Coccidioidomycosis-associated hospitalizations, California, USA, 2000-2011

Abstract

In the past decade, state-specific increases in the number of reported cases of coccidioidomycosis have been observed in areas of California and Arizona where the disease is endemic. Although most coccidioidomycosis is asymptomatic or mild, infection can lead to severe pulmonary or disseminated disease requiring hospitalization and costly disease management. To determine the epidemiology of cases and toll of coccidioidomycosis-associated hospitalizations in California, we reviewed hospital discharge data for 2000-2011. During this period, there were 25,217 coccidioidomycosis-associated hospitalizations for 15,747 patients and >$2 billion US in total hospital charges. Annual initial hospitalization rates increased from 2.3 initial hospitalizations/100,000 population in 2000 to 5.0 initial hospitalizations/100,000 population in 2011. During this period, initial hospitalization rates were higher for men than women, African Americans and Hispanics than Whites, and older persons than younger persons. In California, the increasing health- and cost-related effects of coccidioidomycosis-associated hospitalizations are a major public health challenge.

Keywords: California; Coccidioides; Valley fever; coccidioidomycosis; epidemiology; fungal; fungi; hospitalizations; meningitis; pneumonia; public health.

Figure 1

Numbers and annual rates of initial and subsequent coccidioidomycosis-associated hospitalizations (N = 25,217) by year of admission, California, 2000–2011.

Figure 2

Numbers and annual rates of initial coccidioidomycosis-associated hospitalizations (N = 15,747) in endemic and less endemic regions of California by year of admission, 2000–2011. For this study, 6 California counties (Fresno, Kings, Kern, Madera, San Luis Obispo, and Tulare) where coccidioidomycosis is endemic were defined as the endemic region, and all other counties, where coccidioidomycosis is less endemic, were defined as the less endemic region.