Coccidioidomycosis 4-year incidence (N = 903) comparisons by health districts not known to be endemic in Los Angeles County, California, 2000–2011.

<p>Legend. The increase in coccidioidomycosis cases has been extremely high in the health districts not known to be endemic in Los Angeles County. Year of disease onset was categorized into three 4-year time periods, 2000–2003, 2004–2007, and 2008–2011. *Only 19 of 21 health districts not known to be endemic are shown in the figure because East Los Angeles and Whittier had 14% and 18% decreases, respectively, between the first and last time periods. (For each successive time period, East LA had 7, 9, and 6 cases and Whittier had 11, 12, and 9 cases.) Case numbers rose steeply during 2004–2007 for at least eight health districts. For 18 health districts, case numbers rose steeply or continued to climb during 2008–2011. Percent increase in cases between 2000–2003 and 2008–2011 are shown and ranged between 67% and 1500%. Seventeen of the 21 health districts not known to be endemic had at least a 100% increase in the number of cases between 2000–2003 and 2008–2011.