Genomic Epidemiology Linking Nonendemic Coccidioidomycosis to Travel

Coccidioidomycosis is a fungal infection endemic to hot, arid regions of the western United States, northern Mex-ico, and parts of Central and South America. Sporadic cases outside these regions are likely travel-associated; alternatively, an infection could be acquired in as-yet unidentified newly endemic locales. A previous study of cases in nonendemic regions with patient self-reported travel history suggested that infections were acquired during travel to endemic regions. We sequenced 19 Coccidioides isolates from patients with known travel histories from that earlier investigation and performed phylogenetic analysis to identify the locations of potential source populations. Our results show that those isolates were phylogenetically linked to Coccidioides subpopula-tions naturally occurring in 1 of the reported travel lo-cales, confirming that these cases were likely acquired during travel to endemic regions. Our findings demon-strate that genomic analysis is a useful tool for investi-gating travel-related coccidioidomycosis.

Automated summary

Coccidioidomycosis is a fungal infection that is endemic to specific regions and can be acquired during travel to those regions. A study using genomic analysis identified the source of the infection in patients with travel history, confirming the link between travel and the acquisition of the disease. This demonstrates the usefulness of genomic analysis in investigating travel-related Coccidioidomycosis.