Coccidioidomycosis (Valley Fever)

(Rare Disease of Public Health Significance)

Cause: Fungus Coccidioides.

Illness and treatment: Symptoms can include fever, fatigue, cough, dyspnea, headache, night sweats, myalgias, and rash. Typical presentations are shortness of breath and pneumonia. Disseminated disease may also occur, with bones/joints, soft tissues, and meninges most commonly affected. Infection may be asymptomatic. Treatment is with antifungals.

Sources: Coccidioides sp. are environmental fungi that have been isolated from the soil in south-central Washington; cases are most common in the southwestern United States. Exposure is through inhalation of the organism, generally from dust or disturbed soil.

Prevention: There are no specific precautions.

Recent Washington trends: Since 2010, sixteen human cases of coccidioidomycosis with suspected exposure in Washington have been reported, all from south-central Washington. Animal cases with presumed in-state exposure have also been reported. C. immitis was found in soil from south-central Washington, including in Benton, Yakima, and Kittitas counties.

Purpose of Reporting and Surveillance

  • To track the emergence of Coccidioides in Washington.
  • To differentiate between infection acquired in Washington versus disease acquired outside of Washington.
  • To monitor trends in the epidemiology of disease due to Coccidioides.

Legal Reporting Requirements

Human or animal infections with Coccidioides are reportable in Washington State as rare diseases of public health significance.

  • Healthcare providers: Coccidioides infections notifiable to local health jurisdiction within 24 hours
  • Health care facilities: Coccidioides infections notifiable to local health jurisdiction within 24 hours
  • Laboratories: Coccidioides notifiable to local health jurisdiction within 24 hours; specimen submission required – cultures (2 business days); other specimens upon request
  • Veterinarians: Suspected human cases notifiable within 24 hours to the local health jurisdiction; animal cases notifiable to Washington State Department of Agriculture (see: https://app.leg.wa.gov/wac/default.aspx?cite=16-70)
  • Local health jurisdictions: notifiable to the Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (OCDE) within 7 days of case investigation completion or summary information required within 21 days