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Volume 24, Number 8—August 2018
Research

Enhanced Surveillance for Coccidioidomycosis, 14 US States, 2016

Kaitlin BenedictComments to Author , Malia Ireland, Meghan P. Weinberg, Randon J. Gruninger, Jenna Weigand, Lei Chen, Katharine Perez-Lockett, Catherine Bledsoe, Lynn Denny, Katie Cibulskas, Suzanne Gibbons-Burgener, Anna Kocharian, Emilio DeBess, Tracy K. Miller, Alicia Lepp, Laura Cronquist, Kimberly Warren, Jose Antonio Serrano, Cody Loveland, George Turabelidze, Orion McCotter, and Brendan R. Jackson
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K. Benedict, O. McCotter, B.R. Jackson); Minnesota Department of Health, St. Paul, Minnesota, USA (M. Ireland); Michigan Department of Health and Human Services, Lansing, Michigan, USA (M.P. Weinberg); Utah Department of Health, Salt Lake City, Utah, USA (R.J. Gruninger); Southwest Utah Public Health Department, Cedar City, Utah, USA (J. Weigand); Washoe County Health District, Reno, Nevada, USA (L. Chen); New Mexico Department of Health, Las Cruces, New Mexico, USA (K. Perez-Lockett, C. Bledsoe); Ohio Department of Health, Columbus, Ohio, USA (L. Denny, K. Cibulskas); Wisconsin Division of Public Health, Madison, Wisconsin, USA (S. Gibbons-Burgener, A. Kocharian); Public Health Division, Oregon Health Authority, Portland, Oregon, USA (E. DeBess); North Dakota Department of Health, Bismarck, North Dakota, USA (T.K. Miller, A. Lepp, L. Cronquist); Pennsylvania Department of Health, Wilkes-Barre, Pennsylvania, USA (K. Warren); Louisiana Department of Health, Baton Rouge, Louisiana, USA (J.A. Serrano); Wyoming Department of Health, Cheyenne, Wyoming, USA (C. Loveland); Missouri Department of Health and Senior Services, St. Louis, Missouri, USA (G. Turabelidze)

Main Article

Table 2

Symptoms and healthcare use among coccidioidomycosis patients in 14 low-endemic and nonendemic US states, 2016*

Characteristic Value
Symptoms 170 (91)
  Cough 121 (65)
  Fatigue 116 (62)
  Shortness of breath 96 (52)
  Fever 85 (46)
  Night sweats 71 (38)
  Chest pain 65 (35)
  Chills 60 (32)
  Weight loss 60 (32)
  Headache 55 (30)
  Rash 54 (29)
  Joint pain 49 (26)
  Muscle pain 42 (23)
  Wheezing 38 (20)
  Sore throat 35 (19)
  Stiff neck 30 (16)
  Coughing up blood 13 (7)
  Other symptoms
 38 (20)
Type of facility where patient first sought care, n = 160
  Emergency room 57 (36)
  Primary care 57 (36)
  Urgent care 32 (20)
  Specialist 9 (6)
  Other 5 (3)
Patient first sought care in an endemic state, n = 166† 105 (63)
Patient first sought care in Arizona, n = 166 46 (28)
Ever went to the emergency room, n = 162
 91 (56)
No. visits before being tested for coccidioidomycosis, n = 130
  1 33 (25)
  2 27 (21)
  >2
 70 (54)
Type of doctor who first tested for coccidioidomycosis, n = 172
  Primary care 51 (30)
  Urgent care 6 (4)
  Emergency room 16 (9)
  Infectious disease 30 (17)
  Pulmonologist 45 (26)
  Other
 24 (14)
Site of infection, n = 127‡
  Pulmonary 105 (83)
  Disseminated
 22 (17)
Total no. healthcare visits for coccidioidomycosis, n = 139
  1 28 (20)
  2–3 43 (31)
  >3
 68 (49)
Prescribed antifungal medication, n = 169 115 (68)
  Fluconazole 95 (83)
  Itraconazole 13 (11)
  Voriconazole 4 (4)
  Amphotericin B
 3 (3)
Median symptom duration, d (range), n = 56 60 (7–1800)
Median symptom duration among patients recovered at interview, d (range), n = 44 38.5 (7–1800)
Median symptom duration among patients not recovered at interview, d (range), n = 12 90 (28–360)
Median time between symptom onset and interview, d (range), n = 107 115 (12–1672)

*Values are no. (%) patients except as indicated. n values are provided for categories with <186 responses.
†Arizona, California, Nevada, New Mexico, Texas, Utah, or Washington.
‡Site of infection was defined as pulmonary if lungs were the only body site involved and disseminated if another body part was involved, based on patient self-report.

Main Article

Page created: July 17, 2018
Page updated: July 17, 2018
Page reviewed: July 17, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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