Coccidioidomycosis 4-year incidence (N = 1040) comparisons by endemic health districts of Los Angeles County, California, 2000–2011.

<p>Legend. Among the 24 health districts of Los Angeles County, Antelope Valley, San Fernando, and West Valley health districts are endemic for coccidioidomycosis as they have much higher case numbers traditionally as well as environments more favorable to <i>Coccidioides</i> spp growth. Year of disease onset was categorized into three 4-year time periods, 2000–2003, 2004–2007, and 2008–2011. For all three health districts, incidence sharply rose during 2004–2007. Unlike the other two health districts, Antelope Valley continued to see even more cases during 2008–2011. Percent increase in cases between 2000–2003 and 2008–2011 were 545%, 376%, and 58% for Antelope Valley, San Fernando, and West Valley, respectively.