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Infectious Disease Index

Coccidioides immitis

MATERIAL SAFETY DATA SHEET - INFECTIOUS SUBSTANCES

SECTION I - INFECTIOUS AGENT

NAME: Coccidioides immitis

SYNONYM OR CROSS REFERENCE: Coccidioidomycosis, Valley fever, Desert fever

CHARACTERISTICS: Dimorphic fungus, reproduces by arthroconidia, swelling of arthroconidia in vivo into spherules (which burst and release endospores)

SECTION II - HEALTH HAZARD

PATHOGENICITY: Systemic mycosis beginning as a respiratory infection; primary infection asymptomatic or influenza-like; 1/5 clinical cases develop erythema nodosum; rare progression to disseminated disease (more common in pregnant women, blacks and filipinos); progressive, frequently fatal granulomatous disease with lung lesions and abscesses throughout body. Meningitis common, 90% fatal if not treated. Increasingly important in immunocompromised patients.

EPIDEMIOLOGY: Primary infections common in arid and semiarid areas of Western Hemisphere (California to South Texas, northern Argentina, Paraguay, Colombia, Venezuela, Mexico and Central America); dusty fomites from endemic areas can transmit infection elsewhere; affects all ages, both sexes and all races; most frequent in summer after wind and dust storms

HOST RANGE: Humans, domestic animals, cattle and horses, sheep, swine, wild desert rodents and other animals

INFECTIOUS DOSE: Unknown

MODE OF TRANSMISSION: Inhalation of infective arthroconidia from soil (arthroconidium is 2-5 µm with high propensity for airborne transmission and retention in deep pulmonary spaces); laboratory accidents involving cultures are common; parasitic spherules not usually infective (larger size 30-60 µm of spherule reduces effectiveness of this form as an airborne pathogen) but accidental inoculation of infected pus or other materials can result in granuloma formation

INCUBATION PERIOD: One to 4 weeks in primary infection; disseminated infection may develop insidiously, sometimes without recognized symptoms of primary infection

COMMUNICABILITY: Not directly transmitted from person to person; parasitic form on dressings or casts and in clinical specimen may however change to the infective form after 7 days

SECTION III - DISSEMINATION

RESERVOIR: Soil; especially in and around indian middens and rodent burrows, in regions with appropriate temperature, moisture and soil requirements

ZOONOSIS: Not directly transmitted from animal to humans

VECTORS: None

SECTION IV - VIABILITY

DRUG SUSCEPTIBILITY: Sensitive to Amphotericin B, ketoconazole and itraconazole for chronic infections, fluoconazole for meningeal infections

SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite, phenolics, glutaraldehyde, formaldehyde; susceptibility to 70% ethanol questionable

PHYSICAL INACTIVATION: Spores can withstand dry heat; inactivation by moist heat 121°C for at least 15 min

SURVIVAL OUTSIDE HOST: Arthrospores survive for months to years in soil, dust

SECTION V - MEDICAL

SURVEILLANCE: Monitor for symptoms; demonstration of fungus microscopically in sputum, CSF or tissue biopsy specimens, or in culture; skin test to coccidioidin or spherulin or serological analysis for confirmation

FIRST AID/TREATMENT: Amphotericin B for severe or disseminated forms

IMMUNIZATION: None

PROPHYLAXIS: None

SECTION VI - LABORATORY HAZARDS

LABORATORY-ACQUIRED INFECTIONS: Well documented laboratory hazard; 108 reported cases with 2 deaths; 10th most commonly reported laboratory-acquired infection; 90% of cases in one institution resulted in clinical disease (more than half of infections acquired in nature were asymptomatic)

SOURCES/SPECIMENS: Spherules may be present in clinical specimens and animal tissues; infectious arthroconidia in mold cultures and soil samples

PRIMARY HAZARDS: Inhalation of arthroconidia from soil samples, mold cultures, or following transformation from spherule form in clinical materials; arthroconidia are easily dispersed when cultures are opened

SPECIAL HAZARDS: Accidental percutaneous inoculation of the spherule form may result in local granuloma formation

SECTION VII - RECOMMENDED PRECAUTIONS

CONTAINMENT REQUIREMENTS: Biosafety level 3 practices, containment equipment and facilities are recommended for all activities with cultures of C. immitis and for processing soil or other materials known or likely to contain infectious arthroconidia

PROTECTIVE CLOTHING: Laboratory coat; gloves and wrap-around gown with tight wrists and when manipulating cultures

OTHER PRECAUTIONS: Appropriate practices and precautions to minimize the production of infectious aerosols

SECTION VIII - HANDLING INFORMATION

SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with paper towels and apply 1.0% sodium hypochlorite, starting at perimeter and working towards the centre; allow sufficient contact time (30 min) before clean up

DISPOSAL: Decontaminate before disposal; steam sterilization, incineration

STORAGE: In sealed containers that are appropriately labelled

SECTION IX - MISCELLANEOUS INFORMATION

Date prepared: January 2000

Prepared by: Office of Laboratory Security, PHAC

Although the information, opinions and recommendations contained in this Material Safety Data Sheet are compiled from sources believed to be reliable, we accept no responsibility for the accuracy, sufficiency, or reliability or for any loss or injury resulting from the use of the information. Newly discovered hazards are frequent and this information may not be completely up to date.

Copyright © Health Canada, 2001

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