Sunenshine Rebecca H, Anderson Shoana, Erhart Laura, Vossbrink Anne, Kelly Peter C, Engelthaler David, Komatsu Kenneth
Arizona Department of Health Services, Phoenix, AZ 85007, USA.
Ann N Y Acad Sci. 2007 Sep;1111:96-102. doi: 10.1196/annals.1406.045. Epub 2007 May 18.
Coccidioidomycosis or Valley Fever is a fungal disease that occurs primarily in the southwestern United States. Of the estimated 150,000 U. S. coccidioidomycosis infections per year, approximately 60% occur in Arizona, making this state the focal point for investigation of the disease. In this manuscript, we describe the epidemiology of coccidioidomycosis reported in Arizona over the last decade, hypotheses for the findings, and Arizona's response to the rising epidemic. Coccidioidomycosis surveillance data in Arizona consist of basic demographics of all laboratory and physician-diagnosed cases, the reporting of which has been mandated by law since 1997. The rate of reported coccidioidomycosis has more than quadrupled over the last decade from 21 cases per 100,000 population in 1997 to 91 cases per 100,000 in 2006 (P < 0.001). Case rates in older age groups (>/=65 years old) have more than doubled since 2000 (P < 0.001). These data demonstrate the rising coccidioidomycosis epidemic in Arizona, especially among the elderly. The increase in the numbers of reported cases can be partially explained by the institution of mandatory laboratory reporting in 1997, but the cause of the persistent rise after 1999 is unknown. Further investigation of coccidioidomycosis will not only assist with the development of public health interventions to control this disease in Arizona and the southwestern United States, but will also provide important information to prepare for a bioterrorism event caused by this select agent.
球孢子菌病或圣河谷热是一种主要发生在美国西南部的真菌病。在美国，每年估计有15万例球孢子菌病感染病例，其中约60%发生在亚利桑那州，这使得该州成为该病调查的重点地区。在本论文中，我们描述了亚利桑那州过去十年报告的球孢子菌病的流行病学情况、这些发现的假设以及亚利桑那州对不断上升的疫情的应对措施。亚利桑那州的球孢子菌病监测数据包括所有实验室和医生诊断病例的基本人口统计学信息，自1997年起法律就规定必须报告这些信息。在过去十年中，报告的球孢子菌病发病率增长了四倍多，从1997年每10万人中的21例增至2006年的每10万人中的91例（P < 0.001）。自2000年以来，老年人群（≥65岁）的发病率增长了一倍多（P < 0.001）。这些数据表明亚利桑那州球孢子菌病疫情在不断上升，尤其是在老年人中。报告病例数的增加部分可以由1997年实行的强制实验室报告制度来解释，但1999年之后持续上升的原因尚不清楚。对球孢子菌病的进一步调查不仅将有助于制定公共卫生干预措施以控制亚利桑那州和美国西南部的这种疾病，还将为应对由这种特定病原体引起的生物恐怖主义事件提供重要信息。
