Environmental and Occupational Health Sciences, School of Public Health and School of Medicine, Louisiana State University Health Sciences Center (LSUHSC), Office 2020 Gravier Street, Third Floor, New Orleans, LA 70112, USA.
J Travel Med. 2018 Jan 1;25(1). doi: 10.1093/jtm/tay027.
Coccidioidomycosis is a regionally endemic systemic mycosis with unique risk factors. Since people travel for business or pleasure, and often in conjunction with their avocations or hobbies, the objectives of this review were to describe these and other risk factors for coccidioidomycosis; to alert travel medicine clinicians to the different presenting manifestations of coccidioidomycosis; and to recommend effective treatment, disease control and prevention strategies.
To meet the objectives of this review, Internet search engines were queried with the keywords as medical subject headings over the study period, 1970-2017.
The principle transmission mechanism of coccidioidomycosis is by deep inhalation of aerosolized arthroconidia with resulting symptomatic pulmonary infections ranging from febrile influenza-like illnesses to fatal disseminated mycoses. In addition to residency or travel in endemic areas, persons immunocompromised by advancing age, pregnancy, cancer, corticosteroid therapy, diabetes, organ transplantation and human immunodeficiency virus infection are at significantly increased risks of contracting coccidioidomycosis. Persons of African, Asian, Filipino and Hispanic descent are also at increased risks of contracting coccidioidomycosis. Hobbies associated with coccidioidomycosis have included armadillo hunting, model airplane flying and archaeological digging. Occupational risk factors for coccidioidomycosis include endemic exposures during military maneuvers, outdoor track and field events, road construction, solar-power and wind-power farm construction, archaeological excavation and prison work.
Coccidioidomycosis is more common in endemic and non-endemic areas than previously recognized and can result in considerable morbidity and mortality. Coccidioidomycosis is increasingly imported from endemic areas in the Western Hemisphere to non-endemic areas worldwide. Increased awareness of disease risk factors among the public and the international healthcare community will improve the timely diagnosis and treatment of coccidioidomycosis and prevent disease progression, dissemination and deaths in residents in and in travellers returning from endemic regions. A vaccine for the primary prevention of coccidioidomycosis would be cost-effective.
球孢子菌病是一种具有独特危险因素的地方性系统性真菌病。由于人们出差或旅游，而且通常与他们的业余爱好或兴趣有关，因此，本综述的目的是描述这些和其他球孢子菌病的危险因素；提醒旅行医学临床医生注意球孢子菌病的不同表现形式；并推荐有效的治疗、疾病控制和预防策略。
为了达到本综述的目的，在研究期间（1970 年至 2017 年），使用医学主题词在互联网搜索引擎上进行了检索。
球孢子菌病的主要传播机制是通过深吸入气生孢子，导致症状性肺部感染，从发热性流感样疾病到致命的播散性真菌病不等。除居住或旅行在流行地区外，因年龄增长、怀孕、癌症、皮质类固醇治疗、糖尿病、器官移植和人类免疫缺陷病毒感染而免疫功能低下的人患球孢子菌病的风险显著增加。非洲裔、亚裔、菲律宾裔和西班牙裔的人也有更高的患球孢子菌病的风险。与球孢子菌病相关的爱好包括犰狳狩猎、模型飞机飞行和考古挖掘。球孢子菌病的职业危险因素包括在军事演习、户外田径比赛、道路建设、太阳能和风力发电场建设、考古挖掘和监狱工作期间接触地方性暴露。
球孢子菌病在流行地区和非流行地区比以前认识到的更为常见，可导致相当大的发病率和死亡率。球孢子菌病正从西半球的流行地区越来越多地传入世界其他非流行地区。公众和国际医疗保健界对疾病危险因素的认识提高，将改善球孢子菌病的及时诊断和治疗，防止居民和从流行地区返回的旅行者病情恶化、传播和死亡。预防球孢子菌病的疫苗具有成本效益。
