Enhanced Surveillance of Coccidioidomycosis, Arizona, USA, 2007–2008

作者：Clarisse A. Tsang, Shoana M. Anderson, Sara Imholte, Laura M. Erhart, Sanny Y. Chen, Benjamin J. Park, Cara M. Christ, Kenneth K. Komatsu, Tom M Chiller, Rebecca H. Sunenshine · 发表于：Emerging infectious diseases · 年份：2010 · DOI：10.3201/eid1611.100475 · 被引用次数：144 · 研究领域：Fungal Infections and Studies、Phytoplasmas and Hemiptera pathogens、Nail Diseases and Treatments

Coccidioidomycosis is endemic to the southwestern United States; 60% of nationally reported cases occur in Arizona.Although the Council of State and Territorial Epidemiologists case defi nition for coccidioidomycosis requires laboratory and clinical criteria, Arizona uses only laboratory criteria.To validate this case defi nition and characterize the effects of coccidioidomycosis in Arizona, we interviewed every tenth case-patient with coccidioidomycosis reported during January 2007-February 2008.Of 493 patients in-terviewed, 44% visited the emergency department, and 41% were hospitalized.Symptoms lasted a median of 120 days.Persons aware of coccidioidomycosis before seeking healthcare were more likely to receive an earlier diagnosis than those unaware of the disease (p = 0.04) and to request testing for Coccidioides spp.(p = 0.05).These fi ndings warrant greater public and provider education.Ninety-fi ve percent of patients interviewed met the Council of State and Territorial Epidemiologists clinical case defi nition, validating the Arizona laboratory-based case defi nition for surveillance in a coccidiodomycosis-endemic area.C occidioidomycosis, or valley fever, is a fungal disease endemic to the southwestern United States, parts of Mexico, and Central and South America.Infection probably occurs when arthroconidia from disrupted soil are inhaled, Enhanced Surveillance of Coccidioidomycosis, Arizona, USA,