Risk factors for acute symptomatic coccidioidomycosis among elderly persons in Arizona, 1996-1997

Because of the increase in incidence of coccidioidomycosis among the elderl y in Arizona between 1990 and 1996, a case-control study was conducted to l ook at risk factors for disease among these persons. Cases (n = 89) were pe rsons aged greater than or equal to 60 years with laboratory-confirmed cocc idioidomycosis; 2 control groups were selected, the first by use of random- digit dialing (geographic controls, n = 91) and the second by use of lists of persons with negative serologic coccidioidomycosis tests (laboratory-neg ative controls, n = 58). Elderly persons with coccidioidomycosis had spent significantly less time in Arizona than did persons in either control group and were more likely than geographic controls to have congestive heart fai lure or cancer, to have smoked, or to have taken corticosteroids. Elderly p ersons who recently have moved to Arizona or who have chronic illnesses and their physicians need to be aware of their higher risk for coccidioidomyco sis in order to improve their chances of early diagnosis and treatment. The se persons may benefit from vaccination, once an effective vaccine for cocc idioidomycosis is developed.