Thursday, August 23, 2018

PRO/EDR> Coccidioidomycosis - USA (02): (CA) increase cases, 2017

COCCIDIOIDOMYCOSIS - USA (02): (CALIFORNIA) INCREASE CASES, 2017
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International Society for Infectious Diseases
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Date: Tue 21 Aug 2018
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/valley-fever-california-reports-highest-annual-number-new-cases-2017/>


The California Department of Public Health (CDPH) is reporting that in
2017, 7466 new cases of valley fever were reported, making 2017 the
highest annual incidence reported in California since
coccidioidomycosis became individually reportable in 1995 [1]. It was
also the 2nd consecutive record year for reported valley fever cases.

Consistent with previous years, the highest coccidioidomycosis
incidence in 2017 were reported in counties in the Central Valley and
central coast regions, including Kern, Kings, San Luis Obispo, Fresno,
Tulare, Madera, and Monterey counties. Nearly 64 percent of the 2017
case-patients resided in one of these counties, with 37 percent
residing in Kern county.

"With the continued increase in valley fever, people living and
working in the Central Valley and central coasts regions should take
steps to avoid breathing in dusty air," said CDPH Director and State
Public Health Officer Dr Karen Smith. "If individuals develop flu-like
symptoms, such as cough, fever, or difficulty breathing, lasting 2
weeks or more, they should ask their health care provider about valley
fever."

It is unclear why there has been such a large increase in reported
valley fever cases in California since 2014. Possible contributing
factors include heavy rainfall after years of drought as well as other
climatic and environmental factors, increased number of susceptible
people in areas where the fungus is present, and increased awareness,
testing, and diagnosis by health care providers.

Valley fever, also known as coccidioidomycosis, or cocci, is caused by
breathing in the spores of a fungus that grows in certain types of
soil. The fungal spores can be present in dust that gets into the air
when it is windy or when soil is disturbed, such as through digging in
dirt during construction.

Most infected people will not show signs of illness. Those who do
become ill with valley fever may have flu-like symptoms that can last
for 2 weeks or more. While most people recover fully, some may develop
more severe complications which include pneumonia, or infection of the
brain, joints, bone, skin, or other organs. There is currently no
vaccine, but antifungal medications are available. Individuals should
specifically ask their health care provider about valley fever if they
think they may be infected.

While anyone can get valley fever, those most at-risk for severe
disease include people 60 years or older, African-Americans,
Filipinos, pregnant women, and people with diabetes or conditions that
weaken their immune system. People who live, work, or travel in valley
fever areas are also at higher risk of getting infected, especially if
they work outdoors or participate in activities where soil is
disturbed.

[1. California Department of Public Health, Office of Public Affairs.
Valley fever cases continued to increase in California in 2017. 16 Aug
2018. 18-040;
<https://www.cdph.ca.gov/Programs/OPA/Pages/NR18-041.aspx>]

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Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[Coccidioidomycosis, commonly known as valley fever, is a fungal
disease caused by inhalation of spores of _Coccidioides immitis_ or
_C. posadasii_, dimorphic saprophytic fungi that grow in soil as a
mycelium that break off into airborne spores. The spores, known as
arthroconidia, become airborne during conditions that disturb the
soil. In the host organism, the inhaled arthrospores develop into
spherules.

In the referenced article, the California Department of Public Health
recommends
(<https://www.cdph.ca.gov/Programs/OPA/Pages/NR18-041.aspx>):

"A person can reduce the risk of illness by avoiding breathing in dirt
or dust in areas where valley fever is common. In these areas, when it
is windy outside and the air is dusty, stay inside and keep windows
and doors closed. While driving, keep car windows closed and use
recirculating air conditioning, if available. If individuals must be
outdoors, they should consider wearing a properly fitted mask when the
air is dusty (such as an N95 respirator mask which is widely available
in retail stores), and refrain from disturbing the soil whenever
possible.

"Employers should train workers about valley fever symptoms and take
steps to limit workers' exposure to dust, such as watering down the
soil before digging.

"It is unclear why there has been such a large increase in reported
valley fever cases in California since 2014. Possible contributing
factors include heavy rainfall after years of drought as well as other
climatic and environmental factors, increased number of susceptible
people in areas where the fungus is present, and increased awareness,
testing, and diagnosis by health care providers. It is unknown if or
how the relatively dry 2017-2018 winter in California will impact the
number of valley fever cases this year."

The state of California can be located on the HealthMap/ProMED-mail
interactive map at <http://healthmap.org/promed/p/204>. A county map
can be seen at
<https://www.mapofus.org/wp-content/uploads/2013/09/CA-county.jpg>. -
Mod.ML]

[See Also:
Coccidioidomycosis - USA: (AZ) increased cases
http://promedmail.org/post/20180413.5744992
Coccidioidomycosis - Worldwide: outbreaks, epidemiology, 1940-2015
http://promedmail.org/post/20180215.5630685
2017
----
Coccidioidomycosis - USA (04): (AZ) canine
http://promedmail.org/post/20171209.5493257
Coccidioidomycosis - USA (03): (CA) increase
http://promedmail.org/post/20171121.5456947
Coccidioidomycosis - USA (02): (CA) increased cases
http://promedmail.org/post/20170512.5030268
Coccidioidomycosis - Brazil: (PE) possible new state, RFI
http://promedmail.org/post/20170504.5014040
Coccidioidomycosis - USA: (CA) increased cases
http://promedmail.org/post/20170206.4817960
2016
----
Coccidioidomycosis - USA (02): (CA) increased cases
http://promedmail.org/post/20161211.4691082
Coccidioidomycosis - USA: (WA) soil
http://promedmail.org/post/20160401.4131891
2015
----
Coccidioidomycosis - USA (03): (Southwest)
http://promedmail.org/post/20151114.3790558
Coccidioidomycosis - USA (02): (AZ) increased cases
http://promedmail.org/post/20151111.3784402
Coccidioidomycosis - USA: (NV)
http://promedmail.org/post/20150812.3573696]
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