Seasonal Increase in Coccidioidomycosis Occurring Locally

Current Situation

Coccidioidomycosis, also known as Valley Fever, results from inhalation of Coccidioides immitis and Coccidioides posadasii spores. Monterey County is a Coccidioides endemic area, particularly the Salinas Valley and South County regions. While individuals may become infected and ill at any time of the year, the highest rates of illness normally occur between September and March. There have been 75 new cases of coccidioidomycosis reported since October 2023, compared to 28 reported cases in the last quarter of 2022. Among 2023 cases for which information was available, nearly half (46%) were hospitalized. Public health officials urge medical providers to include coccidioidomycosis in their differential diagnoses when evaluating patients with progressive respiratory illness or lingering cough.

Recommendations for Health Care Providers

• Be aware of symptoms and risk factors for severe disease.
  • Following an incubation period of one to four weeks, clinical manifestations occur in 40% of infected individuals and include one or more of the following: influenza-like illness, pneumonia or other pulmonary lesion, erythema nodosum or erythema multiforme rash.
  • Disseminated infection, which can be fatal, most commonly involves skin and soft tissues, bones, joints, and the central nervous system.
  • Once infected, African-Americans, Filipinos, and other Asians are at higher risk of developing more serious or disseminated illness. Women in their third trimester of pregnancy, diabetics, and immunocompromised individuals are also at higher risk of serious disease.

• Take a risk history that includes occupation.
  • Certain occupational groups including agricultural workers, construction workers, military personnel, and wildland firefighters may be at increased risk for exposure.

• Test for cocci.
  • Fungal cultures and/or coccidioidal serologic testing using immunodiffusion and complement fixation should be considered. These tests are available at most commercial labs, Kern County Public Health Laboratory, and the University of California Davis’ Coccidioidomycosis Serology Laboratory. County of Monterey Public Health Laboratory offers Nucleic Acid Amplification (NAA) testing for cocci (e.g., sputum and bronchial wash specimens).

• Report all confirmed, probable, and suspect cases to the County of Monterey Health Department.
  • Blank Confidential Morbidity Report (CMR) forms can be downloaded by clicking here.

For more information about testing, diagnosing, and reporting, please contact the County of Monterey Health Department’s Communicable Disease Unit at 831-755-4521.  For information about submitting patients’ specimens to the County of Monterey Public Health Laboratory, call 831-755-4516. Additional information is available on the CDC's website. 

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