Top 5 Takeaways

  1. Case Counts Fluctuated During the Pandemic: Coccidioidomycosis and histoplasmosis case counts dropped in 2020 compared to 2019, but saw an increase in 2021. A notable high blastomycosis case fatality rate of 17% in 2021 and atypical seasonality in 2020 across all diseases suggest impacts from the COVID-19 pandemic.
  2. Changes in Healthcare Behavior: The study suggests changes in health care-seeking behavior, diagnostic testing, or reporting related to the pandemic may have influenced the detection and management of these fungal infections.
  3. Public Health Implications: There’s a need for increased clinician education on these fungal diseases and the integration of diagnostic guidance into broader respiratory disease awareness to improve patient management and outcomes.
  4. Demographics and Outcomes: Most cases occurred in males and persons aged 40-64 years. The racial and ethnic disparities observed align with historical trends, showing higher incidence among American Indian or Alaska Native persons.
  5. Importance of Early Diagnosis: The findings emphasize the necessity for early diagnosis of fungal diseases, especially during periods of high incidence of other respiratory diseases, to prevent misdiagnosis and improve patient outcomes.

Original Article Author and Citation

Corresponding Author

Samantha L. Williams,

Suggested Citation

Williams SL, Smith DJ, Benedict K, et al. Surveillance for Coccidioidomycosis, Histoplasmosis, and Blastomycosis During the COVID-19 Pandemic — United States, 2019–2021. MMWR Morb Mortal Wkly Rep 2024;73:239–244. DOI:


The report analyzed surveillance data from 2019 to 2021 to describe the epidemiologic characteristics of coccidioidomycosis, histoplasmosis, and blastomycosis during the COVID-19 pandemic. The data revealed fluctuations in case counts and atypical seasonal patterns that were attributed to the pandemic’s impact on health behaviors and reporting practices.


CDC analyzed case surveillance data for coccidioidomycosis, histoplasmosis, and blastomycosis from 2019 to 2021, including confirmed cases and demographic information. The analysis aimed to identify changes in case counts, seasonality, hospitalizations, deaths, and demographic trends during the pandemic.


The discussion highlights the potential influence of the COVID-19 pandemic on the diagnosis, reporting, and management of these fungal diseases. It suggests that public health efforts should focus on improving awareness and diagnosis among healthcare providers and integrating fungal diseases into respiratory disease preparedness efforts.


The report concludes that the COVID-19 pandemic likely influenced the epidemiology of coccidioidomycosis, histoplasmosis, and blastomycosis, underscoring the importance of continued surveillance, education, and integration of diagnostic resources for fungal diseases in public health practice.


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