Chest
Clinical InvestigationsSymptomatic Coccidioidomycosis following a Severe Natural Dust Storm: An Outbreak at the Naval Air Station, Lemoore, Calif.
Section snippets
Materials and Methods
Eighteen new cases of symptomatic valley fever were diagnosed at the Naval Hospital, Lemoore, Calif, following a severe natural dust storm that occurred from Dec 20 to 22, 1977. This storm arose from the southeast near Bakersfield, Calif, an area of high endemicity. The storm lasted approximately 48 hours. Visibility during the storm decreased to approximately 0.25 mile. The wind velocity rose to 34 mph. The dust was ubiquitous. It seeped through windows, depositing a layer of dust on car seats
Results
In all 18 cases (nine male and nine female patients), symptoms of valley fever developed within two to four weeks after exposure to the dust storm. Initial symptoms generally consisted of low-grade fever, nonproductive cough, fatigue, and pain in the chest. Eight patients were white, and ten patients were nonwhite (two blacks, two Mexican-Americans, one Oriental, four Filipinos, and one Samoan). There were four cases of disseminated disease (three men and one woman), all in nonwhites (one
Case Reports
The following case reports illustrate the unusual manner in which disseminated disease can occur.
Discussion
A previous study alluded to soil or dust contaminated with C immitis as the “vehicle of natural infection.”1 More recent epidemiologic studies at archaeologic sites have confirmed the relationship between inhalation of fungus-contaminated soil and infection.3, 4, 5 Zoologists whose work brings them into contact with rodent burrows are also likely to become infected.6 Coccidioides immitis has been isolated from samples of air collected during dust storms.7, 8 Smith and Beard1 stated in 1946 that
ACKNOWLEDGMENT
We are grateful for the assistance of David A. Stevens, M.D.; Demosthenes Pappagianis, M.D., PhD; Richard R. Hooper, M.D.; and John N. Galgiani, M.D., in reviewing this manuscript and for the secretarial assistance of Mrs. Donna Sparlin and Mrs. Carolyn Kink.
References (20)
- et al.
Effect of season and dust control on coccidioidomycosis
JAMA
(1946) Epidemiology of coccidioidomycosis
JAMA
(1964)- et al.
Coccidioidomycosis in northern California
Calif Med
(1973) - et al.
Endemic coccidioidomycosis in northern California
Calif Med
(1969) - et al.
An epidemic of coccidioidomycosis among archaeology students in northern California
N Engl J Med
(1972) - et al.
An epidemic of coccidioidal infection
JAMA
(1942) - et al.
Isolation of Coccidioides immitis from the air
Stanford Med Bull
(1956) Comparative ecology of respiratory mycotic disease agents
Bacteriol Rev
(1967)- et al.
Primary pulmonary coccidioidomycosis
War Med War Med
(1943) - Pappagianis D: Coccidioidomycosis in northern California winter 1978. In Proceedings of the 23rd Annual...
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or necessarily reflecting the views of the Bureau of Medicine or of the Naval Service at large.