He thinks it probably happened in one breath.
One breath of air that led to the endless pain dulled only by morphine, a two-month hospital stay and the removal of four neck bones.
Even though it's been more than a year since his diagnosis, ASU electrical engineering senior Vamsi Gurram still suffers from the overwhelming effects left by valley fever and wants others to be aware of the airborne illness.
"As an international student, with no family nearby to take care [of me] and financial constraints, it was a difficult year," he said. "I don't want anyone to go through all that I have gone through."
Aside from the physical hardships, he said he also worries about the $130,000 medical bill and lifelong dependence on medication needed to fight the infection.
Valley fever is a fungal infection that lays dormant in the soil in most of the Southwest, said Dr. Gary Septon, chief of medical services at the Student Health Center.
The spores are found just beneath the soil, but when the soil is disturbed, as happens during construction, the spores become airborne and can then be inhaled, he said.
Septon added that even when people contract valley fever, 80 percent never need treatment.
"Most of the time people may not even know they have it because they never feel sick enough to see the doctor," Septon said. "Most people usually get a fever, dry cough, chest pains and sometimes hives on their legs and feet."
Certain ethnic groups, such as those from Africa and the Philippines, as well as diabetics, pregnant women and those with already-existing cancers are more susceptible to the disease, while others have a 3 percent risk each year of contracting valley fever.
"It is a risk that sounds kind of high to me, considering that after 10 years living in Arizona, your chances are raised to 30 percent," Septon said. "It's part of the geography."
About 100,000 people are infected with valley fever every year, and most develop a lifelong immunity, according to the Valley Fever Center for Excellence.
An international student from South India, Gurram only had been in the United States one year when he started feeling back and neck pain.
Doctors at the Student Health Center couldn't diagnose Gurram until two months after his initial appointment because he didn't have the symptoms normally associated with valley fever.
In September 2001 Gurram finally was diagnosed with the illness.
By then he had lost movement in his left hand, and the infection had spread to his bones, he said. He was taken to Scottsdale Health Care's emergency ward days later where he was rushed to surgery to replace the infected bones in his neck with a metal support structure.
"Of five bones, only one was healthy; the rest were as if my bones had been eaten by something," he said.
In a room with another patient who had an even worse case of valley fever, Gurram said he lost hope of ever recovering.
"It's probably the worst nightmare. I could not cry because no one was there for me to make me feel good or comfort me," he said. "I went through some really scary moments ... I saw tears in the doctor's eyes when she was telling me that anything could happen to me; death and paralysis might occur."
In the midst of a grim situation, students and the Indian community in Phoenix came together to raise about $10,000 and volunteered their time to cook and clean for Gurram after he was released, said Prasad Chavali, board member of the Arizona Telugu Association.
Though Gurram's student insurance will cover 90 percent of medical bills, he also must be on medication for the rest of his life - medication that costs about $1,800 per month, he said.
More than a year later, Gurram is no longer as frail and dependent. He now works as a library clerk at ASU. He plans to graduate next spring and hopes to find a job soon after graduation to pay off his bills.
Nevertheless, Gurram said he still suffers mentally and emotionally.
"When I go to bed, I keep wondering why it happened to me," he said. "I just hope everything will work out fine someday."
Gurram added that he would like to create awareness for new students and residents who are unfamiliar with the disease.
"Be vigilant of valley fever," Gurram said. "Don't neglect even simple health problems."
Reach the reporter at jacqueline.shoyeb@asu.edu.
