Coccidioidomycosis, active component, U.S. Armed Forces, 2007-2017

During 2007-2017, there were 574 incident cases of coccidioidomycosis among active component service members, with an overall unadjusted incidence rate of 3.9 cases per 100,000 person-years (p-yrs). Compared to their respective counterparts, the overall rates were highest among those aged 40 years or older, Navy members, enlisted service members, and those in healthcare occupations. Overall incidence rates were similar for males and females. Within race/ethnicity groups, the overall rates of coccidioidomycosis were highest among Asian/Pacific Islanders and lowest among non-Hispanic whites. During the surveillance period, crude annual incidence rates decreased from a high of 5.2 cases per 100,000 p-yrs in 2007 to a low of 2.3 cases per 100,000 p-yrs in 2017. Of the total U.S. cases (n=547), the vast majority (85.0%) were associated with locations within states in the southwestern U.S. with Coccidioides-endemic areas, including California (47.3%), Arizona (32.5%), Texas (4.6%), and New Mexico (0.5%). Providers of health care to U.S. military members should consider coccidioidomycosis as a potential cause of febrile respiratory infectious illnesses, particularly when the individual has a history of recent travel to an endemic area (especially those who work or participate in activities where dust is generated).