Valley Fever Is an Occupational Illness: Let's Get the Data to Prevent It.

Valley fever is a fungal disease acquired through inhalation of spores of the fungus Coccidioides. Spores become airborne when soil is disturbed, making outdoor workers, such as agricultural or construction workers, at higher risk of exposure and disease. Valley fever is endemic and increasing in the American Southwest, with numerous documented outbreaks among construction crews, archeologists, prison employees, wildland firefighters, and military personnel. Valley fever is recognized as a work-related disease in California, but not Arizona or other states with endemic disease. Epidemiologists require surveillance data with patient industry and occupation to make the case to clinicians, legislators, and employers that Valley fever is an occupational disease that can be prevented through tailored interventions. Valley fever is a reportable disease in 28 states, including California and Arizona, and Washington, D.C.; however, most case reports are sent through automated lab reports or manual case reporting, which seldom include information about industry or occupation. Electronic case reporting (eCR), in which automated disease reports are sent to public health agencies from health care facilities via electronic medical records, provides a new pathway to streamline case reporting and is more conducive to inclusion of industry and occupation data in case reports. Occupational reporting through eCR would help build the epidemiological base to identify worker populations with excess cases of Valley fever, to identify occupational clusters, facilitate early outbreak detection, provide evidence for worker compensation claims of work-related infections, and support the development of more protective legislation to train and educate workers on prevention methods.