Environmental Variability and Fluctuation of Coccidioidomycosis (Valley Fever) In California: Based on a New Framework Involving Fungal Life Cycle

Coccidioidomycosis (valley fever), caused by inhalation of spores from pathogenic fungus includingCoccidiodes immitis (C. immitis) and Coccidioides posadasii (C. posadasii), is a disease endemic to arid regions in the southwest US, as well as parts of Central and South America. With a projected increase of drought in this region, an improved understanding of environmental factors behind the outbreaks of coccidioidomycosis will enable the prediction of coccidioidomycosis in a changing climate regime. Previous research shows the infections correlate with climate conditions including precipitation, temperature, and dust. However, most studies focus only on the environmental conditions of fungus growth, which is the first stage in the fungal life cycle. In contrast, we extend the analysis to the following two stages in the life cycle, arthrospore formation and dispersal, to form a better model to predict the disease outbreaks. Besides climate conditions, we use relative spectral mixture analysis (RSMA) based on MODIS MOD43 nadir BRDF adjusted reflectance (NBAR) data to derive the relative dynamics of green vegetation, non-photosynthetic vegetation and bare soil coverage as better indicators of soil moisture, which is important for arthospore formation and dispersal. After detecting the hotspots of disease outbreaks, we correlate seasonal incidence from 2000 to 2010 with the environmental variables zero to eight seasons before to obtain candidates for stepwise regression. Regression result shows a seasonal difference in the leading explanatory variables. Such difference indicates the different seasonal main influential process from fungal life cycle. C. immitis (fungus responsible for coccidioidomycosis outbreaks in California) growth explains outbreaks in winter and fall better than other two stages in the life cycle, while arthospore formation is more responsible for spring and summer outbreaks. As the driest season, summer has the largest area related with arthospore dispersal. The seasonal difference of main influential process relates to the length of lags between the outbreaks and stages in fungal life cycle. During wet seasons of California including winter and fall, outbreaks are less correlated with the short-lag process such as dispersal of arthospores because of high soil moisture. In contrast, the long-lag process like C.immitis growth is influential on outbreaks in wet seasons. The arthospore formation, especially during the latest dry season (with a lag less than one year), is more responsible for outbreaks in spring and summer, when the influence of C. immitis growth is dampened by time. However, arthospores formed and preserved years ago may introduce uncertainty to the seasonal lag patterns. The long lags also exist in outbreaks related to arthospore formation. By including all three stages of fungal life cycle, we formed a more comprehensive framework in explaining the relationship between environmental conditions and disease outbreaks. Such analysis can be extended to a finer temporal resolution (e.g. per month) to obtain a clearer picture between environmental variability and coccidioidomycosis fluctuation.