Coccidioidomycosis
What is Coccidioidomycosis?
Disseminated (scatter or spread widely) coccidioidomycosis (Valley Fever) is a fungal infection caused by the dimorphic (having two forms) fungus Coccidioides immitis that spreads through the bloodstream and involves many organs. In the disseminated form of the disease, the infection may spread to the bones, lungs, liver, brain, skin, heart, and pericardium. Pericardium is the sac around the heart.
Who Gets Coccidioidomycosis?
Coccidioides immitis resides in the soil of semiarid (low annual rainfall) areas in certain parts of the southwestern United States, parts of Mexico and South America. Most of the people who get the disease are people who live in or visit places where the fungus is in the soil and who engage in activities that expose them to dust, such as construction, agricultural work, military field training and archeological exploration.
It is a reportable disease in states where the disease is endemic (native to or confined to a particular place or region), such as California, New Mexico, Arizona and Nevada. Of people who live in an endemic region, about 10 to 50 percent will have evidence of exposure to Coccidioides.
How Do Coccidioidomycosis Infections Spread?
People get infected with Coccidioides immitis by inhaling fungal spores that become airborne after disturbance of contaminated soil by humans or natural disasters, for example, dust storms and earthquakes.
Is Coccidioidomycosis Contagious?
Coccidioidomycosis is not contagious. The infection is not spread from person to person, or from animals to people.
What are the Symptoms of Coccidioidomycosis?
Symptoms may appear between 1 to 3 weeks after exposure. About 60 percent of infections do not cause any symptoms.
People who develop symptoms may experience a flu-like illness, with fever, cough, headache, rash and muscle aches. If you have symptoms, you should see your doctor.
Most people make a full recovery, within weeks to months of symptom onset, but a small number of people may develop chronic pulmonary infection or widespread disseminated infection. When the infection spreads outside of the lungs, it most commonly results in skin lesions, central nervous system infection, such as meningitis, and bone and joint infection. Some people are at increased risk for developing disseminated infection: people of African-American, Asian or Filipino descent appear to be at increased risk, as do pregnant women during the third trimester and immunocompromised persons.
Treatment for Coccidioidomycosis
Symptoms from the acute infection may resolve on their own without treatment. However, some doctors prefer to prescribe antifungal drugs, such as fluconazole, to treat patients with acute, uncomplicated coccidioidomycosis. There is not enough information about whether treating acute, uncomplicated pulmonary coccidioidomycosis is beneficial or not, although many experts feel that persons at risk for developing severe disease should receive treatment. Antibacterial drugs do not treat coccidioidomycosis.
In more severe infections, treatment with antifungal drugs is necessary. People who have pneumonia from coccidioidomycosis affecting both lungs, people who have disseminated disease, and people who have chronic pneumonia all need treatment.
Prevention of Coccidioidomycosis
Avoidance of dusty environments in endemic regions may help to prevent infection. In addition, persons at risk for severe disease should avoid activities that may result in dust exposure, such as digging.
Recent Outbreaks of Coccidioidomycosis
Outbreaks of coccidioidomycosis do occasionally occur, particularly following earthquakes or other events that disturb large amounts of soil in endemic regions. More recent outbreaks have occurred among military trainees and among archeological workers. If you live in an endemic area, such as Arizona or the San Joaquin Valley area of California, contact your local or state health department for the most up to date information.
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References:
Centers for Disease Control and Prevention (CDC)
March 2008
www.cdc.gov
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