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(a) Counties our climate‐constrained niche model identify as endemic (with a mean annual temperature greater than or equal to 10.7°C and a mean annual precipitation level less than or equal to 600 mm/year) are colored in magenta. (b) There is reasonable agreement between this set of counties and the endemic region identified by the CDC. Counties shown in red in panel a have a mean annual temperature greater than or equal to 10.7°C but unsuitable mean annual precipitation (greater than 600 mm/year). Counties shown in blue have a mean annual precipitation level less than or equal to 600 mm/year but unsuitable mean annual temperature (less than 10.7°C). Counties in white our model defines as unsuitable according to both thresholds.
Source publication
Abstract Coccidioidomycosis (Valley fever) is a fungal disease endemic to the southwestern United States. Across this region, temperature and precipitation influence the extent of the endemic region and number of Valley fever cases. Climate projections for the western United States indicate that temperatures will increase and precipitation patterns...
Citations
... The rise in CM cases could be due to shifts in climatic conditions, as factors such as temperature, humidity, nutrient availability, and other soil microbes influence fungi. With climate change, we are facing a potential shift in the distribution of fungal diseases [9,10]. The burden of disease in Mexico is unknown despite its high prevalence because it has not been reportable 2 of 8 since 1995, and access to mycological diagnosis is difficult [10,11]. ...
... With climate change, we are facing a potential shift in the distribution of fungal diseases [9,10]. The burden of disease in Mexico is unknown despite its high prevalence because it has not been reportable 2 of 8 since 1995, and access to mycological diagnosis is difficult [10,11]. Despite this, the global health community is realizing the importance of Coccidioides spp. with its inclusion in the fungal priority pathogens list developed by the World Health Organization (WHO) [12]. ...
... The burden of fungal infections is changing significantly, which may lead to some fungal infections losing their endemic status. Cases are anticipated to be more common in areas beyond the usual exposure locations [9,10,22]. ...
The incidence and distribution of coccidioidomycosis are increasing. Information scarcity is evident in Mexico, particularly in non-endemic zones and specific populations. We compared the treatment and outcomes for patients with isolated pulmonary infections and those with disseminated coccidioidomycosis, including mortality rates within six weeks of diagnosis. Of 31 CM cases, 71% were male and 55% were disseminated. For 42% of patients, there was no evidence of having lived in or visited an endemic region. All patients had at least one comorbidity, and 58% had pharmacologic immunosuppressants. The general mortality rate was 30%; without differences between disseminated and localized disease. In our research, we describe a CM with a high frequency of disseminated disease without specific risk factors and non-significant mortality. Exposure to endemic regions was not found in a considerable number of subjects. We consider diverse reasons for why this may be, such as climate change or migration.
... grow in arid soils, mainly in the southwestern deserts of North America as well as desert regions in Central and South America [2]. With the increase in global temperatures, the possibility of Coccidioides becoming endemic in more regions has increased [3]. Unlike an opportunistic pathogen, Coccidioides spp. ...
Valley Fever (VF), caused by fungi in the genus Coccidioides, is a prevalent disease in southwestern and western parts of the United States that affects both humans and animals, such as dogs. Although the immune responses to infection with Coccidioides spp. are not fully characterized, antibody-detection assays are used in conjunction with clinical presentation and radiologic findings to aid in the diagnosis of VF. These assays often use Complement Fixation (CF) and Tube Precipitin (TP) antigens as the main targets of IgG and IgM reactivity, respectively. Our group previously reported evidence of over 800 genes expressed at the protein level in C. posadasii. However, antibody reactivity to the majority of these proteins has never been explored. Using a new, high-throughput screening technology, the Nucleic Acid Programmable Protein Array (NAPPA), we screened serum specimens from dogs against 708 of these previously identified proteins for IgG reactivity. Serum from three separate groups of dogs was analyzed and revealed a small panel of proteins to be further characterized for immuno-reactivity. In addition to CF/CTS1 antigen, sera from most infected dogs showed antibody reactivity to endo-1,3-betaglucanase, peroxisomal matrix protein, and another novel reactive protein, CPSG_05795. These antigens may provide additional targets to aid in antibody-based diagnostics.
... More recently, infections are less clearly confined to a particular geographic region, possibly as a result of climate change. [5] The majority of exposures (>60%) do not result in clinically apparent infection [1,2,3]. More severe diseases are thought to be the result of larger inoculum size [3] (hence the occurrence of environmental outbreaks such as during earthquakes) and host factors such as immunocompromise [6]. ...
A 79-year-old man with type II diabetes mellitus and recently diagnosed idiopathic thrombocytopenic purpura presented to the Emergency Department with progressive dyspnea over the course of two weeks. He was found to have diffuse miliary nodules, dense cavitary consolidation, and widespread cystic changes on chest imaging and died within 48 hours of admission to the hospital. His serum Coccidioides antibody and urine Histoplasma antigen were both positive. He later grew Coccidioides immitis from the blood, supporting the theory that Histoplasma positivity was likely the result of antigen test cross-reactivity. Coccidioidomycosis typically presents with mild, self-limited symptoms, but may also disseminate rapidly, causing fulminant, life-threatening disease. Prompt recognition of risk factors for fulminant coccidioidomycosis and understanding flaws in serologic testing are essential to the appropriate diagnosis and management of this disease.
... Coccidioidomycosis is a prominent infectious disease in the western United States, primarily reported in California and Arizona, and is characterized by a noteworthy case fatality ratio. It is estimated that over 500,000 people are naturally infected per year in the US, and increases in cases have been observed in association with severe droughts [7][8][9] . The majority of infections are asymptomatic or present as mild cases resembling community-acquired pneumonia, while chronic and severe forms are rare, affecting fewer than 5% of symptomatic cases 10 . ...
Coccidioidomycosis, listed as a priority mycosis by the WHO, is endemic in the United States but often overlooked in Central and South America. Employing a multi-institutional approach, we investigate how disease characteristics, pathogen genetic variation, and environmental factors impact coccidioidomycosis epidemiology and outcomes in South America. We identified 292 cases (1978–2021) and 42 outbreaks in Piauí and Maranhão states, Brazil, the largest series outside the US/Mexico epidemic zone. The male-to-female ratio was 57.4:1 and the most common activity was armadillo hunting (91.1%) 4 to 30 days before symptom onset. Most patients (92.8%) exhibited typical acute pulmonary disease, with cough (93%), fever (90%), and chest pain (77%) as predominant symptoms. The case fatality rate was 8%. Our negative binomial regression model indicates that reduced precipitation levels in the current (p = 0.015) and preceding year (p = 0.001) predict heightened incidence. Unlike other hotspots, acidic soil characterizes this region. Brazilian strains differ genomically from other C. posadasii lineages. Northeastern Brazil presents a distinctive coccidioidomycosis profile, with armadillo hunters facing elevated risks. Low annual rainfall emerges as a key factor in increasing cases. A unique C. posadasii lineage in Brazil suggests potential differences in environmental, virulence, and/or pathogenesis traits compared to other Coccidioides genotypes.
... [39][40][41] Climate change appears to be an important cause for the expansion of the endemic areas of coccidioidomycosis observed in the USA. 42,43 However, the geographical distribution of coccidioidomycosis is far from exhaustive, since it is not a notifiable disease yet in 24 US states and in Latin America (except Argentina). Although previous estimates of coccidioidomycosis in the USA are of approximately 150 000 new annual infections, 44 there is evidence of an eight-fold increase in incidence (from 5⋅3 to 42⋅6 cases per 100 000) in a timeframe of 14 years (1998-2011). ...
... The pathogenic Onygenales fungi not only are increasing in infection prevalence, over 20,000 reported cases in 2019, but also are expanding in geographic range [9][10][11][12][13]. Climate change is implicated as the main culprit behind this range expansion and, with it, introduces naïve populations to these pathogenic fungi potentially causing more outbreaks [14,15]. The fungi in this order cause a spectrum of disease from some of the most aggressive mycoses, such as coccidioidomycosis, blastomycosis, and histoplasmosis but also includes commensal-like pathogens such as the dermatophytic fungi Trichophyton spp. ...
... For example, Coccidioides, Histoplasma, and Blastomyces are environmentally acquired fungal pathogens with distinct geographical niches, as they are endemic fungi restricted to these areas [45][46][47]. Studies have predicted that these endemic fungi have the potential to expand their geographic range due to the changing climate, allowing these fungi to occupy different niches [13,15,38,45,48,49]. These expanding ranges will expose naïve humans and animals to these novel fungi, leaving them vulnerable to severe mycoses. ...
... Models need to account for complex ecological variation that can lead to fungal population growth and in turn the spread of infection. Ecological niche models have been used to predict the geographic distribution of fungal pathogens and in recent years specifically for Onygenalean fungi [7,15,[67][68][69]. These models are a powerful tool when environmental presence data is available; however, often, there is a lack of this data so modelers turn to using clinical data which may misrepresent the realized niche of these organisms [68][69][70][71]. ...
Purpose of Review
Onygenalean fungi have the potential to cause disease in vertebrates, including humans, due to their possession of various virulence factors. The risk of infection and degree of their pathogenicity may increase as climate change persists and worsens. Here, we examine recent literature of the ecology of these fungi and argue a need for more surveillance to understand the evolution of virulence in the presence of climate change.
Recent Findings
Climate change will cause a multitude of environmental impacts, but for Onygenalean fungi, these effects include increased thermotolerance, range expansion, and host immunosuppression. Many species within Onygenales are already closely associated with vertebrates in the environment, so an increase in pathogenicity as an effect from climate change indicates that vertebrates are at high risk for outbreaks and potential biodiversity loss due to Onygenalean fungal infections.
Summary
In this review, we highlight the topic of disease ecology of Onygenalean fungi and explore the challenges and unknowns that inhibit our understanding of these fungi.
... 51 Modelling suggests that the endemic range of coccidioidomycosis in the USA will more than double, expanding north into dry regions in Idaho, Wyoming, Nebraska, Montana, South Dakota, and North Dakota, with the current estimate of 34 460 cases projected to increase by 50% by the year 2100. 52 Globally, this modelling suggests that coccidioidomycosis might eventually spread to Canada, throughout Mexico, and parts of Central and South America, where the numbers of reported cases are progressively increasing. 52,53 Blastomyces spp, which cause blastomycosis, have historically been endemic to the southcentral, southeastern, and midwestern regions of the USA and a few provinces in Canada. ...
... 52 Globally, this modelling suggests that coccidioidomycosis might eventually spread to Canada, throughout Mexico, and parts of Central and South America, where the numbers of reported cases are progressively increasing. 52,53 Blastomyces spp, which cause blastomycosis, have historically been endemic to the southcentral, southeastern, and midwestern regions of the USA and a few provinces in Canada. Cases are increasingly being seen outside of these traditionally endemic areas, 54,55 and blastomycosis is now recognised to occur in parts of Africa and the Middle East. ...
... Approximately 20,000 cases are reported in the U.S. each year, but preliminary studies from the CDC suggest that the actual burden of symptomatic cases may be 6-14 times higher [23]. However, climate change will likely expand the endemic region to include large portions of the western United States [24]. In addition, the number of cases will also increase due to population growth in endemic regions and advances in healthcare that will expand the at-risk population [25]. ...
Immunoassays for cell wall mannans that are excreted into serum and urine have been used as an aid in the diagnosis of many disseminated fungal infections, including coccidioidomycosis. Antigen-detection immunoassays are critically dependent on the detection of an analyte, such as mannan, by antibodies that are specific to the analyte. The goal of this study was to evaluate the extent of cross-reactivity of polyclonal antibodies raised against Coccidioides spp. Analysis of antigenic relatedness between mannans from C. posadasii and C. immitis spherules and mycelia showed complete relatedness when evaluated by the method of Archetti and Horsfall, which was originally used to study the antigenic relationships between Influenzae virus isolates. In a further effort to validate the suitability of the antigenic relatedness calculation methodology for polysaccharide antigens, we also applied the method of Archetti and Horsfall to published results that had previously identified the major capsular serotypes of Cryptococcus species. The results of this analysis showed that Archetti and Horsfall’s antigenic relatedness calculation correctly identified the major cryptococcal serotypes. Together, these results suggest that the method is applicable to polysaccharide antigens, and that immunoassays that detect Coccidioides mannans are likely to have good reactivity across Coccidioides species (inclusivity) due to the species’ high level of antigenic relatedness.
... When the soil dries, the disease spreads easily via the inhalation of the spores in dust clouds. A recent model predicted that a high global warming scenario could make the disease endemic in 5 states in the Northwestern USA, increasing the incidence by 50% (81). It is uncertain whether all these scenarios would come true. ...
Climate, an integral part of life, varies by region. Climate change and deterioration could lead to significant problems. The Industrial Revolution introduced anthropogenic factors in climate change for the first time in the 19th century. Due to the increase in energy requirements, large volumes of greenhouse gases were released into the atmosphere due to the utilization of fossil fuels such as coal, natural gas and oil. The Industrial Revolution led to rapid climate change and environmental problems. The consequences of these problems are felt in our age. The most affected area is human health by the climate crisis. Its effect on health could be direct or indirect. Infectious diseases that spread globally, crossing both international and intercontinental borders, are described as pandemics. Today, infectious diseases continue to be the most common cause of death in developed countries.Population growth, unplanned urbanization, consumption of unhealthy industrial food items, high exposure toradiation, air pollution and climate change play a role in the development of pandemics. It was reported that climate change altered intra-species interaction and increased the risk of infection. Nations should adopt various measures to mitigate the effects of climate change to preserve public health and minimize human loss or health risks. The present study aimed to determine whether we should expect novel pandemics due to the climate crisis induced by climate change. Thus, studies on the issue were reviewed and the findings are discussed in the present study.
... In the United States, the incidence of CM has been increasing since 2000, with a steady rise between 2009 and 2019 [1]. Factors thought to be responsible for this sustained increase include the expansion of suitable environmental conditions for the growth of Coccidioides in the soil and a surge in the population of major cities in the endemic region [2]. The documented increase in the number of cases and areas in which CM is now being found heightens the importance of better understanding the pathophysiology of this condition and improving on existing therapeutic approaches [3][4][5][6]. ...
... State of residency is not predictive by itself, given the potential for significant travel: 290 (1.4%) of the 20 003 case reports of CM received by the Centers for Disease Control and Prevention in 2019 originated from outside Arizona, California, Nevada, New Mexico, and Utah [3]. Similarly, a carefully detailed travel history does not fully exclude the possibility of exposure, in view of the recent evidence of expansion of Coccidioides beyond what were seen as the limited endemic areas [1,2]. ...
A wide array of clinical manifestations follow infection with Coccidioides immitis or Coccidioides posadasii, ranging from asymptomatic infection to life-threatening pulmonary disease or extrapulmonary dissemination and meningitis. Epidemiological studies require consistent definitions of cases and their comparative clinical features. Understanding host and pathogen determinants of the severity of coccidioidomycosis also requires that specific clinical features (such as coccidioidal meningitis) and their overlap be precisely defined and quantified. Here we propose a system for categorization of outcomes of coccidioidomycosis in individuals who are not overtly immunocompromised that harmonizes clinical assessments during translational research of this increasingly common disease.
