Coccidioidomycosis “Valley Fever ”

By: Isatu ContehCourse: MycologyDate: 11/25/2013

Outline of Presentation

• Background of disease• Transmission and Risk Factors• Fungal Species Responsible• Forms of the disease & Symptoms• Treatment• Methods of Prevention

Statistics• 30% – 60% of people who

live in an endemic region are exposed to the fungus at some point during their lives.

• Over 20,000 cases are reported each year in the United States, but many more likely go undiagnosed.

• In 2012, 12,920 cases of Valley Fever were in Arizona.

History of Disease

• 1891 Buenos Aires, Argentina

• Soldier, Student, Alejandros Posadas

• Person to person transmission documented in only 5 cases

Whose At Greatest Risk ?

Coccidioides

Acute Progressive Coccidiomycosis

• Fever & Headache

• Muscle aches

• Nonproductive cough

• Weight loss

• Malaise

Severe Progressive Coccidiomycosis

Treatment

• Amphotericin B

• Ketoconazole

• Fluconazole

• Itraconazole

How Do They Do It?

Amphotherin B

• Amphotericin B acts through pore formation at the cell membrane after binding to ergosterol.

• AmB induces oxidative damage in the cells.

• Modulates the immune system, and this activity has been related to the protective effect of the molecule, but also to its toxicity in the host.

Azoles• 1980s introduced as orally active

compounds.

• Azoles stop fungal growth by preventing fungi from making an essential part of their cell wall.

• Of the three, previously mentioned azole, Itraconazole is the newest and highly effective against a range of different fungal infections.

Don’t Put Your Head in the Sand

Prevention

• Surveillance

• Mask

• Prophylactic anti-fungal medication

• HEPA Air Filters

References1. Fisher M, Koenig G, and Taylor J. 2002. Molecular and phenotypic description of

Coccidioides posadasii sp. nov.,previously recognized as the non-California population of Coccidioides immitis. Mycologia. 94(1): 73–84.

2. Galgiani J. 1993. Coccidioidomycosis. Medicine. Volume 159:153-1713. Greene D, Koenig G, Fisher M, and Taylor J. 2000. Soil Isolation and Molecular

Identification of Coccidioides immitis. Mycologia, Volume 92:(3):406-4104. Hector R. and Laniado-Laborin R. 2005. Coccidioidomycosis a Fungal Disease of the

Americas. Americas. PLoS Medicine. Volume 2:1.5. Kirkland T and Fierer J. 1996. Coccidioidomycosis: A Reemerging Infectious Disease.

Emerging Infectious Diseases. Vol. 3(2).6. Panackal A, Hajjeh R, Cetron M, and Warnock D. 2002. Fungal Infections among

Returning Travelers. Volume 35:1088–95.7. Pappagianis D. and Zimmer B. 1990. Serology of Coccidioidomycosis. Clinical

Microbiology Review. Volume 3:3:2478. Stevens D. 1995 Coccidioidomycosis . The New Englans Journal of Medicine. Vol.

332: 16.