29/08/2025
【Imported Cases of Coccidioidomycosis on the Rise
NTUH Joins Hands with the Ministry of Health and Welfare
to Safeguard Public Health】
https://www.ntuh.gov.tw/ntuh/News.action?l=en_US&q_type=-1&q_itemCode=17441
Coccidioidomycosis, also known as Valley Fever, is a pulmonary infectious disease endemic to the southwestern United States, Mexico, and parts of Central and South America. The disease is caused by Coccidioides species, and infection occurs when individuals inhale fungal arthroconidia present in dust, particularly during construction, outdoor activities, or dust storms. Importantly, no cases of human-to-human transmission have been reported.
Clinically, about 40% of infected individuals develop symptoms 1 to 4 weeks after exposure, most commonly fatigue, cough, shortness of breath, headache, and myalgia. The majority of cases resolve spontaneously within a few weeks, approximately 5 to 10% of patients fail to recover and develop complications or chronic pulmonary disease. Diagnostic methods include serology, sputum or tissue culture, and histopathology. Among these, serological detection of IgM and IgG antibodies is the most widely used. Pathological identification of the characteristic spherule structure also confirms the diagnosis.
In Taiwan, coccidioidomycosis is categorized as an imported disease. Historically, cases were rare, with only one case reported at National Taiwan University Hospital (NTUH) from 2010 to 2020. However, since 2020, 13 cases have been identified, all involving individuals with travel, residence, or occupational history in the endemic regions of the southwestern United States. six of these cases had long-term stays prior to 2020, while seven occurred after 2020, coinciding with an increase in overseas assignments and travel. Individuals engaged in outdoor work in endemic areas are at higher risk due to inhalation of airborne fungal spores. As global mobility increases, the risk of exposure for Taiwanese nationals has also risen.
Because the clinical presentation lacks specificity, timely diagnosis of coccidioidomycosis can be challenging. At NTUH, Dr. Ming-Shu Hsieh from the Department of Pathology successfully achieved accurate diagnosis through expert histopathological interpretation, enabling patients to receive appropriate treatment without delay—demonstrating the strength of NTUH’s multidisciplinary collaboration.
To strengthen medical awareness and prevention, the Taiwan Centers for Disease Control (CDC) under the Ministry of Health and Welfare has established testing protocols and enhanced laboratory reporting systems, urging clinicians to maintain a high index of suspicion.
NTUH Superintendent Dr. Chong-Jen Yu stated:With Taiwan’s industries expanding globally, our healthcare system must also be prepared. NTUH will continue to align with national policy, leveraging clinical expertise and diagnostic capacity to safeguard the health of Taiwanese people abroad. We stand as a solid pillar of support for Taiwan’s global development.”
NTUH Department of Surgery Chair, Dr. Jin-Shing Chen, remarked:For individuals returning from overseas assignments in endemic areas, close collaboration between surgery and pathology teams is essential. By strengthening cross-disciplinary diagnostic and treatment pathways, we can ensure timely management of suspected cases and minimize the risk of complications.”
NTUH Department of Internal Medicine Chair, Dr. Jann-Tay Wang, emphasized:Clinicians must remain vigilant for imported diseases, particularly in patients presenting with respiratory symptoms. We will continue to promote physician education and enhance diagnostic capacity to ensure optimal care. Members of the public should not be overly alarmed if they have traveled to endemic areas. Practicing proper personal protection during work, and providing physicians with complete ‘TOCC’ information—"Travel history, Occupation, Contact history, and Cluster information"—when seeking care will greatly assist early diagnosis and treatment.”
NTUH remains committed to working hand in hand with the Ministry of Health and Welfare. Beyond being a leader in clinical diagnosis and treatment, NTUH also strives to advance public health preparedness, providing strong support for both national industrial development and the health of the Taiwanese people.
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