3-14. OTHER RESPIRATORY DISEASES
a. Coccidioidomycosis. This highly infectious disease is endemic to the arid
and semi-arid areas of the Southwestern United States, particularly the San Joaquin
Valley of California, and areas of similar climate in Argentina, Mexico, and Russia.
Coccidioidomycosis is a fungus infection of the respiratory tract.
(1) Transmission/diagnosis. Coccidioidomycosis is transmitted by inhalation
dust laden with the spores of the fungus, Coccidioidosis immitis. Confirmation of the
diagnosis includes finding C. immitis in the sputum.
(2) Control measures. Dust control measures on installations include paving
or oiling roads and runways and planting grass. Such measures may be of value in
preventing the transmission of disease.
b. Q Fever. Q fever is an acute disease, which may become chronic. It is
caused by CoxielIa burnetii (Rickettsia burnetii) and distributed worldwide, including
endemic areas of the United States.
(1) Cause/transmission. This disease is unique, in that it is caused by a
rickettsia transmitted by respiratory means rather than by an arthropod vector.
(2) Signs/symptoms. Characteristically there is:
Sudden onset of chills
Attendant fever similar to primary atypical pneumonia (PAP)
(3) Reservoir/transmission. C. burnetii survives well and may be transmitted
by several means. Cattle, sheep, and goats are natural reservoirs important in the
transmission of the disease to man. The animals, as well as their milk and afterbirth,
contaminate barnyard soil, straw, railroad cars, with C. burnetii organisms that are later
inhaled with dust by man.
(4) In military personnel. Outbreaks in military personnel have occurred
among troops occupying barns, houses, railroad cars, or ships previously housing
A classic example was an outbreak in Italy during World War II when
269 cases from an infantry battalion were hospitalized in a 3-week period.
All 900 members of this unit had attended compulsory training films
shown in the loft of a barn, which was partially filled with old dirty hay.