Human Health and Environmental Change: The Strange and Perplexing Case of Valley Fever (Coccidioidomycosis)

Authors: Andrew Comrie*, University of Arizona
Topics: Medical and Health Geography, Climatology and Meteorology, Environment
Keywords: Health, climate, valley fever, disease
Session Type: Virtual Paper
Day: 4/10/2021
Start / End Time: 9:35 AM / 10:50 AM
Room: Virtual 8
Presentation File: No File Uploaded

Valley Fever (coccidioidomycosis) is a disease caused by soil fungi (Coccidioides immitis, Coccidioides posadasii) endemic to semi-arid regions of the New World, including the US Southwest, Great Basin, and the San Joaquin Valley of California (from whence it gets its name), as well as northern Mexico and parts of South America. The focal points of the disease in the United States are Kern County (Bakersfield area) in California and Maricopa county (Phoenix area) and Pima County (Tucson) in Arizona, essentially the largest population centers in the endemic zone. Beyond associations with semi-arid landscapes, the biophysical mechanisms controlling valley fever outbreaks, seasonality, interannual variability and trends are still poorly understood. Field observations of the fungus are spatially and temporally rare. Human case data are available for some areas since the 1990s, and they show large increases in incidence. However, there are severe documented and undocumented inhomogeneities in those data, including the most recent decade, because of improvements in surveillance and changes in reporting of the disease. Many studies have produced unsatisfactory conclusions because of oversimplified analyses and poor specification, over-generalizing (having to rely on correlation implying causation), unavoidable imprecision in time and space, and over-enthusiasm for desired or expected outcomes (i.e., apparent trends associated with climate change). These marginal research findings limit our ability to reduce human exposure to the fungus. Based on current science and data challenges, substantive advances will require two things: increased scientific rigor in analyses and claims, and new methods of field observation.

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