Abstract
Coccidioidomycosis, also known as Valley Fever, is often thought of as an endemic disease of central California exclusive of Los Angeles County. The fungus that causes Valley Fever, Coccidioides spp., grows in previously undisturbed soil of semi-arid and arid environments of certain areas of the Americas. LA County has a few large areas with such environments, particularly the Antelope Valley which has been having substantial land development. Coccidioidomycosis that is both clinically- and laboratory-confirmed is a mandated reportable disease in LA County. Population surveillance data for 1973–2011 reveals an annual rate increase from 0.87 to 3.2 cases per 100,000 population (n = 61 to 306 annual cases). In 2004, case frequency started substantially increasing with notable epidemiologic changes such as a rising 2.1 to 5.7 male-to-female case ratio stabilizing to 1.4–2.2. Additionally, new building construction in Antelope Valley greatly rose in 2003 and displayed a strong correlation (R = 0.92, Pearson p<0.0001) with overall LA County incidence rates for 1996–2007. Of the 24 LA County health districts, 19 had a 100%-1500% increase in cases when comparing 2000–2003 to 2008–2011. Case residents of endemic areas had stronger odds of local exposures, but cases from areas not known to be endemic had greater mortality (14% versus 9%) with notably more deaths during 2008–2011. Compared to the 57 other California counties during 2001–2011, LA County had the third highest average annual number of cases and Antelope Valley had a higher incidence rate than all but six counties. With the large number of reported coccidioidomycosis cases, multi-agency and community partnering is recommended to develop effective education and prevention strategies to protect residents and travelers.
Highlights
Coccidioidomycosis, commonly known as Valley Fever, is a fungal disease normally caused by the inhalation of airborne spores of Coccidioides spp. which grow in the soil of PLOS ONE | DOI:10.1371/journal.pone
This study examines population-based surveillance data of 1973–2011 to present the epidemiology of coccidioidomycosis in LA County, California
Because of the distance from large business centers, residential property in Antelope Valley is much cheaper than most parts of the county
Summary
Coccidioidomycosis, commonly known as Valley Fever, is a fungal disease normally caused by the inhalation of airborne spores of Coccidioides spp. which grow in the soil of PLOS ONE | DOI:10.1371/journal.pone.0136753 August 27, 2015Coccidioidomycosis in Los Angeles County, California, 1973–2011 certain areas of the Americas, in routinely hot, arid to semi-arid environments [1,2]. Coccidioidomycosis, commonly known as Valley Fever, is a fungal disease normally caused by the inhalation of airborne spores of Coccidioides spp. which grow in the soil of PLOS ONE | DOI:10.1371/journal.pone.0136753. While an estimated 60% of infected people develop mild to no symptoms [3], the remaining infected present with various symptoms and conditions that can include weeks to months of fatigue, shortness of breath, cough, fever, night sweats, loss of appetite or weight, chest pain, headache, body aches, skin rash, and pneumonia [4]. Less than five percent of infected people develop disseminated disease which is when the fungus spreads beyond the lungs to infect any other body site such as skin, lymph nodes, bones, joints, and brain [4]. In California, the median cost of hospitalization alone is estimated to be U.S $55,062 per patient [7]. As symptoms are nonspecific and disease awareness is low among primary healthcare providers [6,8], disease detection and timely treatment are major challenges
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