Genomic typing of Coccidioides sp. in northeastern Brazil
We conducted a comprehensive investigation of risk factors, clinical and geographical characterization, and genomic typing of Coccidioides sp. in Brazil, which has never been reported before. We described 292 human cases, 23 canine cases and 42 epidemics of coccidioidomycosis in Brazil, being the largest series outside the USA/Mexico endemic range. This study found that coccidioidomycosis affects young, immunocompetent Afro-descendent males who acquire the disease by inhaling a high load of dust from armadillo habitats during hunting, which is a common practice in the Northeastern states of Brazil. We have found that the endemic area of coccidioidomycosis in Brazil must be wider than previously found, and its incidence is linked to long droughts and caused by a unique genotype of Coccidioides posadasii as deduced by species niche modeling and genomic epidemiology.