The epidemiology and clinical features of coccidioidomycosis (Valley fever) and disease ecology of Coccidioides spp. in New Mexico (2006-2023)

Coccidioidomycosis (Valley fever), caused by Coccidioides spp., is a
fungal infection endemic to semi-arid regions of the Americas. Despite 80
years of disease recognition in New Mexico, there is limited disease
awareness. We incorporated clinical, epidemiological, and ecological
datasets to summarize the knowledge of Valley fever in New Mexico. We
analyzed 1,541 human cases from an 18-year period. On average, 86 cases
were reported each year (4.1 cases per 100,000 population per year). The
highest levels of incidence were in southwestern New Mexico. American
Indian or Alaska Natives in New Mexico had a 1.9 times higher incidence
rate of coccidioidomycosis than White people, and among age groups, older
populations in New Mexico had the highest incidence rates. We analyzed 300
soil samples near Las Cruces, New Mexico for the presence of Coccidioides
and report the first known positive soil samples collected from the state,
the majority of which were from grassland dominated sites and from animal
burrows. Sequence analyses from clinical specimens, wild animals, and soil
samples confirm Coccidioides posadasii is the main causative species of
coccidioidomycosis in New Mexico. Environmental surveillance validates
locally acquired infections could occur in, but are not limited to,
Catron, Doña Ana, Sierra, and Socorro Counties.