is needed to at least bring, you know, quality of life

back up for some of these patients. There just isn't a huge arsenal of treatments out there that can really do that. And so, yes, clinicians really want to figure out what are, you know, are there different pathways there are different parts of the body or the immune system that we should be tackling first in order to make these antifungals more effective. I absolutely agree. There are many cases where the antifungals are sufficient, but even there, you know, sometimes treatment can be incredibly long time period, you know, weeks or months, and these medications have some toxicity. And then additionally, I think to complement that our understanding of the immune system has grown by leaps and bounds, in the past decade. And so it will be amazing to use some of this knowledge to help augment

the immune response to fungal infections to have a much better outcome in patients down the road. And that's an interesting point I wanted to talk to you about. Can the immune response tell us about how to treat the less severe cases of this? I think that's certainly something on the horizon and there's being some very interesting work done, some of it funded through this University of California mechanism to look at whether particular ways of modulating the immune response can help in severe disease. And certainly that will translate, I think, to, you know, we want to have a better outcome for all individuals who are infected with valley fever. And I think there's a lot of hope there. Your work looks at studying how the fungus knows it's no longer in the

soil. What changes the fungus undergoes once it's in a host or a human, right? You mentioned that something changes. What do we know about that? Well, we know that there are major changes in the molecules that the fungus is expressing in the soil versus the host. So there are some really interesting molecular changes as well as some very fundamental changes in what we call morphology or the shape of the cells. So I like to think about, you know, in the soil, the fungus grows in this very elaborate, multicellular form. where it's got interconnected chains of cells, and it's sort of as the organism could forage in different directions in the soil.

But that's not necessarily the best, you know, there are fungi who grow in that type of format inside the human body. The valley fever fungus is not one of them. But instead, when coxidioides is inside a person, it changes its cell shape in that way that I described that must be beneficial in a number of ways for causing disease. So we know some of the, you know, there have been over the years, you know, as Carrie said, people have been studying this fungus for decades. You know, there are some known fundamental

changes when you compare the soil form to the host form. But really integrating our understanding of those changes with the key elements that drive disease is something that we hope to shed some light on. Is the fungus sort of dormant as it's in the soil and waiting for a host to latch on to? and then here come the workers and we're going to infect them? It's definitely not completely dormant. So I think we all hear about fungal spores, maybe as what, you know, we think about, you know, you can see it when you have fruit that, you know, is gone bad like oranges with all this fuzzy white stuff. And you can see it, at least in my bathroom, there's some mold spores that I need to clean up for sure. Fungi use spores as a way of disseminating or spreading.

So it's sort of a natural part of the life cycle. but in the soil, the fungus is actively growing and then just generating these spores so that if there's nutrient limitation in the soil, there is a dormant form that can survive until the conditions improve. Or this is also, you know, a form that can be specialized for dispersal, you know, in the wind or in other elements that might agitate or disrupt the soil in some way. And then there are some researchers who feel like that there could be a source of coxidioides that's not just the soil, but because these fungi are very good at infecting all mammals, including humans, it's possible that, you know, rodent burrows or other small mammals could also be a reservoir of the fungus in addition to the fungal burden that's present in the soil.

There's a category called orphan diseases. Is it an orphan disease and get special treatment or is it not? I think it is considered an orphan disease, and I think that has, that categorization has been invoked in the past to boost its funding, but I don't know that that really has borne out into any sort of long-term improvements. And I don't know that it was a tremendous amount of funding either. Carrie, we talked about and you mentioned California and Arizona as both hotspots for Valley fever. Do we expect it to be spreading more, possibly due to climate changes? Is climate change a factor here? Yeah, that's a really excellent question.

There was just a study that came out last year that examined that very question. You know, the fungus, coxccibiotides, is found in under 12 states right now. And that under a high climate warming scenario by the year 2100, that could jump from 12 to 17 states by the year 2100, which would double the amount of geographic area where the fungus could grow and that could raise the case rate by as much as 50% over what it is now. And of course, you know, we may not follow that exact scenario of high climate warming. But the reason for that would be because so much more of the U.S., you know, could become a little more arid, a little bit less humid and a little bit hotter.

And those might just be the, you know, the right conditions to grow coxidioids. We've run out of time. I'd like to thank my guests. Carrie Klein, a reporter at Valley Public Radio in Fresno. She covers Valley fever and teamed up with us on this method piece. And Dr. Anita Sill, Professor of Microbiology. and immunology at the University of California, San Francisco. And you can read, listen, and learn more about Valley Fever

by our digital producer, Lauren Young. You can see all of her reporting as part of our methods project. It's up at our website at science friday.com slash valley fever. April is Citizen Science Month, and this year in particular, it's been the gift that keeps on giving. We have featured projects for all ages and interests. letting you tell scientists everything from what spring looks like in your neighborhood to what kinds of spiders are living in your yard, to what kind of pipes you have in your home. But citizen

science isn't just about collecting data. Researchers also need you to help them analyze it, and a citizen science platform Zuniverse has an array of projects just begging for your eyes and brains. It's got pictures of raccoons, handwritten letters, tuberculosis back to, and in Beatry dishes. Also, the wind-swept poles of Mars. They're all handpicked to help distract and soothe you during what is for everyone a difficult time. Here to explain is Zuniverse co-leader and vice president of citizen science at the Adler

Planetarium in Chicago. Dr. Laura Truy, welcome back, Laura. Thanks for having me. One of the projects you've got for people to work on is called bash the bug. First, what's the bug? And how do you bash it? So tuberculosis is an ancient disease. It kills more people worldwide today than any other infectious disease.

It's 1.5 million people per year. And so Bash the Bug is a Zuniverse project in partnership with the University of Oxford's cryptic biomedical research team, working alongside this community of Zuniverse participants around the world to map antibiotics effectiveness against different strains of TB. The goal is then that hospitals around the world, will be able to routinely and accurately predict which antibiotics will be most effective for a given patient. So how do I participate in this? How do I bash above? Yeah. So the team collected 20,000 samples from 15 labs around the world, including the CDC. And each sample has 14 different

antibiotics at different dosage levels being tested. So they then uploaded these images of these samples into Zuniverse to crowdsource the classification. So what you do as a participant is you indicate the first well in which the antibiotic concentration level is effective at killing the bacteria. And while the crowd is helping to unlock the data, in parallel, the team is sequencing the whole gene for all 20,000 samples and looking for variants. And then they're mapping out the genetic variations and associating those statistically with whether they confer resistance. Our past citizen science projects have been about people sending data to researchers. But Zooniverse is, as a a bit different. Tell us about that. So it's the world's largest platform for online citizen science,

or we like to call it people-powered research. There are 2 million people around the world contributing to over 100 active projects, and all you need is the internet. It's all about engaging the public in meaningful ways in real research and harnessing the power of the crowd to enable research that would otherwise not be practical or possible because of the huge data sets that really characterize modern science. So just this past week, We've had hundreds of thousands of people contribute over 5 million classifications, and that's the equivalent of a researcher working full time for 49 years straight in just one week. So let's talk about engaging in some space science.

Do you have a project about Mars this month, my kind of stuff? So in Planet 4, planet 4.org, the Zuniverse Project has you working alongside NASA and astronomers around the world in exploring the surface and weather of Mars. Mars is polar regions. So it's welcome escape to these other worlds during this period of limited real person travel. So the projects run for a few years and it just relaunched on our newer platform. And it's already led to several publications and really a major impact on our understanding of Mars from learning about seasons on Mars to recording activity below its dry ice polar caps to understanding the winds in the atmosphere and more.

I'm Ira Flato. This is Science Friday from WNYC Studios. Talking with Dr. Laura Truy, who is here to help us explain what Zuniverse is and how you can participate in it. You also have something that's dear to my heart, which is history. I'm a history buff. And you have something where we are transcribing letters. I want to know more about that. There are currently over 20 different digital humanities projects on Zuniverse. And many of them are about transcribing. handwritten documents. So anti-slavery manuscripts is one of the projects. It's in partnership with the Boston Public Library. What you do is you're helping transcribe the handwritten letters between William Lloyd Garrison and his network of 19th century abolitionists. So by digitizing these texts,

historians, students, and amateurs can then really dig into the research and the big data applications. That's what I was going to ask. How does history, become citizen science. Is that where big data is involved? It is. In the humanities, now that we're able to scan in images of all sorts of interesting historical documents,

it's one thing to have the scanned image, but then another to actually have that data be searchable. And so part of the magic of the universe is that the lessons learned from one project or one discipline can then be applied to all the other disciplines because it's all in this one shared platform.

I don't want to miss this other topic you have for something completely different. You want us to identify raccoons. Yes, or trash pandas as we refer to them. So raccoons have demonstrated an incredible ability to adapt to new environments. And so there's a team based at the University of Wyoming with colleagues at the University of Minnesota that are really studying the cognitive abilities of this extremely intelligent animal. But because raccoons are nocturnal, they've been really hard to track and study. So what this team has done is collected years of video data from night trials around raccoons interacting with puzzle boxes in the wild. And the team has way more data than they can

analyze on their own, which is sort of a characteristic of many Zuniverse projects. So they really need the crowd, the power of the crowd, to build up the training sets so that then machine learning algorithms can efficiently process through the rest of the data knowing which raccoons are doing which behaviors over those years. Terrific. So there's just one more project that I want to talk about if people want more information about these projects. We're holding some citizen science parties on Zoom next week.

So Monday through Thursday of next week, a different Zooniverse project research team will lead the Science Friday, Facebook, and Zoom live. event. On Monday, it'll be the Planet 14. On Tuesday, the anti-slavery manuscripts team. On Wednesday, the Raccoon Project, and on Thursday, the Bash the Bug, Biomedical Research Project. And what they'll do is they'll share about themselves, their research. You'll engage in real-time classifications and some interactive games and talk about some of the unusual and weird discoveries that have been made possible with so many eyes on the data. It's just going to be a lot of fun. definitely join in.

And we're out of time. I want to thank Laura Truy, vice president of citizen science at the Adlaplanetarium in Chicago, and co-lead of the Zuniverse Citizen Science platform. And if you want to know more about how to participate in these and other citizen science projects, we've partnered with. Go to our website at sciencefriety.com slash citizen science.

Charles Berkwurst is our director. Our producers are Alexa Lim, Christy Taylor, Katie Feather, and Kathleen Davis. BJ Leiderman composed our theme music, and if you missed any part of this program or would like to hear it again, subscribe to our podcasts or ask your smart speaker to play Science Friday. Have a great weekend. I'm Ira Flato.