Biological Health Hazard – Coccidioidomycosis (Valley Fever): Monterey County, California
COCCIDIOIDOMYCOSIS – USA (02): (CALIFORNIA) INCREASED CASES
Published Date: 2016-12-11 17:40:44
Subject: PRO/EDR> Coccidioidomycosis – USA (02): (CA) increased cases
Archive Number: 20161211.4691082
Date: Saturday, 10 Dececember 2016
Source: Monterey County Weekly [edited]
Monterey County [California] officials are reporting a “concerning” increase in cases of valley fever [coccidioidomycosis] in the Salinas Valley and South County this fall . Some patients have been hospitalized as a result of the illness, which is caused by inhaling specific fungal spores that live in the soil.
There are 73 reported cases so far in 2016, up from 42 cases in 2015 and 24 cases in 2014. County Epidemiologist Kristy Michie says health providers noticed an uptick in this year’s  cases starting in October 2016, near the start of valley fever season, which runs September through March in the Monterey region.
Everyone is susceptible to the disease, but some will never experience symptoms, and about 60 percent will have mild symptoms. The fever mimics the flu, making diagnosis difficult. Symptoms include fever, coughing, and muscle aches. But unlike the flu, which goes away after about a week, serious cases of valley fever most likely will not go away without the use of anti-fungal medications, says Michie. Doctors use blood or mucus tests or x-rays to confirm the diagnosis.
Michie says it’s important to note that because the disease is caused by a fungus, it cannot be spread from person to person.
There are groups that are more susceptible to becoming seriously ill, including African Americans, Filipinos and other Asians, pregnant women in their 3rd trimester, diabetics, and anyone with a suppressed immune systems, as well as infants and the elderly.
Why Monterey County is experiencing an increase in cases is unknown, but there are theories. “It’s a fungus, essentially, and it naturally lives in the soil. It can stay inactive in moist soil for a very long time. When the soil dries out, the wind blows the spores,” she says, explaining what causes the fever. “There isn’t one specific thing we can point to, but drought can be one thing that can come into play.” Weather changes, new construction projects, or anything that creates the opportunity for more dust to be in the air can send spores flying.
Michie has gotten questions about whether the Soberanes Fire could have created an increase in cases, but she said they would have seen firefighters with the disease if that were the culprit.
[The Soberanes Fire in July-October 2016, the result of an illegal campfire, burned 132 127 acres (53 470 ha) along the Big Sur coast in the Los Padres National Forest, Ventana Wilderness, and adjacent private and public land in Monterey County, California (https://en.wikipedia.org/wiki/Soberanes_Fire)].
[Byline: Pam Marino]
ProMED-mail from HealthMap Alerts
[Coccidioidomycosis is a fungal infection that occurs in hot, semi-arid regions in the southwestern United States (mainly the states of Arizona, California, New Mexico, and Texas, but also Nevada, Utah and Washington state), parts of northern Mexico, and in Central and South America. It is caused by _Coccidioides immitis_ and _C. posadasii_, 2 nearly identical species of pathogenic fungi that grow in the top 2-8 inches [5 to 20 cm] of soil where the organism produces arthroconidia that can be disrupted and become airborne during conditions that disturb the soil. The airborne spores then can travel great distances by currents of air. The airborne spores can be inhaled and produce an acute infection in humans, as well as other animals.
The California counties of Kern, Kings, Tulare, Fresno, Madera, and San Luis Obispo are the _Coccidioides_-endemic areas; these counties had the highest annual average incidence rates for coccidioidomycosis, and their cumulative cases represent 76 per cent of all cases reported from California for the years 2001-2009 (see figure 9 at https://www.vfce.arizona.edu/resources/pdf/2011_coccidioidomycosis_epi.pdf). A California county map can be seen at http://geology.com/county-map/california.shtml.
For further discussions of coccidioidomycosis, see my moderator comments in prior ProMED-mail posts (Coccidioidomycosis – USA (03): (Southwest) 20151114.3790558, Coccidioidomycosis – USA (02): (AZ) increased cases 20151111.3784402, and Coccidioidomycosis – USA (06): (CA) prison 20130707.1811603). – Mod.ML
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/204.]
Coccidioidomycosis – USA: (WA) soil 20160401.4131891
Coccidioidomycosis – USA: (WA) soil 20140524.2495865
Coccidioidomycosis – USA (04): (CA) prison, fatal 20130502.1685779
Reference: CDC – Valley Fever (Coccidioidomycosis)