Skip to main content

Advertisement

Log in

Update on the Epidemiology of Coccidioidomycosis

  • Epidemiology of Fungal Infections (T Chiller and JW Baddley, Section Editors)
  • Published:
Current Fungal Infection Reports Aims and scope Submit manuscript

Abstract

Coccidioidomycosis is an illness caused by the soil-dwelling, dimorphic fungi, Coccidioides immitis and Coccidioides posadasii, which are found primarily in niche ecological zones of the Western Hemisphere. The bulk of infections due to Coccidioides are found within the endemic areas of Arizona, California, Mexico, and Central America. Outcomes run the gamut from asymptomatic to a self-limited or even chronic pulmonary process, up to severe disseminated, and life-threatening disease. Patients at particular risk include the elderly, pregnant women, and members of certain ethnicities. Recent changes in the epidemiology and our overall understanding of coccidioidomycosis that pose a particular challenge to healthcare professionals include the rising incidence of disease, identification of infections thought to be acquired outside the previously described zones of endemicity, and the risks posed to the immunosuppressed population due to the increasing use of immunomodulatory pharmaceutical agents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Galgiani JN, Ampel NM, Blair JE, Catanzaro A, Johnson RH, Stevens DA, et al. Coccidioidomycosis. Clin Infect Dis. 2005;41(9):1217–23.

    Article  PubMed  Google Scholar 

  2. Thompson 3rd GR. Pulmonary coccidioidomycosis. Semin Respir Crit Care Med. 2011;32(6):754–63.

    Article  PubMed  Google Scholar 

  3. Laniado-Laborin R. Expanding understanding of epidemiology of coccidioidomycosis in the Western hemisphere. Ann N Y Acad Sci. 2007;1111:19–34.

    Article  PubMed  Google Scholar 

  4. Engelthaler DM, Roe CC, Hepp CM, Teixeira M, Driebe EM, Schupp JM, et al. Local population structure and patterns of Western Hemisphere dispersal for Coccidioides spp., the fungal cause of valley fever. MBio. 2016;7(2):e00550.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Teixeira MM, Barker BM. Use of population genetics to assess the ecology, evolution, and population structure of coccidioides. Emerg Infect Dis. 2016;22(6):1022–30.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Brown J, Benedict K, Park BJ, Thompson 3rd GR. Coccidioidomycosis: epidemiology. Clin Epidemiol. 2013;5:185–97.

    PubMed  PubMed Central  Google Scholar 

  7. Nguyen C, Barker BM, Hoover S, Nix DE, Ampel NM, Frelinger JA, et al. Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis. Clin Microbiol Rev. 2013;26(3):505–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Comrie AC. Climate factors influencing coccidioidomycosis seasonality and outbreaks. Environ Health Perspect. 2005;113(6):688–92.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kolivras KN, Comrie AC. Modeling valley fever (coccidioidomycosis) incidence on the basis of climate conditions. Int J Biometeorol. 2003;47(2):87–101.

    PubMed  Google Scholar 

  10. Wack EE, Ampel NM, Sunenshine RH, Galgiani JN. The return of delayed-type hypersensitivity skin testing for coccidioidomycosis. Clin Infect Dis. 2015;61:787–91.

    Article  PubMed  Google Scholar 

  11. Litvintseva AP, Marsden-Haug N, Hurst S, Hill H, Gade L, Driebe EM, et al. Valley fever: finding new places for an old disease: coccidioides immitis found in Washington State soil associated with recent human infection. Clin Infect Dis. 2015;60(1):e1–3.

    Article  PubMed  Google Scholar 

  12. Edwards PQ, Palmer CE. Prevalence of sensitivity to coccidioidin, with special reference to specific and nonspecific reactions to coccidioidin and to histoplasmin. Dis Chest. 1957;31(1):35–60.

    Article  CAS  PubMed  Google Scholar 

  13. Hector RF, Laniado-Laborin R. Coccidioidomycosis—a fungal disease of the Americas. PLoS Med. 2005;2(1):e2.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Marsden-Haug N, Goldoft M, Ralston C, Limaye AP, Chua J, Hill H, et al. Coccidioidomycosis acquired in Washington State. Clin Infect Dis. 2013;56(6):847–50.

    Article  PubMed  Google Scholar 

  15. Stockamp NW, Thompson 3rd GR. Coccidioidomycosis. Infect Dis Clin North Am. 2016;30(1):229–46.

    Article  PubMed  Google Scholar 

  16. Cummings KC, McDowell A, Wheeler C, McNary J, Das R, Vugia DJ, et al. Point-source outbreak of coccidioidomycosis in construction workers. Epidemiol Infect. 2010;138(4):507–11.

    Article  CAS  PubMed  Google Scholar 

  17. Crum N, Lamb C, Utz G, Amundson D, Wallace M. Coccidioidomycosis outbreak among United States Navy SEALs training in a Coccidioides immitis-endemic area—Coalinga, California. J Infect Dis. 2002;186(6):865–8.

    Article  PubMed  Google Scholar 

  18. Flynn NM, Hoeprich PD, Kawachi MM, Lee KK, Lawrence RM, Goldstein E, et al. An unusual outbreak of windborne coccidioidomycosis. N Engl J Med. 1979;301(7):358–61.

    Article  CAS  PubMed  Google Scholar 

  19. Schneider E, Hajjeh RA, Spiegel RA, Jibson RW, Harp EL, Marshall GA, et al. A coccidioidomycosis outbreak following the Northridge, Calif, earthquake. JAMA. 1997;277(11):904–8.

    Article  CAS  PubMed  Google Scholar 

  20. Thompson 3rd GR, Stevens DA, Clemons KV, Fierer J, Johnson RH, Sykes J, et al. Call for a California coccidioidomycosis consortium to face the top ten challenges posed by a recalcitrant regional disease. Mycopathologia. 2015;179(1-2):1–9.

    Article  PubMed  Google Scholar 

  21. Twarog M, Thompson 3rd GR. Coccidioidomycosis: recent updates. Semin Respir Crit Care Med. 2015;36(5):746–55.

    Article  PubMed  Google Scholar 

  22. Leake JA, Mosley DG, England B, Graham JV, Plikaytis BD, Ampel NM, et al. Risk factors for acute symptomatic coccidioidomycosis among elderly persons in Arizona, 1996-1997. J Infect Dis. 2000;181(4):1435–40.

    Article  CAS  PubMed  Google Scholar 

  23. Centers for Disease C, Prevention. Increase in reported coccidioidomycosis—United States, 1998-2011. MMWR Morb Mortal Wkly Rep. 2013;62(12):217–21.

    Google Scholar 

  24. Blair JE, Mayer AP, Currier J, Files JA, Wu Q. Coccidioidomycosis in elderly persons. Clin Infect Dis. 2008;47(12):1513–8.

    Article  PubMed  Google Scholar 

  25. Rosenstein NE, Emery KW, Werner SB, Kao A, Johnson R, Rogers D, et al. Risk factors for severe pulmonary and disseminated coccidioidomycosis: Kern County, California, 1995-1996. Clin Infect Dis. 2001;32(5):708–15.

    Article  CAS  PubMed  Google Scholar 

  26. Hector RF, Rutherford GW, Tsang CA, Erhart LM, McCotter O, Anderson SM, et al. The public health impact of coccidioidomycosis in Arizona and California. Int J Environ Res Public Health. 2011;8(4):1150–73.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Guevara RE, Motala T, Terashita D. The changing epidemiology of coccidioidomycosis in Los Angeles (LA) County, California, 1973-2011. PLoS One. 2015;10(8):e0136753.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Drutz DJ, Huppert M, Sun SH, McGuire WL. Human sex hormones stimulate the growth and maturation of Coccidioides immitis. Infect Immun. 1981;32(2):897–907.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Wack EE, Ampel NM, Galgiani JN, Bronnimann DA. Coccidioidomycosis during pregnancy. An analysis of ten cases among 47,120 pregnancies. Chest. 1988;94(2):376–9.

    Article  CAS  PubMed  Google Scholar 

  30. Bercovitch RS, Catanzaro A, Schwartz BS, Pappagianis D, Watts DH, Ampel NM. Coccidioidomycosis during pregnancy: a review and recommendations for management. Clin Infect Dis. 2011;53(4):363–8.

    Article  PubMed  Google Scholar 

  31. Crum NF, Ballon-Landa G. Coccidioidomycosis in pregnancy: case report and review of the literature. Am J Med. 2006;119(11):993. e11-7.

    Article  PubMed  Google Scholar 

  32. Smith CE, Beard RR, et al. Varieties of coccidioidal infection in relation to the epidemiology and control of the diseases. Am J Public Health Nations Health. 1946;36(12):1394–402.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Santelli AC, Blair JE, Roust LR. Coccidioidomycosis in patients with diabetes mellitus. Am J Med. 2006;119(11):964–9.

    Article  PubMed  Google Scholar 

  34. Blair JE, Smilack JD, Caples SM. Coccidioidomycosis in patients with hematologic malignancies. Arch Intern Med. 2005;165(1):113–7.

    Article  PubMed  Google Scholar 

  35. Rutala PJ, Smith JW. Coccidioidomycosis in potentially compromised hosts: the effect of immunosuppressive therapy in dissemination. Am J Med Sci. 1978;275(3):283–95.

    Article  CAS  PubMed  Google Scholar 

  36. Masannat FY, Ampel NM. Coccidioidomycosis in patients with HIV-1 infection in the era of potent antiretroviral therapy. Clin Infect Dis. 2010;50(1):1–7.

    Article  CAS  PubMed  Google Scholar 

  37. Woods CW, McRill C, Plikaytis BD, Rosenstein NE, Mosley D, Boyd D, et al. Coccidioidomycosis in human immunodeficiency virus-infected persons in Arizona, 1994-1997: incidence, risk factors, and prevention. J Infect Dis. 2000;181(4):1428–34.

    Article  CAS  PubMed  Google Scholar 

  38. Bergstrom L, Yocum DE, Ampel NM, Villanueva I, Lisse J, Gluck O, et al. Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor alpha antagonists. Arthritis Rheum. 2004;50(6):1959–66.

    Article  CAS  PubMed  Google Scholar 

  39. Blair JE, Kusne S, Carey EJ, Heilman RL. The prevention of recrudescent coccidioidomycosis after solid organ transplantation. Transplantation. 2007;83(9):1182–7.

    Article  PubMed  Google Scholar 

  40. Mendoza N, Noel P, Blair JE. Diagnosis, treatment, and outcomes of coccidioidomycosis in allogeneic stem cell transplantation. Transpl Infect Dis. 2015;17(3):380–8.

    Article  CAS  PubMed  Google Scholar 

  41. Blair JE. Coccidioidomycosis in patients who have undergone transplantation. Ann N Y Acad Sci. 2007;1111:365–76.

    Article  PubMed  Google Scholar 

  42. Winthrop KL, Chiller T. Preventing and treating biologic-associated opportunistic infections. Nat Rev Rheumatol. 2009;5(7):405–10.

    Article  CAS  PubMed  Google Scholar 

  43. Mendoza N, Blair JE. The utility of diagnostic testing for active coccidioidomycosis in solid organ transplant recipients. Am J Transplant. 2013;13(4):1034–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to George R. Thompson III.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of Topical Collection on Epidemiology of Fungal Infections

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stewart, E.R., Thompson, G.R. Update on the Epidemiology of Coccidioidomycosis. Curr Fungal Infect Rep 10, 141–146 (2016). https://doi.org/10.1007/s12281-016-0266-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12281-016-0266-1

Keywords

Navigation