Survey of United States-based veterinarians reveals knowledge gaps in coccidioidomycosis and guides future One Health-based educational initiatives.

Abstract

OBJECTIVE: Coccidioidomycosis, or Valley fever, is a climate-driven fungal disease. Dogs are valuable sentinels for human disease. We sought to evaluate veterinarian-reported clinical encounters with coccidioidomycosis in dogs and the relative awareness of coccidioidomycosis by veterinarians in endemic versus nonendemic states. METHODS: Survey responses were solicited from 45,240 veterinarians subscribing to the Veterinary Information Network in June/July 2024. For US-based veterinarians, data were gathered on the number of coccidioidomycosis cases evaluated, recall of education on coccidioidomycosis, and respondent knowledge of diagnostic tests, epidemiology, causative agents, and human exposure. Knowledge responses were averaged to yield an awareness score. Reported case data and continuing education hours were normalized with publicly available population data. For a subset of cases reported from nonendemic states, medical records were reviewed for travel history. RESULTS: Responses were received from 640 veterinarians (365 endemic, 275 nonendemic [response rate, 1.4%]). Median case encounters reported per 100,000 households was 230-fold higher for veterinarians working in endemic states compared to those in nonendemic states. Median awareness scores were low (≤ 50%) in both groups. Most education occurred during veterinary school. There was no difference in practitioner-reported median continuing education hours for endemic versus nonendemic states. All cases for which medical records were reviewed had travel history to endemic regions. CONCLUSIONS: Awareness of coccidioidomycosis amongst veterinarians using the Veterinary Information Network was low, especially among nonendemic states. CLINICAL RELEVANCE: Educational and reporting initiatives are needed to improve disease awareness and recognition by veterinarians, with implications for early recognition of human disease in nonendemic regions.