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. 2011 Sep;17(9):1664-9.
doi: 10.3201/eid1709.101987.

Geographic distribution of endemic fungal infections among older persons, United States

John W Baddley  1 , Kevin L Winthrop, Nivedita M Patkar, Elizabeth Delzell, Timothy Beukelman, Fenglong Xie, Lang Chen, Jeffrey R Curtis
Affiliations

Geographic distribution of endemic fungal infections among older persons, United States

John W Baddley et al. Emerg Infect Dis. 2011 Sep.

Abstract

To investigate the epidemiology and geographic distribution of histoplasmosis, coccidioidomycosis, and blastomycosis in older persons in the United States, we evaluated a random 5% sample of national Medicare data from 1999 through 2008. We calculated national, regional, and state-based incidence rates and determined 90-day postdiagnosis mortality rates. We identified 776 cases (357 histoplasmosis, 345 coccidioidomycosis, 74 blastomycosis). Patient mean age was 75.7 years; 55% were male. Histoplasmosis and blastomycosis incidence was highest in the Midwest (6.1 and 1.0 cases/100,000 person-years, respectively); coccidioidomycosis incidence rate was highest in the West (15.2). On the basis of available data, for 86 (11.1%) cases, there was no patient exposure to a traditional disease-endemic area. Knowledge of areas where endemic mycosis incidence is increased may affect diagnostic or prevention measures for older adults at risk.

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Figures

Figure 1
Figure 1
Geographic distribution of histoplasmosis in persons >65 years of age, United States, 1999–2008. Values are no. cases/100,000 person-years.
Figure 2
Figure 2
Geographic distribution of coccidioidomycosis in persons >65 years of age, United States, 1999–2008. Values are no. cases/100,000 person-years.
Figure 3
Figure 3
Geographic distribution of blastomycosis in persons >65 years of age, United States, 1999–2008. Values are no. cases/100,000 person-years.
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