Northern Arizona Universitygrid.261120.6, Flagstaff, Arizona, USA.
Translational Genomics Research Institutegrid.250942.8 (TGen), Phoenix and Flagstaff, Arizona, USA.
mSphere. 2022 Oct 26;7(5):e0035222. doi: 10.1128/msphere.00352-22. Epub 2022 Aug 16.
and are the etiological agents of coccidioidomycosis (Valley fever [VF]). Disease manifestation ranges from mild pneumonia to chronic or extrapulmonary infection. If diagnosis is delayed, the risk of severe disease increases. In this report, we investigated the intersection of pathogen, host, and environment for VF cases in Northern Arizona (NAZ), where the risk of acquiring the disease is much lower than in Southern Arizona. We investigated reported cases and assessed pathogen origin by comparing genomes of NAZ clinical isolates to isolates from other regions. Lastly, we surveyed regional soils for presence of . We found that cases of VF increased in NAZ in 2019, and NAZ isolates are assigned to Arizona populations using phylogenetic inference. Importantly, we detected DNA in NAZ soil. Given recent climate modeling of the disease that predicts that cases will continue to increase throughout the region, and the evidence presented in this report, we propose that disease awareness outreach to clinicians throughout the western United States is crucial for improving patient outcomes, and further environmental sampling across the western U.S. is warranted. Our work is the first description of the Valley fever disease triangle in Northern Arizona, which addresses the host, the pathogen, and the environmental source in the region. Our data suggest that the prevalence of diagnosed cases rose in 2019 in this region, and some severe cases necessitate hospitalization. We present the first evidence of spp. in Northern Arizona soils, suggesting that the pathogen is maintained in the local environment. Until disease prevention is an achievable option via vaccination, we predict that incidence of Valley fever will rise in the area. Therefore, enhanced awareness of and surveillance for coccidioidomycosis is vital to community health in Northern Arizona.
和 是球孢子菌病（山谷热[VF]）的病原体。疾病表现范围从轻度肺炎到慢性或肺外感染。如果诊断延迟，患严重疾病的风险会增加。在本报告中，我们研究了北亚利桑那州（NAZ）VF 病例的病原体、宿主和环境的交集，在该地区，患病的风险比南亚利桑那州低得多。我们调查了报告的病例，并通过将 NAZ 临床分离株与来自其他地区的分离株进行比较来评估病原体的起源。最后，我们调查了该地区土壤中 是否存在 。我们发现，2019 年 NAZ 的 VF 病例有所增加，并且使用系统发育推断将 NAZ 分离株分配到亚利桑那种群中。重要的是，我们在 NAZ 土壤中检测到了 DNA。鉴于最近对该疾病的气候建模预测，整个地区的病例将继续增加，以及本报告中提出的证据，我们建议向整个美国西部的临床医生开展疾病意识宣传对于改善患者预后至关重要，并且有必要在美国西部各地进行更多的环境采样。我们的工作首次描述了北亚利桑那州的山谷热疾病三角，其中涉及该地区的宿主、病原体和环境来源。我们的数据表明，该地区 2019 年确诊病例的患病率上升，一些严重病例需要住院治疗。我们首次提出了在北亚利桑那州土壤中存在 spp.的证据，表明该病原体在当地环境中得以维持。在通过疫苗接种实现疾病预防之前，我们预计该地区山谷热的发病率将会上升。因此，提高对球孢子菌病的认识和监测对于北亚利桑那州的社区健康至关重要。
