Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA.
Social and Economic Sciences Research Center, Department of Sociology, Washington State University, Pullman, WA, USA.
Zoonoses Public Health. 2020 Feb;67(1):25-34. doi: 10.1111/zph.12651. Epub 2019 Sep 21.
Coccidioides immitis is an emerging fungal pathogen in Washington State (WA). While the geographical boundaries of C. immitis in WA have not been well characterized, human infections have resulted from exposure in the south-central region of the state. Since 2010, only one dog has been identified as a probable locally acquired animal case, despite pilot canine serological surveys from south-central WA revealing a 9.8% seroprevalence. On the suspicion that clinical animal cases may be underdiagnosed and/or underreported, we assessed WA veterinarians' knowledge, attitudes and practices regarding coccidioidomycosis. All veterinarians with active licenses in WA were invited to complete a self-administered, web-based survey from November 2018 to January 2019. Four hundred and twenty-five of 2,211 (19.2%) veterinarians returned the survey and were eligible for inclusion in the final analysis. Nearly, all respondents (98.8%) had heard of coccidioidomycosis, but only 31.5% and 25.6% knew that locally acquired animal and human cases, respectively, had been reported in WA. Only half (52.6%) of participants knew that the disease was reportable. Fewer than 20% of respondents reported confidence that their knowledge of coccidioidomycosis was up to date, and 76.9% "never" or "rarely" considered the risk of disease in their patients. A statistically significant predictor of a high knowledge score (≥70%), however, included practicing in endemic counties where the Washington State Department of Health had previously delivered outreach and education services. While the results suggest some success with these activities, it is clear that information on the emergence of coccidioidomycosis is not adequately reaching veterinary practitioners in WA. The data support that more frequent CE opportunities, and dissemination of public health communications through veterinary-specific modalities, would help fill the knowledge gap. In turn, improved diagnosis and reporting of animal cases would assist in our overall understanding the epidemiology of coccidioidomycosis in WA.
荚膜组织胞浆菌是华盛顿州（WA）新兴的真菌病原体。荚膜组织胞浆菌在 WA 的地理边界尚未得到很好的描述，但该州中南部地区的人类感染已经出现。自 2010 年以来，尽管来自 WA 中南部的试点犬血清学调查显示血清阳性率为 9.8%，但仅发现一例可能是本地获得的动物病例。由于怀疑临床动物病例可能被漏诊和/或漏报，我们评估了 WA 兽医对球孢子菌病的知识、态度和做法。我们邀请所有在 WA 有有效执照的兽医填写一份自我管理的、基于网络的调查，时间从 2018 年 11 月到 2019 年 1 月。2211 名兽医中有 425 名（19.2%）返回了调查，符合最终分析的条件。几乎所有的受访者（98.8%）都听说过球孢子菌病，但只有 31.5%和 25.6%的受访者知道，在 WA 分别报告了本地获得的动物和人类病例。只有一半（52.6%）的参与者知道该病需要报告。不到 20%的受访者表示对自己的球孢子菌病知识是否最新有信心，76.9%的受访者“从未”或“很少”考虑过患者患病的风险。然而，一个知识得分高（≥70%）的统计学显著预测因素是在华盛顿州卫生部门以前提供过外展和教育服务的地方性县行医。尽管这些结果表明这些活动取得了一些成功，但显然有关球孢子菌病出现的信息并没有充分传达给 WA 的兽医。数据表明，更多的继续教育机会，以及通过兽医特定模式传播公共卫生信息，将有助于填补知识空白。反过来，改善动物病例的诊断和报告将有助于我们全面了解 WA 球孢子菌病的流行病学。
