title: Rates and risk factors for Coccidioidomycosis among prison inmates, California, USA, 2011.
abstract: In California, coccidioidomycosis is a disease acquired by inhaling spores of Coccidioides immitis, a fungus found in certain arid regions, including the San Joaquin Valley, California, USA, where 8 state prisons are located. During 2011, we reviewed coccidioidomycosis rates at 2 of the prisons that consistently report >80% of California's inmate cases and determined inmate risk factors for primary, severe (defined as pulmonary coccidioidomycosis requiring >10 hospital days), and disseminated coccidioidomycosis (defined by hospital discharge International Classification of Disease, Ninth Revision code). Inmates of African American ethnicity who were >40 years of age were at significantly higher risk for primary coccidioidomycosis than their white counterparts (odds ratio = 2.0, 95% CI 1.5-2.8). Diabetes was a risk factor for severe pulmonary coccidioidomycosis, and black race a risk factor for disseminated disease. These findings contributed to a court decision mandating exclusion of black inmates and inmates with diabetes from the 2 California prisons with the highest rates of coccidioidomycosis.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Wheeler
authors.forename: Kimberley D
authors.initials: KD
authors.lastname: Lucas
authors.forename: Janet C
authors.initials: JC
authors.lastname: Mohle-Boetani
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D003047:Coccidioidomycosis / Q000453:epidemiology*; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D012307:Risk Factors; D055815:Young Adult