Coccidioidomycosis: epidemiology

Jennifer Brown,¹ Kaitlin Benedict,² Benjamin J Park,² George R Thompson III<sup>1,3

1</sup>Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Medical Center, Sacramento, CA, USA; ²Mycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA; ³Department of Medical Microbiology and Immunology, One Shields Avenue, Tupper Hall, Coccidioidomycosis Serology Laboratory, University of California, Davis, CA, USA

Abstract: Coccidioidomycosis consists of a spectrum of disease, ranging from a mild, self-limited, febrile illness to severe, life-threatening infection. It is caused by the soil-dwelling fungi, Coccidioides immitis and C. posadasii, which are present in diverse endemic areas. Climate changes and environmental factors affect the Coccidioides lifecycle and influence infection rates. The incidence of coccidioidomycosis has risen substantially over the past two decades. The vast majority of Coccidioides infections occur in the endemic zones, such as California, Arizona, Mexico, and Central America. Infections occurring outside those zones appear to be increasingly common, and pose unique clinical and public health challenges. It has long been known that elderly persons, pregnant women, and members of certain ethnic groups are at risk for severe or disseminated coccidioidomycosis. In recent years, it has become evident that persons with immunodeficiency diseases, diabetics, transplant recipients, and prisoners are also particularly vulnerable.

Keywords: coccidioidomycosis, Coccidioides, epidemiology, incidence, risk factors, geography