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BACKGROUND: Coccidioidomycosis, a fungal infection endemic in the southwestern United States, can lead to severe and potentially fatal disseminated disease. Workplace-acquired coccidioidomycosis can result from soil-disturbing activities or windborne dust. In December 2012, San Luis Obispo County (SLO) Public Health alerted the California Department of Public Health (CDPH) to three coccidioidomycosis cases among construction workers at Solar Power Farm A. CDPH investigated to determine the extent of the outbreak and risk factors.
METHODS: Because use of coccidioidomycosis prevention measures within this growing industry is unknown, CDPH reviewed routinely collected occupational injury/illness and confidential morbidity reports, and associated medical records. Cases were defined as both clinical- and laboratory-diagnosed coccidioidomycosis, symptom onset since January 1, 2012, and working on solar farm construction in SLO.
RESULTS: By March 7, 2013, a total of 12 cases were identified from two solar farms in SLO, five from Farm A and seven from Farm B. Five patients resided outside SLO and two outside California. All patients were male, aged 21–63 years, and had symptom onset January 13, 2012–January 1, 2013. Six patient records noted dusty workplace conditions, four working in or near heavy equipment, five digging or working in soil, and four lack of respiratory protection. Two patients were hospitalized; four visited emergency departments; and five were unable to work for 2 weeks–12 months.
CONCLUSIONS: Data from routine public health and occupational illness reporting revealed ongoing occurrence of coccidioidomycosis among construction workers at two solar power farms in SLO. An Epi-X call for cases was posted March 5, 2013, and worksite investigations are under way to assess practices, identify additional cases, and educate construction employers in endemic areas.