Abstract
Coccidioidomycosis (Valley Fever) is a disease caused by species of Coccidioides. The disease is endemic to arid regions of the Southwestern US and while most common in CA and AZ is also present in NM. We present the first genetic analysis of clinical isolates from NM. Travel and demographic information was available for a number of patients, which included individuals from NM and the Southwestern US Four Corners region. Multi-gene phylogenetic analyses revealed the presence of both C. posadasii and C. immitis. While NM is predicted to be within the endemic range for C. posadasii, our results expand the known range of C. immitis, often considered to be the “California species”. Five of eight infections for which patient ethnicity existed occurred in Native Americans, and two occurred in African Americans. Several isolates came from the northwestern part of NM—outside the predicted “highly-endemic” region. Our study suggests Native Americans represent an unrecognized at-risk group, and it provides a foundation for better defining the geographic distribution of the Coccidioides species and for preventing exposure among populations at risk. In the course of this study, we developed a reliable PCR-based method to distinguish species targeting regions of the mitochondrial genome.
Highlights
Coccidioidomycosis, commonly known as Valley Fever, is caused by the soil-dwelling fungiCoccidioides immitis and C. posadasii
Health records from patients in our study suggest the possibility that Native American Indians represent an additional risk group for disseminated disease
All four gene regions examined were capable of distinguishing between the two Coccidioides species, based on comparisons with sequences reported in Genbank
Summary
Coccidioidomycosis, commonly known as Valley Fever, is caused by the soil-dwelling fungi. Molecular and phenotypic analyses have resulted in Coccidioides being divided into two species: C. immitis, known primarily from California, and C. posadasii, recognized originally as the non–California group [6]. The isolates studied have been mainly limited to California, Arizona, Central America, Mexico, and Texas [14,15], and the genetics of isolates from New Mexico have not been examined. The study reported here employed genetic analyses of 18 isolates collected from patients diagnosed with coccidioidomycosis from diverse locations across. Southern New Mexico has been recognized as part of the endemic region for Coccidioides [12,16], several of the isolates examined here were from Northern and Central New Mexico, suggesting a broad range for Coccidioides that includes the Four Corners region. Health records from patients in our study suggest the possibility that Native American Indians represent an additional risk group for disseminated disease
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