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Coccidioidomycosis — or valley fever — is caused by inhaling the spores of Coccidioides immitis or Coccidioides posadasii. Historically, these fungi have been endemic to the southwestern U.S. and Central and South America. In 2010–2011, acute coccidioidomycosis was diagnosed in three south-central Washington residents who had not traveled to a known endemic area within the preceding 22 months.
Investigation of these cases included soil sampling at two locations (a dirt track used for all-terrain vehicle riding and a residential site) in Benton County, Washington. Samples were obtained from where patients had played or fallen in the dirt and from nearby snake holes and rodent burrows. At the time of collection, there was no reliable test for …