May 09, 2013
According to the Centers for Disease Control and Prevention (CDC), coccidiodomycosis, a potentially lethal but often misdiagnosed disease is infecting more and more people in California. Most often prevalent in arid regions of the United States, coccidiodomycosis (also known as "valley fever") can be contracted by simply breathing in fungus-laced spores from dust disturbed by wind.
Reported cases of valley fever cases have continued to increase in California from about 700 in 1998 to more than 5,500 cases reported in 2011. The disease has seen the sharpest rise in Kern County, followed by Kings and Fresno counties. Out of the 18,776 California cases between 2001 and 2008, 265 people died, according to the California Department of Public Health (CDPH). According to state public health officials, the reasons for the increase is still unclear.
With the reemergence of coccidiodomycosis, CDPH is urging California physicians to refresh their knowledge and understanding of the disease and to report suspected cases to their local health departments.
Concerns about increases in reported cases valley fever were heightened during the first week of May when a federal health official ordered the transfer of more than 3,000 inmates from two San Joaquin Valley prisons where several dozen have died of the disease in recent years. A day later, state officials began investigating an outbreak in February that sickened 28 workers at two solar power plants under construction in San Luis Obispo County.
Although most individuals infected with coccidiodomycosis will not have any symptoms, approximately 40 percent of patients will present with symptoms that range from pneumonia to skin lesions.
Symptoms arise at 1-3 weeks following infection. Most symptomatic persons will present with a mild, self-limited influenza-like illness or community-acquired pneumonia and may complain of fever, cough, chest discomfort, malaise and fatigue. Infected individuals may also develop diffuse or progressive pneumonia, mediastinitis or pulmonary nodules or cavities. About 5 percent of symptomatic persons will develop disseminated disease, which most often presents as skin lesions, osteomylitis or meningitis.
While anyone in the endemic area is at risk, persons working in occupations involving dirt and dust exposure may be at increased risk of developing valley fever. African Americans, Filipinos, persons aged 65 and older, pregnant women in their third trimester and persons with diabetes or immunocompromising conditions are at increased risk of severe pulmonary or disseminated disease when infected.
Several diagnostic methods for coccidioidomycosis are available including serology, culture and histopathology and several antifungal medications are available for treatment.
For more information:Infectious Disease Society of AmericaFree CME on valley fever for primary care physiciansCalifornia Department of Public Health