Understanding the exposure risk of aerosolized Coccidioides in a Valley fever endemic metropolis.

Coccidioides is the fungal causative agent of Valley fever, a primarily pulmonary disease caused by inhalation of fungal arthroconidia, or spores. Although Coccidioides has been an established pathogen for 120 years and is responsible for hundreds of thousands of infections per year, little is known about when and where infectious Coccidioides arthroconidia are present within the ambient air in endemic regions. Long-term air sampling programs provide a means to investigate these characteristics across space and time. Here we present data from > 18 months of collections from 11 air sampling sites across the Phoenix, Arizona, metropolitan area. Overall, prevalence was highly variable across space and time with no obvious spatial or temporal correlations. Several high prevalence periods were identified at select sites, with no obvious spatial or temporal associations. Comparing these data with weather and environmental factor data, wind gusts and temperature were positively associated with Coccidioides detection, while soil moisture was negatively associated with Coccidioides detection. These results provide critical insights into the frequency and distribution of airborne arthroconidia and the associated risk of inhalation and potential disease that is present across space and time in a highly endemic locale.

Detection of Hantavirus during the COVID-19 Pandemic, Arizona, USA, 2020.

We identified 2 fatal cases of persons infected with hantavirus in Arizona, USA, 2020; 1 person was co-infected with SARS-CoV-2. Delayed identification of the cause of death led to a public health investigation that lasted ≈9 months after their deaths, which complicated the identification of a vector or exposure.

Phylogenomic Placement of American Southwest-Associated Clinical and Veterinary Isolates Expands Evidence for Distinct Cryptococcus gattii VGVI.

Whole-genome sequencing has advanced our understanding of the population structure of the pathogenic species complex Cryptococcus gattii, which has allowed for the phylogenomic specification of previously described major molecular type groupings and novel lineages. Recently, isolates collected in Mexico in the 1960s were determined to be genetically distant from other known molecular types and were classified as VGVI. We sequenced four clinical isolates and one veterinary isolate collected in the southwestern United States and Argentina from 2012 to 2021. Phylogenomic analysis groups these genomes with those of the Mexican VGVI isolates, expanding VGVI into a clade and establishing this molecular type as a clinically important population. These findings also potentially expand the known Cryptococcus ecological range with a previously unrecognized endemic area.

Secuelas neurológicas y psicológicas que deja la radioterapia o el metotresate intratecal en niños con leucemia linfoblástica aguda / Neurogical and psycological sequelae in children with acute lymphoblastic. leukemia who received central nervous system prophylaxis with radiotherapy or intrathecal methrotexate

Comparar las alteraciones neurológicas y psicológicas en niños con leucemia linfoblástica aguda (LLA), quienes habían estado con más de tres años sin tratamiento antineoplásico, y que recibieron profilaxis al sistema nervioso central (SNC) con base a radioterapia (RT), más quimioterapia intratecal (QTT) con metotrexate (Grupo 1) o sólo con QTIT (Grupo 2). En ambos grupos se realizó evaluación neurológica, electroencefalograma (EEG) y tomografía computada de cráneo (TACC). La evaluación psicológica consistió en la medición del coeficiente intelectual y de la función visomotora con la prueba de Bender. Las personas que realizaron cada una de las evaluaciones desconocían a que grupo de pacientes correspondía. Análisis estadístico: prueba exacta de Fisher y U de Mann-Whitnney. Catorce pacientes del grupo 1 y ocho pacientes del grupo 2. En el grupo 1 se encontró coeficiente intelectual significativamente inferior (mediana 83.5) al del segundo (90.5). En un paciente de cada grupo se encontraron alteraciones neurológicas, alteraciones en el EEG en 6 del grupo 1 y en 4 del grupo 2 y en la TACC, sólo en 2 pacientes del segundo grupo, sin tener diferencia estadística. Los niños con LLA quienes recibieron profilaxis al SNC con RT más QTIT, tuvieron mayor alteración en el rendimiento intelectual, en comparación con los tratados con metotrexate intratecal. En los dos grupos se presentaron anormalidades neurológicas, sin diferencia entre uno y otro grupo