Valley Fever in Central California: Diagnosis is Not the Finish Line, the Real Gap is Longitudinal Care.

Coccidioidomycosis continues to shape life across California's southern San Joaquin Valley, where thousands fall ill each year. Yet for many, diagnosis marks not the end of uncertainty but the start of another challenge, staying in care. In communities already strained by clinician shortages, distance, and limited insurance coverage, the year-long follow-up recommended after Valley Fever is rarely feasible. Lessons from other rural Latino populations show that continuity can be rebuilt through community-rooted approaches: trusted health workers, mobile clinics, peer education, and simple digital tools that meet patients where they are. Bringing these models into existing county and safety-net systems will require dedicated funding and shared commitment across institutions. Strengthening continuity of care, not only diagnostic capacity, offers the most realistic path to better outcomes for those living in the heart of California's Valley Fever region.