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Valley fever cases rise in Missouri
Reported cases of coccidioidomycosis — commonly referred to as valley fever — increased more than fivefold in Missouri from 2004 to 2013, according to research published in MMWR.
Researcher George Turabelidze, MD, PhD, epidemiologist at the Missouri Department of Health and Senior Services, and colleagues retrospectively examined coccidioidomycosis surveillance data from 2004 to 2013 in Missouri, a state without endemic coccidioidomycosis. They determined that the incidence of reported cases across the state increased from 0.05 per 100,000 population in 2004 to 0.28 per 100,000 in 2013 (P < .001).
The researchers wrote that 48% of the 93 Missouri patients with confirmed coccidioidomycosis during the study period had visited a place where the disease is endemic, and those who traveled to an endemic area were much more likely to be diagnosed with coccidioidomycosis by PCR or positive culture (21 of 45) compared with those who had not undertaken such travel (4 of 24; P = .018). Those aged 60 years or older accounted for 43 cases; pneumonia (40%) and influenza-like illness (33%) were the most common symptoms of the disease.
Thirty-one percent of the patients received antifungal treatment; of those (20%) received fluconazole, the researchers wrote. Forty-six percent of patients were hospitalized due to the illness, and 8.6% of the 93 patients died. Coccidioidomycosis was determined as the cause of death in three cases.
“The increase in the incidence of reported coccidioidomycosis in Missouri from 2004 through 2013 was statistically significant and substantial,” according to Turabelidze and colleagues. “The increase is consistent with the national trend of increasing incidence of coccidioidomycosis that includes states with and without endemic disease.”
The researchers suggested that coccidioidomycosis becoming a reportable disease in Missouri in 2003 could be a factor in the rise in reported cases, as it can increase disease awareness and testing by physicians. Nationally, cases of coccidioidomycosis increased eightfold from 1998 to 2012, Turabelidze and colleagues wrote. – by David Jwanier
Disclosure: The researchers report no relevant financial disclosures.