The California Department of Public Health (CDPH) is warning physicians about an increased number of reported cases of coccidioidomycosis with onset dates in 2023. Health care providers should consider testing for coccidioidomycosis in patients who present with compatible symptoms and risk factors.

Coccidioidomycosis (also called Valley fever or “cocci”) is a disease caused by inhalation of the spores of the Coccidioides fungus that grows in the soil and dirt in some areas of the southwestern United States, with 97% of cases reported in Arizona and California. Coccidioidomycosis may be asymptomatic but typically presents as a self-limited respiratory illness or pneumonia. Patients may also present with erythema nodosum. However, infection can also lead to progressive pulmonary disease or severe disseminated disease including meningitis and can be fatal. 

A total of 9280 cases of coccidioidomycosis with onset dates in 2023 have been reported in California to date, which is higher than any other year on record. The increase in reported coccidioidomycosis cases is likely to continue throughout this winter due to heavy rainfall in the winter of 2022-2023 after years of drought.

Although the Central Valley continues to have the highest rates of coccidioidomycosis, the geographic distribution of coccidioidomycosis in California appears to be shifting, with notable increases in the Northern San Joaquin Valley, Central Coast, and Southern California.

Given these increases, CDPH is reminding physicians to consider coccidioidomycosis in the differential diagnosis of community acquired pneumonia or other respiratory illnesses in endemic or emerging areas.

View the full CDPH guidance here. For more  information on testing protocols and treatment practices, ​please refer to the CDC website and the IDSA guidelines​.