Epidemiologic Highlight: Outbreak of Valley Fever in U.S. residents returning from a service trip to Mexico.
Eight cases of valley fever were reported in 4 states (Kansas, Maryland, Michigan, and New York) in persons who traveled on multiple service trips during June–July 2018 (Toda et al., 2019). Four patients were hospitalized, one required intensive care, one required a chest tube for pleural effusion, and one who was hospitalized for >10 d. All were male, 5 high school students, and 3 adults. Patients were part of 7 separate trips organized by churches, high schools, or community groups. The trips were coordinated by 2 organizations and involving 225 travelers from 6 states. Seven patients performed building a single house south of Tijuana; this site was the likely source of exposure. State and local health departments notified all travelers about their risk for valley fever.

Potential mitigation efforts could include soil wetting, using professionals with occupational safety training for excavation, staying upwind of digging when possible, and using approved N-95 respirators when for dust-generating activities. Early diagnosis, treatment, and surveillance for valley fever could reduce misdiagnosis and improve outcomes.