1. AZ Space Grant Symposium 11 April 2014
The Epidemiology of Coccidioidomycosis: Correlating Rainfall, Temperature, and Wind Speed
Angélica Álvarez, NASA Space Grant Intern
Dr. Joellen Russell, Department of Geosciences
Dr. Eyal Oren, Division of Epidemiology & Biostatistics

2. Coccidiodes: Valley Fever What is it? Where is it?
Centers for Disease Control and Prevention
By Janet loehrke and Karl Gelles, USA TODAY

3. Objectives
To what extent do climate anomalies such as in wind speed, temperature and rainfall correlate with Valley Fever reporting data in the state of Arizona?
Is there variability in the influence of these climate variables to specific locations of Arizona?
What is the influence of wind speed, temperature, and rainfall anomalies on Valley Fever reporting data one month later?

4. Methods
Calculation of regression maps of statewide monthly Valley Fever reporting data from the Arizona Department of Health Services on various climate anomalies (wind speed, temperature, rainfall) across Arizona from
Climate variable data taken from Climate Forecast Reanalysis System under the National Oceanic and Atmospheric Administration
Climate anomalies are defined as monthly deviations from normal months (average taken between 1979 – 2010)
Example: Normal January is the average of all Januaries whereas the anomaly in January of 2000 is the difference between the actual value in January of 2000 and the normal value
Calculation of significance of correlation coefficients calculated using student t-tests on regression maps
Correlation and significance of one month lag analysis by correlating the monthly anomaly for a specific climate variable with the following month’s reporting data (ADHS)

5. Cocci Timeline
1930s – physicians in AZ began reporting cases of Cocci to ADHS
1990s – increase in Cocci cases became apparent
annually reported cases doubled
1997 – ADHS changed its reporting rules to made Cocci laboratory-reportable
2009 – “in June, major commercial laboratory changed its reporting practice by beginning to report positive Cocci enzyme immunoassay (EIA) results without confirmation by immunodiffusion assay in accordance with Arizona reporting rules, thereby further increasing the number of reported Cocci cases”
2012 – change in laboratory testing methods contributed to a decrease in the number of reported cases
change in major commercial
laboratory reporting practices
change in laboratory
testing methods

6. Endemic Areas
Source
Arizona Department of Health Services

7. Each individual pixel on regression analysis maps cover 30 x 35 km
Source
Arizona Department of Health Services
Climate Forecast Reanalysis System

8. Source
Arizona Department of Health Services
Climate Forecast Reanalysis System

9. Source
Arizona Department of Health Services
Climate Forecast Reanalysis System

10. Regression Analyses & One Month Lag
Regression Analysis
One Month Lag Regression Analysis
Source
Arizona Department of Health Services
Climate Forecast Reanalysis System

11. Conclusions
Positive correlation between wind anomaly and Cocci in southeast AZ
Strong positive correlation between rain anomaly and Cocci in northwest AZ
Negative correlation of rain anomaly in one month lag regression
No significant difference in lagged correlation using wind anomalies
Further testing with climate variables needed
Correlate meteorological factors such as precipitation, dust exposure, humidity (RH & AH) with Valley Fever looking at incidence rates, date of exposure, and per varying lagged time frames
Correlate comorbidity of Valley Fever with other respiratory diseases

12. Acknowledgements Dr. Paul Goodman, Department of Geosciences
Dr. Andrew C. Comrie, School of Geography & Development
Susan Brew, UA Space Grant Consortium
Dr. Barron Orr, UA NASA Space Grant Program
Reporting Data - Arizona Department of Health Services
Climate Forecast Reanalysis System, National Oceanic and Atmospheric Administration