Saturday, March 25, 2023
| Characteristic | Arizona No. (%) | California No. (%) | Nevada, New Mexico, Utah, and Washington combined† No. (%) | Other states combined§ No. (%) | Total No. (%) |
|---|---|---|---|---|---|
| Sex (n = 20,034) | |||||
| Male | 4,679 (45) | 5,301 (59) | 243 (59) | 169 (59) | 10,392 (52) |
| Female | 5,668 (55) | 3,687 (41) | 168 (41) | 115 (41) | 9,638 (48) |
| Other | 0 (0) | 3 (0) | 1 (<1) | 0 (0) | 4 (0) |
| Age group (yrs) (n = 20,041) | |||||
| <1 | 0 (0) | 9 (0) | 0 (0) | 0 (0) | 9 (0) |
| 1–5 | 33 (<1) | 51 (1) | 1 (<1) | 0 (0) | 85 (<1) |
| 6–20 | 650 (6) | 706 (8) | 25 (6) | 6 (2) | 1,387 (7) |
| 21–40 | 2,111 (20) | 2,596 (29) | 71 (17) | 28 (10) | 4,806 (24) |
| 41–64 | 3,874 (37) | 3,754 (42) | 172 (42) | 111 (39) | 7,911 (40) |
| 65–80 | 2,925 (28) | 1,489 (17) | 126 (31) | 117 (41) | 4,657 (23) |
| >80 | 759 (7) | 386 (4) | 17 (4) | 24 (8) | 1,186 (6) |
| Race and ethnicity (n = 7,846) | |||||
| American Indian or Alaska Native, non-Hispanic | 177 (8) | 47 (1) | 16 (6) | 1 (<1) | 241 (3) |
| Asian and Native Hawaiian or other Pacific Islander, non-Hispanic | 72 (3) | 358 (7) | 11 (4) | 9 (5) | 450 (6) |
| Black, non-Hispanic | 161 (7) | 336 (6) | 16 (6) | 15 (8) | 528 (7) |
| Hispanic or Latino (all races) | 511 (23) | 1,972 (38) | 65 (26) | 11 (6) | 2,559 (33) |
| White, non-Hispanic | 1,260 (56) | 1,706 (33) | 140 (55) | 146 (77) | 3,252 (41) |
| Other¶ | 51 (2) | 752 (15) | 5 (2) | 8 (4) | 816 (10) |
| Total | 10,359 (100) | 9,004 (100) | 412 (100) | 286 (100) | 20,061 (100) |
Number and percentage of coccidioidomycosis cases, by area and selected patient characteristics* — 23 states, 2019
*Sex was missing for 27 cases, age was missing for 20 cases, and race and ethnicity was missing for 12,215 cases.
†
Coccidioides is known to be present in Nevada, New Mexico, Utah, and Washington, although these states report fewer cases than Arizona
and California.
§Refers to all other states where coccidioidomycosis is reportable and at least one case was reported in 2019 (Alabama, Arkansas,
Delaware, Indiana, Kansas, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, North Dakota,
Ohio, Oregon, Rhode Island, South Dakota, Wisconsin, and Wyoming).
¶Calculated on basis of two or more race category.
| Characteristic | Arizona | California | Nevada, New Mexico, Utah, and Washington combined§ | Other states combined¶ | Total |
|---|---|---|---|---|---|
| Sex (n = 20,034) | |||||
| Male | 129.4 | 27.0 | 3.0 | 0.2 | 15.8 |
| Female | 154.8 | 18.6 | 2.1 | 0.1 | 14.4 |
| Age group (yrs) (n = 20,041) | |||||
| <1 | 0 | 2.0 | 0 | 0 | 0.6 |
| 1–5 | 7.5 | 2.1 | 0.1 | 0 | 1.0 |
| 6–20 | 45.9 | 9.4 | 0.8 | 0.1 | 5.5 |
| 21–40 | 107.7 | 22.6 | 1.6 | 0.2 | 13.2 |
| 41–64 | 186.8 | 31.9 | 3.7 | 0.5 | 19.9 |
| 65–80 | 280.6 | 32.6 | 6.4 | 1.2 | 27.3 |
| >80 | 285.2 | 30.3 | 3.7 | 1.0 | 26.2 |
| Race and ethnicity (n = 7,846) | |||||
| American Indian or Alaska Native, non-Hispanic | 61.7 | 29.0 | 4.7 | 0.2 | 17.4 |
| Asian and Native Hawaiian or other Pacific Islander, non-Hispanic | 27.4 | 6.0 | 1.0 | 0.4 | 4.6 |
| Black, non-Hispanic | 49.4 | 15.1 | 2.4 | 0.2 | 4.0 |
| Hispanic or Latino (all races) | 24.6 | 14.1 | 2.2 | 0.3 | 11.2 |
| White, non-Hispanic | 32.0 | 11.8 | 1.4 | 0.3 | 4.1 |
| Other** | 33.4 | 67.5 | 1.0 | 0.5 | 24.6 |
| Total | 142.3 | 22.8 | 2.6 | 0.4 | 15.1 |
Incidence rate* of coccidioidomycosis, by area and selected patient characteristics† — 23 states, 2019
*Cases per 100,000 population. State-specific denominators from estimated 2019 U.S. Census Bureau data were used for Arizona
and California incidence rates. Pooled state-specific denominators from estimated 2019 U.S. Census Bureau data were used for
the respective incidence rates of the Nevada, New Mexico, Utah, and Washington combined grouping; other states combined grouping;
and the total grouping. U.S. Census Bureau data were not available to calculate incidence rate for sex category "other" (three
cases in California and one case in Nevada, New Mexico, Utah, and Washington combined).
†Sex was missing for 27 cases, age was missing for 20 cases, and race and ethnicity was missing for 12,215 cases.
§
Coccidioides is known to be present in Nevada, New Mexico, Utah, and Washington, although these states report fewer cases than Arizona
and California.
¶Refers to all other states where coccidioidomycosis is reportable and at least one case was reported in 2019 (Alabama, Arkansas,
Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oregon, Rhode Island,
South Dakota, Wisconsin, and Wyoming).
**Calculated on basis of two or more races category.
| Characteristic | Arkansas No. (%) | Delaware No. (%) | Illinois No. (%) | Indiana No. (%) | Kansas No. (%) | Kentucky No. (%) | Louisiana No. (%) | Michigan No. (%) | Minnesota No. (%) | Nebraska No. (%) | Pennsylvania No. (%) | Wisconsin No. (%) | Total No. (%) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sex (n = 1,119) | |||||||||||||
| Male | 45 (48) | 0 (0) | 160 (55) | 61 (57) | 7 (50) | 30 (65) | 12 (60) | 133 (59) | 133 (62) | 29 (43) | 7 (44) | 14 (58) | 631 (56) |
| Female | 49 (52) | 0 (0) | 131 (45) | 46 (43) | 7 (50) | 16 (35) | 8 (40) | 92 (41) | 81 (38) | 39 (57) | 9 (56) | 10 (42) | 488 (44) |
| Age group (yrs) (n = 1,124) | |||||||||||||
| <1 | 0 (0) | 0 (0) | 0 (0) | 2 (2) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 2 (<1) |
| 1–5 | 2 (2) | 0 (0) | 1 (<1) | 2 (2) | 0 (0) | 0 (0) | 1 (5) | 1 (<1) | 2 (1) | 0 (0) | 0 (0) | 0 (0) | 9 (1) |
| 6–20 | 15 (16) | 0 (0) | 34 (12) | 23 (21) | 0 (0) | 7 (15) | 2 (10) | 17 (8) | 22 (10) | 8 (12) | 0 (0) | 4 (17) | 132 (12) |
| 21–40 | 32 (34) | 1 (100) | 79 (27) | 36 (33) | 1 (7) | 11 (24) | 9 (43) | 60 (27) | 51 (24) | 18 (27) | 2 (13) | 3 (13) | 303 (27) |
| 41–64 | 25 (26) | 0 (0) | 119 (41) | 28 (26) | 9 (64) | 22 (48) | 7 (33) | 101 (45) | 83 (39) | 29 (43) | 8 (50) | 9 (38) | 440 (39) |
| 65–80 | 20 (21) | 0 (0) | 49 (17) | 14 (13) | 3 (21) | 5 (11) | 2 (10) | 41 (18) | 50 (23) | 12 (18) | 5 (31) | 8 (33) | 209 (19) |
| >80 | 1 (1) | 0 (0) | 10 (3) | 3 (3) | 1 (7) | 1 (2) | 0 (0) | 5 (2) | 6 (3) | 1 (2) | 1 (6) | 0 (0) | 29 (3) |
| Race and ethnicity (n = 859) | |||||||||||||
| American Indian or Alaska Native, non-Hispanic | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (<1) | 1 (<1) | 2 (3) | 0 (0) | 0 (0) | 4 (<1) |
| Asian and Native Hawaiian or other Pacific Islander, non-Hispanic | 1 (2) | 0 (0) | 7 (3) | 2 (2) | 1 (8) | 0 (0) | 9 (47) | 0 (0) | 5 (3) | 0 (0) | 0 (0) | 0 (0) | 25 (3) |
| Black, non-Hispanic | 12 (21) | 0 (0) | 34 (17) | 15 (16) | 0 (0) | 0 (0) | 1 (5) | 8 (5) | 5 (3) | 3 (5) | 1 (14) | 0 (0) | 79 (9) |
| Hispanic or Latino (all races) | 5 (9) | 0 (0) | 27 (13) | 5 (5) | 0 (0) | 2 (8) | 7 (37) | 7 (4) | 3 (2) | 4 (6) | 1 (14) | 2 (9) | 63 (7) |
| White, non-Hispanic | 38 (68) | 0 (0) | 133 (66) | 70 (73) | 12 (92) | 22 (88) | 2 (11) | 137 (77) | 159 (92) | 58 (87) | 5 (71) | 20 (91) | 656 (76) |
| Other§ | 0 (0) | 0 (0) | 2 (4) | 4 (7) | 0 (0) | 1 (2) | 0 (0) | 25 (45) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 32 (4) |
| Hospitalization (n = 460) | |||||||||||||
| Yes | 36 (69) | —¶ | — | 62 (63) | 10 (71) | — | — | — | 101 (49) | 27 (42) | — | 13 (54) | 249 (54) |
| No | 16 (31) | — | — | 36 (37) | 4 (29) | — | — | — | 107 (51) | 37 (58) | — | 11 (46) | 211 (46) |
| Death (n = 415) | |||||||||||||
| Yes | 2 (8) | — | — | 5 (5) | 2 (14) | — | — | — | 10 (5) | 1 (2) | — | 0 (0) | 20 (5) |
| No | 23 (92) | — | — | 93 (95) | 12 (86) | — | — | — | 196 (95) | 47 (98) | — | 24 (100) | 395 (95) |
| Total | 95 (100) | 1 (100) | 292 (100) | 108 (100) | 14 (100) | 46 (100) | 21 (100) | 225 (100) | 214 (100) | 68 (100) | 16 (100) | 24 (100) | 1,124 (100) |
Number and percentage of histoplasmosis cases, by state, selected patient characteristics, and clinical outcomes* — 12 states,† 2019
*Sex was missing for five cases, race and ethnicity was missing for 265 cases, hospitalization status was missing for 664
cases, and death status was missing for 709 cases.
†Rhode Island reported zero cases in 2019.
§Calculated on basis of two or more race category.
¶Not available.
| Characteristic | Arkansas | Delaware | Illinois | Indiana | Kansas | Kentucky | Louisiana | Michigan | Minnesota | Nebraska | Pennsylvania | Wisconsin | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sex (n = 1,119) | |||||||||||||
| Male | 3.0 | 0 | 2.6 | 1.8 | 0.5 | 1.4 | 0.5 | 2.7 | 4.7 | 3.0 | 0.1 | 0.5 | 1.8 |
| Female | 3.2 | 0 | 2.0 | 1.4 | 0.5 | 0.7 | 0.3 | 1.8 | 2.9 | 4.0 | 0.1 | 0.3 | 1.3 |
| Age group (yrs) (n = 1,124) | |||||||||||||
| <1 | 0 | 0 | 0 | 2.5 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0.2 |
| 1–5 | 1.1 | 0 | 0.1 | 0.5 | 0 | 0 | 0.3 | 0.2 | 0.6 | 0 | 0 | 0 | 0.2 |
| 6–20 | 2.5 | 0 | 1.4 | 1.7 | 0 | 0.8 | 0.2 | 0.9 | 2.0 | 2.0 | 0 | 0.4 | 1.0 |
| 21–40 | 4.1 | 0.4 | 2.3 | 2.0 | 0.1 | 1.0 | 0.7 | 2.3 | 3.4 | 3.5 | 0.1 | 0.2 | 1.6 |
| 41–64 | 2.8 | 0 | 3.1 | 1.4 | 1.1 | 1.6 | 0.5 | 3.3 | 4.9 | 5.3 | 0.2 | 0.5 | 2.0 |
| 65–80 | 4.8 | 0 | 3.1 | 1.6 | 0.8 | 0.8 | 0.3 | 2.9 | 7.0 | 5.0 | 0.3 | 1.0 | 2.2 |
| >80 | 0.9 | 0 | 2.2 | 1.3 | 0.9 | 0.7 | 0 | 1.4 | 2.9 | 1.4 | 0.2 | 0 | 1.1 |
| Race and ethnicity (n = 859) | |||||||||||||
| American Indian or Alaska Native, non-Hispanic | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1.8 | 1.7 | 12.3 | 0 | 0 | 1.2 |
| Asian and Native Hawaiian or other Pacific Islander, non-Hispanic | 1.7 | 0 | 1.0 | 1.2 | 1.1 | 0 | 10.8 | 0 | 1.7 | 0 | 0 | 0 | 1.0 |
| Black, non-Hispanic | 2.6 | 0 | 1.9 | 2.3 | 0 | 0 | 0.1 | 0.6 | 1.3 | 3.2 | 0.1 | 0 | 0.9 |
| Hispanic or Latino (all races) | 2.4 | 0 | 1.3 | 1.2 | 0 | 1.3 | 3.4 | 1.6 | 1.1 | 2.1 | 0.1 | 0.6 | 1.2 |
| White, non-Hispanic | 1.8 | 0 | 1.7 | 1.3 | 0.6 | 0.6 | 0.1 | 1.8 | 3.6 | 3.8 | 0.1 | 0.4 | 1.3 |
| Other¶ | 0 | 0 | 1.0 | 3.1 | 0 | 1.2 | 0 | 11.0 | 0 | 0 | 0 | 0 | 2.3 |
| Total | 3.2 | 0.1 | 2.3 | 1.6 | 0.5 | 1.0 | 0.5 | 2.3 | 3.8 | 3.5 | 0.1 | 0.3 | 1.6 |
Incidence rate* of histoplasmosis, by state and selected patient characteristics† — 12 states,§ 2019
*Cases per 100,000 population. State-specific denominators from estimated 2019 U.S. Census Bureau data were used for Arkansas,
Delaware, Illinois, Indiana, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Nebraska, Pennsylvania, and Wisconsin incidence
rates. Pooled state-specific denominators from estimated 2019 U.S. Census Bureau data were used to calculate the incidence
rate for the total grouping.
†Sex was missing for five cases, and race and ethnicity was missing for 265 cases.
§Rhode Island reported zero cases in 2019.
¶Calculated on basis of two or more race category.
| Characteristic | Arkansas No. (%) | Louisiana No. (%) | Michigan No. (%) | Minnesota No. (%) | Wisconsin No. (%) | Total No. (%) |
|---|---|---|---|---|---|---|
| Sex (n = 239) | ||||||
| Male | 18 (64) | 7 (100) | 17 (65) | 56 (71) | 70 (71) | 168 (70) |
| Female | 10 (36) | 0 (0) | 9 (35) | 23 (29) | 29 (29) | 71 (30) |
| Age group (yrs) (n = 240) | ||||||
| <1 | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) |
| 1–5 | 1 (4) | 0 (0) | 0 (0) | 1 (1) | 0 (0) | 2 (1) |
| 6–20 | 8 (29) | 0 (0) | 0 (0) | 6 (8) | 10 (10) | 24 (10) |
| 21–40 | 6 (21) | 2 (29) | 4 (15) | 37 (47) | 30 (30) | 79 (33) |
| 41–64 | 11 (39) | 2 (29) | 13 (50) | 22 (28) | 42 (42) | 90 (38) |
| 65–80 | 2 (7) | 3 (43) | 8 (31) | 13 (16) | 15 (15) | 41 (17) |
| >80 | 0 (0) | 0 (0) | 1 (4) | 0 (0) | 3 (3) | 4 (2) |
| Race and ethnicity (n = 208) | ||||||
| American Indian or Alaska Native, non-Hispanic | 0 (0) | 0 (0) | 1 (5) | 5 (7) | 4 (5) | 10 (5) |
| Asian and Native Hawaiian or other Pacific Islander, non-Hispanic | 1 (5) | 0 (0) | 0 (0) | 8 (11) | 6 (7) | 15 (7) |
| Black, non-Hispanic | 3 (15) | 2 (100) | 1 (5) | 7 (9) | 11 (13) | 24 (12) |
| Hispanic or Latino (all races) | 3 (15) | 0 (0) | 1 (5) | 4 (5) | 6 (7) | 14 (7) |
| White, non-Hispanic | 13 (65) | 0 (0) | 19 (86) | 52 (68) | 60 (68) | 144 (69) |
| Other† | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (1) | 1 (1) |
| Hospitalization (n = 228) | ||||||
| Yes | 14 (82) | 5 (83) | 16 (62) | 51 (65) | 61 (61) | 147 (65) |
| No | 3 (18) | 1 (17) | 10 (38) | 28 (35) | 39 (39) | 81 (36) |
| Death (n = 224) | ||||||
| Yes | 1 (8) | 2 (29) | 3 (12) | 5 (6) | 9 (9) | 20 (9) |
| No | 11 (92) | 5 (71) | 23 (88) | 74 (94) | 91 (91) | 204 (91) |
| Total | 28 (100) | 7 (100) | 26 (100) | 79 (100) | 100 (100) | 240 (100) |
Number and percentage of blastomycosis cases, by state, selected patient characteristics, and clinical outcomes* — five states, 2019
*Sex was missing for one case, race and ethnicity was missing for 32 cases, hospitalization status was missing for 12 cases,
and death status was missing for 16 cases.
†Calculated on basis of two or more race category.
| Characteristic | Arkansas | Louisiana | Michigan | Minnesota | Wisconsin | Total |
|---|---|---|---|---|---|---|
| Sex (n = 239) | ||||||
| Male | 1.2 | 0.3 | 0.4 | 1.9 | 2.4 | 1.2 |
| Female | 0.7 | 0 | 0.2 | 0.8 | 1.0 | 0.5 |
| Age group (yrs) (n = 240) | ||||||
| <1 | 0 | 0 | 0 | 0 | 0 | 0 |
| 1–5 | 0.5 | 0 | 0 | 0.3 | 0 | 0.1 |
| 6–20 | 1.4 | 0 | 0 | 0.6 | 0.9 | 0.5 |
| 21–40 | 0.8 | 0.2 | 0.3 | 2.5 | 2.0 | 1.3 |
| 41–64 | 1.2 | 0.2 | 0.8 | 1.3 | 2.3 | 1.2 |
| 65–80 | 0.5 | 0.5 | 1.1 | 1.8 | 1.9 | 1.3 |
| >80 | 0 | 0 | 0.4 | 0 | 1.4 | 0.2 |
| Race and ethnicity (n = 208) | ||||||
| American Indian or Alaska Native, non-Hispanic | 0 | 0 | 1.8 | 8.3 | 7.6 | 4.5 |
| Asian and Native Hawaiian or other Pacific Islander, non-Hispanic | 2.1 | 0 | 0 | 2.7 | 3.4 | 1.6 |
| Black, non-Hispanic | 0.7 | 0.1 | 0.1 | 1.8 | 3.0 | 0.6 |
| Hispanic or Latino (all races) | 1.4 | 0 | 0.2 | 1.5 | 1.7 | 0.9 |
| White, non-Hispanic | 0.6 | 0 | 0.3 | 1.2 | 1.3 | 0.7 |
| Other§ | 0 | 0 | 0 | 0 | 1.0 | 0.2 |
| Total | 0.9 | 0.2 | 0.3 | 1.4 | 1.7 | 0.8 |
Incidence rate* of blastomycosis, by state and selected patient characteristics† — five states, 2019
*Cases per 100,000 population. State-specific denominators from estimated 2019 U.S. Census Bureau data were used for Arkansas,
Louisiana, Michigan, Minnesota, and Wisconsin incidence rates. Pooled state-specific denominators from estimated 2019 U.S.
Census Bureau data were used to calculate the incidence rate for the total grouping.
†Sex was missing for one case, race and ethnicity was missing for 32 cases, hospitalization status was missing for 12 cases,
and death status was missing for 16 cases.
§Calculated on basis of two or more race category.
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This activity is intended for public health officials, infectious disease clinicians, internists, pulmonologists, nurses, pharmacists, and other clinicians caring for patients with or at risk for coccidioidomycosis, histoplasmosis, or blastomycosis.
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In 2019, CDC received 20,061 coccidioidomycosis case reports from 23 of 27 states and jurisdictions where the disease is reportable (Figure 1). Delaware, the District of Columbia, Indiana, and Kansas reported zero cases. The overall incidence of coccidioidomycosis was 15.2 cases per 100,000 population. Most (19,363 [97%]) reported coccidioidomycosis cases came from Arizona and California. Arizona had the highest coccidioidomycosis incidence rate (142.3 per 100,000 population), and California had the second highest (22.8). Nevada, New Mexico, Utah, and Washington reported 2.1% (412; rate: 2.6) of coccidioidomycosis cases, and other states combined reported 1.4% (286; rate: 0.4) (Table 1).
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Incidence rate* of coccidioidomycosis, by state and tertiles†,§ — National Notifiable Diseases Surveillance System, United States, 2019
Abbreviation: DC = District of Columbia.
*Cases per 100,000 population, calculated using state-specific denominators estimated from 2019 U.S. Census Bureau data.
†Coccidioidomycosis is a reportable condition in 26 states (Alabama, Arizona, Arkansas, California, Delaware, Indiana, Kansas,
Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Ohio,
Oregon, Rhode Island, South Dakota, Utah, Washington, Wisconsin, and Wyoming) and the District of Columbia; in Washington,
coccidioidomycosis is reportable as a rare disease of public health significance. Delaware, the District of Columbia, Indiana,
and Kansas reported zero cases in 2019.
§In 2019, California submitted data directly to CDC.
More coccidioidomycosis cases occurred in males (10,392 [52%]; rate:15.8 per 100,000 population) than in females (9,638 [48%]; rate: 14.4). Age groups with the highest coccidioidomycosis incidence rates were 65–80 years (27.3) and >80 years (26.2) (Table 2). Coccidioidomycosis cases were most common in persons aged 65–80 years in states with low endemicity (6.4) and states in which coccidioidomycosis is not known to be endemic (1.2).
Race and ethnicity data were available for 7,846 (39%) coccidioidomycosis cases (Table 1). Among those with available information, coccidioidomycosis cases were most common in non-Hispanic White (White) (3,252 [42%]) and Hispanic or Latino (Hispanic) (2,559 [33%]) persons. Non-Hispanic Black or African American persons accounted for 7% (528) of overall coccidioidomycosis cases. A substantial proportion of coccidioidomycosis cases occurred in Hispanic persons in states with high endemicity (2,483 [34%]) as well as in states with low endemicity (65 [26%]). Overall, coccidioidomycosis incidence rates by race and ethnicity were highest in non-Hispanic American Indian and Alaska Native (AI/AN) persons (17.4 per 100,000 population) and in Hispanic persons (11.2) (Table 2).
Earliest event date type was available for 10,964 (59%) coccidioidomycosis cases, with diagnosis date being the most common in states with high endemicity (6,093 [59%]). Event date type was not available for California, which submitted one composite episode date reflecting the earliest reported data available. Coccidioidomycosis symptom onset date was more commonly reported from states with low endemicity (316 [77%]) and states in which the disease is not known to be endemic (127 [66%]). Data on the earliest event month were submitted for 19,889 coccidioidomycosis cases (99%). Overall, coccidioidomycosis case counts were relatively consistent throughout spring (4,631 [23%]), summer (4,860 [24%]), and winter (4,797 [24%]) and slightly higher in autumn (5,601 [28%]) (Figure 2). States with low endemicity had peaks in summer (29%). In states in which coccidioidomycosis is not known to be endemic, coccidioidomycosis cases were more likely to occur in spring (31%) (Supplementary Figure 4, https://stacks.cdc.gov/view/cdc/118605).
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Percentage of coccidioidomycosis, histoplasmosis, and blastomycosis cases,* by month — United States, 2019
*Denominator is total cases reported in 2019 with a known earliest recorded event month for each fungal disease (coccidioidomycosis:
19,889 cases; histoplasmosis: 887 cases; and blastomycosis: 161 cases).
In 2019, CDC received 1,124 case reports of histoplasmosis from 12 states where the disease is reportable (Figure 3); Rhode Island reported zero histoplasmosis cases. The overall incidence of histoplasmosis in these states was 1.8 cases per 100,000 population. Illinois (292 [26%]; rate: 2.3), Michigan (225 [20%]; rate: 2.3), and Minnesota (214 [19%]; rate: 3.8), accounted for most histoplasmosis cases (Table 3).
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Incidence rate* of histoplasmosis, by state and tertiles† — United States, 2019
Abbreviation: DC = District of Columbia.
*Cases per 100,000 population, calculated using state-specific denominators estimated from 2019 U.S. Census Bureau data.
†Histoplasmosis is a reportable condition in 13 states (Arkansas, Delaware, Illinois, Indiana, Kansas, Kentucky, Louisiana,
Michigan, Minnesota, Nebraska, Pennsylvania, Rhode Island, and Wisconsin); in Rhode Island, histoplasmosis is reportable as
a rare or unusual condition. Rhode Island reported zero cases in 2019. Certain state health departments submit data directly
to CDC.
More histoplasmosis cases occurred in males (631 [56%]; rate: 1.8) than in females (488 [44%]; rate: 1.3 per 100,000 population). The age groups with the highest incidence rates for histoplasmosis were 41–64 years (2.0) and 65–80 years (2.2) (Table 4).
Data on race and ethnicity were submitted for 859 (76%) histoplasmosis cases. Among those with available information, most histoplasmosis cases occurred in White persons (656 [76%]) (Table 3). Incidence rates for histoplasmosis were highest in White persons (1.3 per 100,000 population), AI/AN persons (1.2), and Hispanic persons (1.2) (Table 4).
Earliest event date type was available for 683 (61%) histoplasmosis cases, with symptom onset date the most common type (591 [87%]). Data on the earliest event month were submitted for 887 (79%) cases. Overall, histoplasmosis case frequency was relatively consistent throughout spring (223 [25%]), summer (201 [23%]), and winter (210 [24%]) and was slightly higher in autumn (253 [29%]) (Figure 2).
Hospitalization status was available for 460 (41%) histoplasmosis cases, and mortality data were submitted for 415 (37%) cases from six states (Table 3). Of these cases, 54% (249) of patients were hospitalized, and 5% (20) of patients died.
In 2019, CDC received 240 case reports of blastomycosis from five states (Figure 4). The overall blastomycosis incidence in these states was 0.8 cases per 100,000 population. Minnesota (1.4) and Wisconsin (1.7) accounted for 75% (179) of cases (Table 5).
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Incidence rate* of blastomycosis, by state and tertiles† — United States, 2019
Abbreviation: DC = District of Columbia.
*Cases per 100,000 population, calculated using state-specific denominators estimated from 2019 U.S. Census Bureau data.
†Blastomycosis is a reportable condition in five states (Arkansas, Louisiana, Michigan, Minnesota, and Wisconsin). State health
departments submit data directly to CDC.
More blastomycosis cases occurred in males (168 [70%]; rate: 1.2 per 100,000 population) than in females (71 [30%]; rate: 0.5). The age groups with the highest blastomycosis incidence rates were 21–40 years (1.3), 41–64 years (1.2), and 65–80 years (1.3) (Table 6).
Data on race and ethnicity were submitted for 208 (87%) blastomycosis cases. Among blastomycosis cases with race and ethnicity information, most were in White persons (144 [69%]) (Table 5). Incidence rates for blastomycosis were highest in AI/AN persons (4.5 per 100,000 population) and non-Hispanic Asian and Native Hawaiian or other Pacific Islander persons (1.6) (Table 6).
Earliest event date type was available for 33 (14%) blastomycosis cases, with symptom onset date being the most common type (19 [58%]). Data on the earliest event month were submitted for 161 (67%) blastomycosis cases. Overall, blastomycosis cases were most frequent in summer (46 [29%]) and autumn (42 [26%]) and least frequent in winter (35 [22%]) (Figure 2).
Hospitalization status was available for 228 (95%) blastomycosis cases, and mortality data were submitted for 224 (93%) cases from five states (Table 5). Of these cases, 65% (147) of patients were hospitalized, and 9% (20) of patients died.
