PDF(Pubmed)
Abstract：
Valley Fever is a respiratory disease caused by inhalation of arthroconidia, a type of spore produced by fungi within the genus Coccidioides spp. which are found in dry, hot ecosystems of the Western Hemisphere. A quantitative microbial risk assessment (QMRA) for the disease has not yet been performed due to a lack of dose-response models and a scarcity of quantitative occurrence data from environmental samples. A literature review was performed to gather data on experimental animal dosing studies, environmental occurrence, human disease outbreaks, and meteorological associations. As a result, a risk framework is presented with information for parameterizing QMRA models for Coccidioides spp., with eight new dose-response models proposed. A probabilistic QMRA was conducted for a Southwestern US agricultural case study, evaluating eight scenarios related to farming occupational exposures. Median daily workday risks for developing severe Valley Fever ranged from 2.53 × 10-7 (planting by hand while wearing an N95 facemask) to 1.33 × 10-3 (machine harvesting while not wearing a facemask). The literature review and QMRA synthesis confirmed that exposure to aerosolized arthroconidia has the potential to result in high attack rates but highlighted that the mechanistic relationships between environmental conditions and disease remain poorly understood. Recommendations for Valley Fever risk assessment research needs in order to reduce disease risks are discussed, including interventions for farmers.
摘要：
谷热是由吸入关节分生孢子引起的呼吸道疾病，球虫属真菌产生的一种孢子。在干燥中发现，西半球的热生态系统。由于缺乏剂量反应模型和缺乏来自环境样本的定量发生数据，尚未对该疾病进行定量微生物风险评估（QMRA）。进行了文献综述，以收集实验动物给药研究的数据，环境发生，人类疾病爆发，和气象协会。因此,提出了一个风险框架，其中包含了用于参数化球藻的QMRA模型的信息。,提出了八个新的剂量反应模型。对美国西南部农业案例研究进行了概率QMRA，评估与农业职业暴露相关的八种情景。发生ValleyFever的每日工作日风险中位数从2.53×10-7（戴N95面罩时手工种植）到1.33×10-3（不戴面罩时进行机器收获）。文献综述和QMRA合成证实，暴露于雾化的关节分生孢子有可能导致高发作率，但强调环境条件与疾病之间的机制关系仍然知之甚少。为了减少疾病风险，对山谷发烧风险评估研究需求的建议进行了讨论，包括对农民的干预。
