Sec. 2. Findings
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Congress finds the following: Worldwide fungal infections, such as candidiasis, cryptococcosis, and aspergillosis, often pose fatal opportunistic threats to immunologically impaired persons. Endemic fungal infections, such as histoplasmosis, coccidioidomycosis, and blastomycosis, occur in certain geographic regions worldwide, including in the United States, and are acquired through exposure to the environment. Because the endemic mycoses referred to in paragraph
(2)are regional, such endemic mycoses do not receive the same amount of resources as mycoses of worldwide distribution, even though within the regions in which they are endemic such strains pose significant public health threats. Coccidioidomycosis, also known as Valley Fever, is a fungal infection acquired by the inhalation of spores of certain fungi primarily found in the soil endemic to the American Southwest, including in Arizona, California, Nevada, New Mexico, Texas, Utah, and Washington. According to the Morbidity and Mortality Weekly Report issued by the Centers for Disease Control and Prevention and dated August 11, 2017— 97 percent of the all reported cases of Valley Fever occurred in California and Arizona; individuals at increased risk for severe Valley Fever include persons of African or Filipino descent, pregnant women, adults in older age groups, and other individuals with weakened immune systems; the overall incident rate of Valley Fever peaked in 2011 and again in 2016; in California, the Valley Fever incident rate for 2016 was the highest recorded to date, with 42 percent of cases reported coming from Kern County; and the reason for increases in Valley Fever cases reported in California in 2016 is not known. Valley Fever illness ranges from influenza-like symptoms to life-threatening when the infection spreads to other parts of the body, including the brain. The overall estimated impact of Valley Fever is less than 200,000 people in the United States, with roughly 200 deaths each year and over 11,000 new cases identified in 2016. The estimated economic impact to the United States is at least $500,000,000 from hospital, outpatient, and lost productivity costs. In the past 60 years, only 4 classes of antifungal compounds have been approved by the Food and Drug Administration for treatment for all fungal infections. Existing antifungal therapies often do not cure the fungal infection involved because, similar to how bacteria have become resistant to antibiotic therapies, some fungi no longer respond to the current limited antifungal therapies that are designed to treat them. Coccidioides, the cause of Valley Fever, is not cured by any available drug. Although antibiotic-resistant bacterial infections are a widely recognized public health threat, less is known about the effects of antifungal resistance and the burden of drug-resistant fungal infections. Fungal infections are a rising threat to public health and the resistance to current antifungal therapies will only complicate the Nation’s response in the event of a public health emergency.