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Peçanha-Pietrobom PM, Tirado-Sánchez A, Gonçalves SS, Bonifaz A, Colombo AL. Diagnosis and Treatment of Pulmonary Coccidioidomycosis and Paracoccidioidomycosis. J Fungi (Basel) 2023; 9:218. [PMID: 36836333 PMCID: PMC9959547 DOI: 10.3390/jof9020218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Coccidioidomycosis (CM) and paracoccidioidomycosis (PCM) are systemic mycoses that are highly endemic in Latin America and have recently been included on the World Health Organization (WHO) Fungal Priority Pathogens List. Coccidioides immitis and Coccidioides posadasii are recognized as etiological agents of CM, with peculiarities in their geographic distribution. The genus Paracoccidioides now includes Paracoccidioides lutzii and the Paracoccidioides brasiliensis complex, which encompasses four phylogenetic species. In both diseases, pulmonary signs and symptoms are the main reasons for patients to seek medical assistance, and they are frequently misdiagnosed as tuberculosis. In this paper, we present a critical view of the strategies for diagnosis and clinical management of CM and PCM. Over the past few decades, there has been an increase in the number of reports of endemic fungal infections in areas previously thought to be "non-endemic" due to climate change and increased travel, among other factors. Learning to recognize their main epidemiological aspects and clinical manifestations is crucial so that clinicians can include them in the differential diagnosis of lung disease and avoid late diagnosis.
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Affiliation(s)
| | - Andrés Tirado-Sánchez
- Dermatology Service & Mycology Department, Hospital General de México, “Dr. Eduardo Liceaga”, Mexico City 06726, Mexico
- Internal Medicine Department, Hospital General de Zona 29, Instituto Mexicano del Seguro Social, Mexico City 07950, Mexico
| | - Sarah Santos Gonçalves
- Department of Pathology, Infectious Diseases Postgraduate Program, Federal University of Espírito Santo (UFES), Vitoria 29043900, Brazil
| | - Alexandro Bonifaz
- Internal Medicine Department, Hospital General de Zona 29, Instituto Mexicano del Seguro Social, Mexico City 07950, Mexico
| | - Arnaldo Lopes Colombo
- Department of Medicine, Division of Infectious Diseases, Federal University of São Paulo (UNIFESP), São Paulo 04039032, Brazil
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Abstract
Purpose of Review Climate change represents a major existential threat facing the global community, and it has already begun to affect human health in a multitude of ways. This review highlights and discusses the implications that climate change has already had and is expected to have for inpatient dermatologists. Recent Findings There are a variety of conditions affected by climate changes. The distribution and frequencies of infectious diseases and their vectors are changing in line with variations in climate conditions. Increased temperatures have already been associated with exacerbation of existing skin conditions, such as atopic dermatitis, and recent evidence suggests that higher temperatures will also magnify the effects of harmful ultraviolet radiation. Extreme weather events that result from climate change are followed by an array of dermatologic conditions that may be unusual for the given location. Inpatient dermatologists should be prepared to manage these potentially unfamiliar dermatologic consequences of climate change. Summary Climate change will have widespread effects on the medical field, and inpatient dermatologists will be faced with their own unique set of challenges and practice variations. Practitioners should be familiar with the ongoing and predicted effects of climate change in their locations so that they can readily identify and treat associated conditions, and they should adjust their practice to reduce their carbon footprint and serve as a model for patients to do the same.
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Pearson D, Ebisu K, Wu X, Basu R. A Review of Coccidioidomycosis in California: Exploring the Intersection of Land Use, Population Movement, and Climate Change. Epidemiol Rev 2020; 41:145-157. [PMID: 31497853 DOI: 10.1093/epirev/mxz004] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 02/22/2019] [Accepted: 02/27/2019] [Indexed: 01/12/2023] Open
Abstract
California has seen a surge in coccidioidomycosis (valley fever), a disease spread by the Coccidioides immitis fungus found in soil throughout the state, particularly in the San Joaquin Valley. We reviewed epidemiologic studies in which outbreak and sporadic cases of coccidioidomycosis were examined, and we considered the possible relationship of these cases to environmental conditions, particularly the state's increasing aridity, drought, and wildfire conditions. Most of the studies we reviewed pertained to cases occupationally acquired in construction, military, archeological, and correctional institutional settings where workers were exposed to dust in C. immitis-endemic areas. A few reviewed outbreaks in the general population related to dust exposure from natural disasters, including an earthquake-associated landslide and a dust storm that carried particles long distances from endemic areas. Although many of California's coccidioidomycosis outbreaks have been occupationally related, changing demographics and new, immunologically naïve populations in dry, endemic areas could expose the general population to C. immitis spores. Given the high rate of infection among workers who, for the most part, are healthy, the general population, including some elderly and immunocompromised individuals, could face additional risk. With climate-related events like drought and wildfires also increasing in endemic areas, research is needed to address the possible associations between these phenomena and coccidioidomycosis outbreaks.
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Affiliation(s)
- Dharshani Pearson
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California
| | - Keita Ebisu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California
| | - Xiangmei Wu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, California
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Kollath DR, Miller KJ, Barker BM. The mysterious desert dwellers: Coccidioides immitis and Coccidioides posadasii, causative fungal agents of coccidioidomycosis. Virulence 2019; 10:222-233. [PMID: 30898028 PMCID: PMC6527015 DOI: 10.1080/21505594.2019.1589363] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/07/2019] [Accepted: 02/25/2019] [Indexed: 01/31/2023] Open
Abstract
The genus Coccidioides consists of two species: C. immitis and C. posadasii. Prior to 2000, all disease was thought to be caused by a single species, C. immitis. The organism grows in arid to semiarid alkaline soils throughout western North America and into Central and South America. Regions in the United States, with highest prevalence of disease, include California, Arizona, and Texas. The Mexican states of Baja California, Coahuila, Sonora, and Neuvo Leon currently have the highest skin test positive results. Central America contains isolated endemic areas in Guatemala and Honduras. South America has isolated regions of high endemicity including areas of Colombia, Venezuela, Argentina, Paraguay, and Brazil. Although approximately 15,000 cases per year are reported in the United States, actual disease burden is estimated to be in the hundreds of thousands, as only California and Arizona have dedicated public health outreach, and report and track disease reliably. In this review, we survey genomics, epidemiology, ecology, and summarize aspects of disease, diagnosis, prevention, and treatment.
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Affiliation(s)
- Daniel R. Kollath
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Karis J. Miller
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Bridget M. Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
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5
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Gorris ME, Treseder KK, Zender CS, Randerson JT. Expansion of Coccidioidomycosis Endemic Regions in the United States in Response to Climate Change. GEOHEALTH 2019; 3:308-327. [PMID: 32159021 PMCID: PMC7007157 DOI: 10.1029/2019gh000209] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 08/16/2019] [Accepted: 08/20/2019] [Indexed: 05/21/2023]
Abstract
Coccidioidomycosis (Valley fever) is a fungal disease endemic to the southwestern United States. Across this region, temperature and precipitation influence the extent of the endemic region and number of Valley fever cases. Climate projections for the western United States indicate that temperatures will increase and precipitation patterns will shift, which may alter disease dynamics. We estimated the area potentially endemic to Valley fever using a climate niche model derived from contemporary climate and disease incidence data. We then used our model with projections of climate from Earth system models to assess how endemic areas will change during the 21st century. By 2100 in a high warming scenario, our model predicts that the area of climate-limited endemicity will more than double, the number of affected states will increase from 12 to 17, and the number of Valley fever cases will increase by 50%. The Valley fever endemic region will expand north into dry western states, including Idaho, Wyoming, Montana, Nebraska, South Dakota, and North Dakota. Precipitation will limit the disease from spreading into states farther east and along the central and northern Pacific coast. This is the first quantitative estimate of how climate change may influence Valley fever in the United States. Our predictive model of Valley fever endemicity may provide guidance to public health officials to establish disease surveillance programs and design mitigation efforts to limit the impacts of this disease.
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Affiliation(s)
- Morgan E. Gorris
- Department of Earth System ScienceUniversity of CaliforniaIrvineCAUSA
| | - Kathleen K. Treseder
- Department of Ecology and Evolutionary BiologyUniversity of CaliforniaIrvineCAUSA
| | - Charles S. Zender
- Department of Earth System ScienceUniversity of CaliforniaIrvineCAUSA
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6
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Johnston JE, Razafy M, Lugo H, Olmedo L, Farzan SF. The disappearing Salton Sea: A critical reflection on the emerging environmental threat of disappearing saline lakes and potential impacts on children's health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 663:804-817. [PMID: 30738261 PMCID: PMC7232737 DOI: 10.1016/j.scitotenv.2019.01.365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 05/13/2023]
Abstract
Changing weather patterns, droughts and competing water demands are dramatically altering the landscape and creating conditions conducive to the production of wind-blown dust and dust storms. In California, such factors are leading to the rapid shrinking of the Salton Sea, a 345 mile2 land-locked "sea" situated near the southeastern rural border region known as the Imperial Valley. The region is anticipated to experience a dramatic increase in wind-blown dust and existing studies suggest a significant impact on the health and quality of life for nearby residents of this predominantly low-income, Mexican-American community. The discussion calls attention to the public health dimensions of the Salton Sea crisis. We know little about the possible long-term health effects of exposure to mobilized lakebed sediments or the numerous toxic contaminants that may become respirable on entrained particles. We draw on existing epidemiological literature of other known sources of wind-blown dust, such as desert dust storms, and related health effects to begin to understand the potential public health impact of wind-blown dust exposure. The increased production of wind-blown dust and environmental exposures to such non-combustion related sources of particulate matter are a growing health threat, due in part to drought coupled with increasing pressures on limited water resources. Recent population-based studies have linked dust storms with cardiovascular mortality, asthma hospitalization and decrease in pulmonary function in both adults and children. A growing number of studies provide evidence of the acute health effects of wind-blown dust exposures among children, which with repeated insults have the potential to influence respiratory health over time. The shrinking of the Salton Sea illustrates a public health and environmental justice crisis that requires action and attention to protect the health and well-being of local communities.
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Affiliation(s)
- Jill E Johnston
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America.
| | - Mitiasoa Razafy
- University of Southern California, Los Angeles, CA, United States of America
| | - Humberto Lugo
- Comite Civico del Valle, Brawley, CA, United States of America
| | - Luis Olmedo
- Comite Civico del Valle, Brawley, CA, United States of America
| | - Shohreh F Farzan
- Department of Preventive Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States of America
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7
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Butkiewicz CD, Shubitz LF. Coccidioidomycosis in alpacas in the southwestern United States. Transbound Emerg Dis 2018; 66:807-812. [PMID: 30506909 DOI: 10.1111/tbed.13088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 01/01/2023]
Abstract
An anonymous web-based survey of alpaca owners was used to learn more about the clinical presentation, diagnosis, and treatment of coccidioidomycosis in alpacas in the United States. Thirty-seven owners, with 1,117 alpacas, completed the survey. Over 4% of alpacas included in the study were diagnosed with coccidioidomycosis between 2005 and 2016 (5 post mortem, 46 clinically). Immunodiffusion titers ranged from 1:4 to ≥1:256 in sick animals. Alpacas residing in Arizona counties with a high incidence of human disease were 5.8 times more likely to contract coccidioidomycosis than animals residing in other areas of the state. Treatment was reported in 23 alpacas, and 78% of those animals died or were euthanized. Necropsy records from a veterinary diagnostic laboratory in Tucson, AZ were reviewed to estimate the severity of disease in this species. Nine cases identified for review died of disseminated coccidioidomycosis; the disease was extensive in most animals, with the lungs, lymph nodes, and liver the most frequently affected. Alpacas appear to be highly susceptible to severe illness as a result of infection by Coccidioides spp., frequently resulting in death. More research is needed to better understand the epidemiology, clinical signs, and treatment protocols for coccidioidomycosis in alpacas.
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Affiliation(s)
| | - Lisa F Shubitz
- Valley Fever Center for Excellence, The University of Arizona, Tucson, Arizona
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Weaver EA, Kolivras KN. Investigating the Relationship Between Climate and Valley Fever (Coccidioidomycosis). ECOHEALTH 2018; 15:840-852. [PMID: 30284073 DOI: 10.1007/s10393-018-1375-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/27/2018] [Accepted: 09/04/2018] [Indexed: 05/21/2023]
Abstract
Valley fever (coccidioidomycosis) is a disease caused by inhalation of spores from the soil-dwelling Coccidioides fungal species. The disease is endemic to semiarid areas in the western USA and parts of Central and South America. The region of interest for this study, Kern County, California, accounts for approximately 14% of the reported valley fever cases in the USA each year. It is hypothesized that the weather conditions that foster the growth and dispersal of the fungus influence the number of cases in the endemic area. This study uses regression-based analysis to model and assess the seasonal relationships between valley fever incidence and climatic variables including concurrent and lagged precipitation, temperature, Palmer Drought Severity Index, wind speed, and PM10 using data from 2000 to 2015. We find statistically significant links between disease incidence and climate conditions in Kern County, California. The best performing seasonal model explains up to 76% of the variability in fall valley fever incidence based on concurrent and antecedent climate conditions. Findings are consistent with previous studies, suggesting that antecedent precipitation is an important predictor of disease. The significant relationships found support the "grow and blow" hypothesis for climate-related coccidioidomycosis incidence risk that was originally developed for Arizona.
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Affiliation(s)
- Elizabeth A Weaver
- Virginia Polytechnic Institute and State University, 115 Major Williams Hall, Blacksburg, VA, 4061, USA.
| | - Korine N Kolivras
- Virginia Polytechnic Institute and State University, 115 Major Williams Hall, Blacksburg, VA, 4061, USA
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9
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Sondermeyer GL, Lee LA, Gilliss D, Vugia DJ. Coccidioidomycosis-Associated Deaths in California, 2000-2013. Public Health Rep 2017; 131:531-5. [PMID: 27453596 DOI: 10.1177/0033354916662210] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The number of cases of coccidioidomycosis and associated hospitalizations increased in California during 2000-2013. During that period, a total of 1,098 death records listed coccidioidomycosis as a cause, averaging 78 deaths annually (range: 43-108). The death rate peaked in 2006 and was significantly higher among males than among females, among African American patients than among white patients, and among residents of the coccidioidomycosis-endemic region of California than among residents of the less endemic regions (p<0.001). A higher death rate was associated with increasing age and was highest (8.8 per 1 million population) among adults aged ≥75 years. Of coccidioidomycosis-associated deaths, 31.9% had a contributing cause of death of severe/disseminated disease, 31.8% of unspecified -coccidioidomycosis, and 28.3% of pulmonary unspecified coccidioidomycosis, per International Classification of Diseases codes. Diabetes was a contributing cause in 19.3% of deaths, and other immunocompromising conditions were a contributing cause in 15.9% of deaths. Populations at higher risk for coccidioidomycosis--associated deaths are similar to those at higher risk for coccidioidomycosis-associated hospitalizations and infection. Awareness for coccidioidomycosis among these groups and their providers is important for proper diagnosis and care.
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Affiliation(s)
- Gail L Sondermeyer
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
| | - Lauren A Lee
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
| | - Debra Gilliss
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
| | - Duc J Vugia
- California Department of Public Health, Infectious Diseases Branch, Richmond, CA
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10
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Shriber J, Conlon KC, Benedict K, McCotter OZ, Bell JE. Assessment of Vulnerability to Coccidioidomycosis in Arizona and California. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E680. [PMID: 28644403 PMCID: PMC5551118 DOI: 10.3390/ijerph14070680] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 11/17/2022]
Abstract
Coccidioidomycosis is a fungal infection endemic to the southwestern United States, particularly Arizona and California. Its incidence has increased, potentially due in part to the effects of changing climatic variables on fungal growth and spore dissemination. This study aims to quantify the county-level vulnerability to coccidioidomycosis in Arizona and California and to assess the relationships between population vulnerability and climate variability. The variables representing exposure, sensitivity, and adaptive capacity were combined to calculate county level vulnerability indices. Three methods were used: (1) principal components analysis; (2) quartile weighting; and (3) percentile weighting. Two sets of indices, "unsupervised" and "supervised", were created. Each index was correlated with coccidioidomycosis incidence data from 2000-2014. The supervised percentile index had the highest correlation; it was then correlated with variability measures for temperature, precipitation, and drought. The supervised percentile index was significantly correlated (p < 0.05) with coccidioidomycosis incidence in both states. Moderate, positive significant associations (p < 0.05) were found between index scores and climate variability when both states were concurrently analyzed and when California was analyzed separately. This research adds to the body of knowledge that could be used to target interventions to vulnerable counties and provides support for the hypothesis that population vulnerability to coccidioidomycosis is associated with climate variability.
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Affiliation(s)
- Jennifer Shriber
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Kathryn C Conlon
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Kaitlin Benedict
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, GA 30333, USA.
| | - Orion Z McCotter
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, GA 30333, USA.
| | - Jesse E Bell
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
- Climate and Health Program, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, NC 28801, USA.
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11
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Sondermeyer Cooksey GL, Wilken JA, McNary J, Gilliss D, Shusterman D, Materna BL, Vugia DJ. Dust Exposure and Coccidioidomycosis Prevention Among Solar Power Farm Construction Workers in California. Am J Public Health 2017. [PMID: 28640687 DOI: 10.2105/ajph.2017.303820] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate if work activities, dust exposure, and protection measures were associated with a 2011 to 2014 coccidioidomycosis outbreak among workers constructing 2 solar farms in California. METHODS In 2013, we mailed self-administered questionnaires to employees who were onsite at the solar farms where the outbreak occurred to identify cases of clinical coccidioidomycosis and compare with asymptomatic workers by using multivariate logistic regression. RESULTS When we compared 89 workers with clinical coccidioidomycosis to 325 asymptomatic workers, frequently being in a dust cloud or storm (odds ratio [OR] = 5.93; 95% confidence interval [CI] = 3.18, 11.06) significantly increased the odds of clinical coccidioidomycosis, whereas frequently wetting soil before soil-disturbing activity (OR = 0.42; 95% CI = 0.24, 0.75) was protective. When we controlled for being in a dust cloud or storm, frequent soil disturbance significantly increased the odds of clinical coccidioidomycosis only among those who reported wearing a respirator infrequently (OR = 2.31; 95% CI = 1.27, 4.21). CONCLUSIONS Utilization of personal and employer-driven safety practices and increased coccidioidomycosis awareness among construction workers should be considered during the planning of any construction work in coccidioidomycosis-endemic regions to prevent occupational infections and outbreaks.
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Affiliation(s)
- Gail L Sondermeyer Cooksey
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jason A Wilken
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jennifer McNary
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Debra Gilliss
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dennis Shusterman
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Barbara L Materna
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Duc J Vugia
- All of the authors are with California Department of Public Health, Richmond. Jason A. Wilken is also with the Office of Public Health Preparedness and Response, Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, GA
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12
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Kaffenberger BH, Shetlar D, Norton SA, Rosenbach M. The effect of climate change on skin disease in North America. J Am Acad Dermatol 2017; 76:140-147. [DOI: 10.1016/j.jaad.2016.08.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 08/02/2016] [Accepted: 08/07/2016] [Indexed: 10/20/2022]
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13
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Guevara RE, Motala T, Terashita D. The Changing Epidemiology of Coccidioidomycosis in Los Angeles (LA) County, California, 1973-2011. PLoS One 2015; 10:e0136753. [PMID: 26313151 PMCID: PMC4551673 DOI: 10.1371/journal.pone.0136753] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/07/2015] [Indexed: 11/18/2022] Open
Abstract
Coccidioidomycosis, also known as Valley Fever, is often thought of as an endemic disease of central California exclusive of Los Angeles County. The fungus that causes Valley Fever, Coccidioides spp., grows in previously undisturbed soil of semi-arid and arid environments of certain areas of the Americas. LA County has a few large areas with such environments, particularly the Antelope Valley which has been having substantial land development. Coccidioidomycosis that is both clinically- and laboratory-confirmed is a mandated reportable disease in LA County. Population surveillance data for 1973-2011 reveals an annual rate increase from 0.87 to 3.2 cases per 100,000 population (n = 61 to 306 annual cases). In 2004, case frequency started substantially increasing with notable epidemiologic changes such as a rising 2.1 to 5.7 male-to-female case ratio stabilizing to 1.4-2.2. Additionally, new building construction in Antelope Valley greatly rose in 2003 and displayed a strong correlation (R = 0.92, Pearson p<0.0001) with overall LA County incidence rates for 1996-2007. Of the 24 LA County health districts, 19 had a 100%-1500% increase in cases when comparing 2000-2003 to 2008-2011. Case residents of endemic areas had stronger odds of local exposures, but cases from areas not known to be endemic had greater mortality (14% versus 9%) with notably more deaths during 2008-2011. Compared to the 57 other California counties during 2001-2011, LA County had the third highest average annual number of cases and Antelope Valley had a higher incidence rate than all but six counties. With the large number of reported coccidioidomycosis cases, multi-agency and community partnering is recommended to develop effective education and prevention strategies to protect residents and travelers.
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Affiliation(s)
- Ramon E. Guevara
- Emergency Preparedness and Response Program, Department of Public Health, County of Los Angeles, Los Angeles, California, United States of America
| | - Tasneem Motala
- Acute Communicable Disease Control Program, Department of Public Health, County of Los Angeles, Los Angeles, California, United States of America
| | - Dawn Terashita
- Acute Communicable Disease Control Program, Department of Public Health, County of Los Angeles, Los Angeles, California, United States of America
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14
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Call for a California Coccidioidomycosis Consortium to Face the Top Ten Challenges Posed by a Recalcitrant Regional Disease. Mycopathologia 2014; 179:1-9. [DOI: 10.1007/s11046-014-9816-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
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15
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Langelier C, Baxi SM, Iribarne D, Chin-Hong P. Beyond the superficial: Coccidioides immitis fungaemia in a man with fever, fatigue and skin nodules: a case of an emerging and evolving pathogen. BMJ Case Rep 2014; 2014:bcr-2014-205333. [PMID: 25228676 DOI: 10.1136/bcr-2014-205333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Coccidioidomycosis is an insidious fungal disease, endemic to arid regions of the Americas, which is becoming more frequently recognised worldwide. While most infections resemble a mild respiratory illness, a subset of cases progress to severe pneumonia or systemic dissemination. Here, we describe a case of disseminated coccidioidomycosis in a 54-year-old immunocompetent African-American man with geographic and demographic risk factors for Coccidiodes acquisition who presented with 2 months of fevers, fatigue, weight loss and painful skin lesions. Blood count and serum chemistry studies initially demonstrated leukocytosis, anaemia, hyponatraemia and acute renal failure. Chest imaging revealed numerous small pulmonary nodules and skin biopsy, serological studies and blood cultures eventually confirmed disseminated infection with Coccidioides immitis. This case highlights important features regarding the risk factors, spectrum of clinical findings, evaluation and treatment of coccidioidomycosis relevant to providers in endemic areas and throughout the world.
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Affiliation(s)
- Charles Langelier
- Department of Internal Medicine, University of California San Francisco, San Francisco, California, USA
| | - Sanjiv M Baxi
- Department of Internal Medicine, Division of Infectious Diseases, University of California San Francisco, San Francisco, California, USA
| | - Daniela Iribarne
- Department of Internal Medicine, Mt. Sinai School of Medicine, New York, New York, USA
| | - Peter Chin-Hong
- Department of Internal Medicine, Division of Infectious Diseases, University of California San Francisco, San Francisco, California, USA
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Jude CM, Nayak NB, Patel MK, Deshmukh M, Batra P. Pulmonary Coccidioidomycosis: Pictorial Review of Chest Radiographic and CT Findings. Radiographics 2014; 34:912-25. [DOI: 10.1148/rg.344130134] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Luna-Isaac JA, Muñiz-Salazar R, Baptista-Rosas RC, Enríquez-Paredes LM, Castañón-Olivares LR, Contreras-Pérez C, Bazán-Mora E, González GM, González-Martínez MR. Genetic analysis of the endemic fungal pathogens Coccidioides posadasii and Coccidioides immitis in Mexico. Med Mycol 2014; 52:156-66. [PMID: 24577001 DOI: 10.1093/mmy/myt005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Coccidioidomycosis (CM) is a mycotic disease that affects mammals, including humans. Official data relative to CM in Mexico has not been collected since 1995, thus its prevalence remains unknown. The objectives of this study were to identify the predominant Coccidioides species in Mexico, infer their current geographical distribution and explore the correlation between species and clinical presentation. We collected 154 strains, which were cultured, inactivated, and processed for DNA extraction. Nine microsatellite loci, the Ag2/PRA gene and Umeyama Region were amplified from each isolate. To infer the current geographical distribution of Coccidioides spp. and to establish a correlation between genotype and clinical presentation, we evaluated genetic population structure under the following grouping criteria: putative origin and clinical presentation records. Microsatellite analysis showed that 82% of the isolates corresponded to C. posadasii and 18% were C. immitis. The species identification results obtained using Umeyama region, Ag2/PRA, and microsatellites of five of the isolates were inconsistent with the data collected for the remaining isolates. C. posadasii strains were found primarily in the northeastern region and C. immitis in the northwestern region. However, there was no relationship between clinical presentation and Coccidioides species. The molecular markers used in this study proved to have a high power of resolution to identify the Coccidioides species recovered in culture. While we found C. posadasii to be the most abundant species in Mexico, more detailed clinical records are needed in order to obtain more accurate information about the infections in specific geographical locations.
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Affiliation(s)
- Jorge A Luna-Isaac
- Laboratorio de Epidemiología y Ecología Molecular, Escuela de Ciencias de la Salud, Universidad Autónoma de Baja California
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Sondermeyer G, Lee L, Gilliss D, Tabnak F, Vugia D. Coccidioidomycosis-associated Hospitalizations, California, USA, 2000–2011. Emerg Infect Dis 2013; 19:1590-7. [PMID: 24050438 PMCID: PMC3810749 DOI: 10.3201/eid1910.130427] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In the past decade, state-specific increases in the number of reported cases of coccidioidomycosis have been observed in areas of California and Arizona where the disease is endemic. Although most coccidioidomycosis is asymptomatic or mild, infection can lead to severe pulmonary or disseminated disease requiring hospitalization and costly disease management. To determine the epidemiology of cases and toll of coccidioidomycosis-associated hospitalizations in California, we reviewed hospital discharge data for 2000–2011. During this period, there were 25,217 coccidioidomycosis-associated hospitalizations for 15,747 patients and >$2 billion US in total hospital charges. Annual initial hospitalization rates increased from 2.3 initial hospitalizations/100,000 population in 2000 to 5.0 initial hospitalizations/100,000 population in 2011. During this period, initial hospitalization rates were higher for men than women, African Americans and Hispanics than Whites, and older persons than younger persons. In California, the increasing health- and cost-related effects of coccidioidomycosis-associated hospitalizations are a major public health challenge.
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Abstract
Coccidioidomycosis consists of a spectrum of disease, ranging from a mild, self-limited, febrile illness to severe, life-threatening infection. It is caused by the soil-dwelling fungi, Coccidioides immitis and C. posadasii, which are present in diverse endemic areas. Climate changes and environmental factors affect the Coccidioides lifecycle and influence infection rates. The incidence of coccidioidomycosis has risen substantially over the past two decades. The vast majority of Coccidioides infections occur in the endemic zones, such as California, Arizona, Mexico, and Central America. Infections occurring outside those zones appear to be increasingly common, and pose unique clinical and public health challenges. It has long been known that elderly persons, pregnant women, and members of certain ethnic groups are at risk for severe or disseminated coccidioidomycosis. In recent years, it has become evident that persons with immunodeficiency diseases, diabetics, transplant recipients, and prisoners are also particularly vulnerable.
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Affiliation(s)
- Jennifer Brown
- Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Medical Center, Sacramento, CA, USA
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Sifuentes-Osornio J, Corzo-León DE, Ponce-de-León LA. Epidemiology of Invasive Fungal Infections in Latin America. CURRENT FUNGAL INFECTION REPORTS 2012; 6:23-34. [PMID: 22363832 PMCID: PMC3277824 DOI: 10.1007/s12281-011-0081-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The pathogenic role of invasive fungal infections (IFIs) has increased during the past two decades in Latin America and worldwide, and the number of patients at risk has risen dramatically. Working habits and leisure activities have also been a focus of attention by public health officials, as endemic mycoses have provoked a number of outbreaks. An extensive search of medical literature from Latin America suggests that the incidence of IFIs from both endemic and opportunistic fungi has increased. The increase in endemic mycoses is probably related to population changes (migration, tourism, and increased population growth), whereas the increase in opportunistic mycoses may be associated with the greater number of people at risk. In both cases, the early and appropriate use of diagnostic procedures has improved diagnosis and outcome.
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Affiliation(s)
- Jose Sifuentes-Osornio
- Laboratory of Microbiology, Salvador Zubiran National Institute of Medical Science and Nutrition, 15 Vasco de Quiroga, sección XVI, Tlalpan, México City, ZC 14000 Mexico
| | - Dora E. Corzo-León
- Infectious Diseases, Salvador Zubiran National Institute of Medical Science and Nutrition, México City, Mexico
| | - L. Alfredo Ponce-de-León
- Laboratory of Microbiology, Salvador Zubiran National Institute of Medical Science and Nutrition, 15 Vasco de Quiroga, sección XVI, Tlalpan, México City, ZC 14000 Mexico
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