Epidemiology, Clinical Features, and Outcomes of Coccidioidomycosis, Utah, 2006-2015

Emerg Infect Dis. 2021 Sep;27(9):2269-2277. doi: 10.3201/eid2709.210751.

Abstract

On the basis of a 1957 geographic Coccidioides seropositivity survey, 3 counties in southwestern Utah, USA, were considered coccidioidomycosis-endemic, but there has been a paucity of information on the disease burden in Utah since. We report findings from a recent clinical and epidemiologic study of coccidioidomycosis in Utah. To describe clinical characteristics, we identified all coccidioidomycosis cases in an integrated health system in the state during 2006-2015. For epidemiologic analysis, we used cases reported to the Utah Department of Health during 2009-2015. Mean state incidence was 1.83 cases/100,000 population/year. Washington County, in southwestern Utah, had the highest incidence, 17.2 cases/100,000 population/year. In a generalized linear model with time as a fixed effect, mean annual temperature, population, and new construction were associated with regional variations in incidence. Using these variables in a spatiotemporal model, we estimated the adjusted regional variation by county to predict areas where Coccidioides infections might increase.

Keywords: Coccidioides; Coccidioides immitis; Coccidioides posadasii; Intermountain Healthcare system; United States; Utah; antifungal agents; coccidioidomycosis; epidemiology; fungi; pulmonary infections.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Coccidioides
  • Coccidioidomycosis* / epidemiology
  • Humans
  • Incidence
  • Temperature
  • Utah / epidemiology