{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:58:08Z","timestamp":1773709088252,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Coccidioidomycosis continues to shape life across California's southern San Joaquin Valley, where thousands fall ill each year. Yet for many, diagnosis marks not the end of uncertainty but the start of another challenge, staying in care. In communities already strained by clinician shortages, distance, and limited insurance coverage, the year-long follow-up recommended after Valley Fever is rarely feasible. Lessons from other rural Latino populations show that continuity can be rebuilt through community-rooted approaches: trusted health workers, mobile clinics, peer education, and simple digital tools that meet patients where they are. Bringing these models into existing county and safety-net systems will require dedicated funding and shared commitment across institutions. Strengthening continuity of care, not only diagnostic capacity, offers the most realistic path to better outcomes for those living in the heart of California's Valley Fever region.<\/jats:p>","DOI":"10.1093\/cid\/ciaf728","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T12:50:12Z","timestamp":1766667012000},"page":"e497-e502","source":"Crossref","is-referenced-by-count":0,"title":["Valley Fever in Central California: Diagnosis is Not the Finish Line, the Real Gap is Longitudinal Care"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8443-7095","authenticated-orcid":false,"given":"Geetha","family":"Sivasubramanian","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of California, San Francisco , Fresno, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"2026031619524862800_ciaf728-B1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.idc.2024.11.012","article-title":"Coccidioidomycosis","volume":"39","author":"Donovan","year":"2025","journal-title":"Infect Dis Clin North Am"},{"key":"2026031619524862800_ciaf728-B2","doi-asserted-by":"crossref","first-page":"e2513572","DOI":"10.1001\/jamanetworkopen.2025.13572","article-title":"Estimated burden of coccidioidomycosis","volume":"8","author":"Williams","year":"2025","journal-title":"JAMA Netw open"},{"key":"2026031619524862800_ciaf728-B3","first-page":"185","article-title":"Coccidioidomycosis: epidemiology","volume":"5","author":"Brown","year":"2013","journal-title":"Clin Epidemiol"},{"key":"2026031619524862800_ciaf728-B4","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1055\/s-0039-3400998","article-title":"Pulmonary coccidioidomycosis","volume":"41","author":"Kimes","year":"2020","journal-title":"Semin Respir Crit Care Med"},{"key":"2026031619524862800_ciaf728-B5","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/0007-0971(83)90010-4","article-title":"The effect of established diabetes mellitus on the presentation of infiltrative pulmonary tuberculosis in the immigrant Asian community of an inner city area of the United Kingdom","volume":"77","author":"Hendy","year":"1983","journal-title":"Br J Dis Chest"},{"key":"2026031619524862800_ciaf728-B6","doi-asserted-by":"crossref","first-page":"myac054","DOI":"10.1093\/mmy\/myac054","article-title":"Natural history of pulmonary coccidioidomycosis: further examination of the VA-armed forces database","volume":"60","author":"Shemuel","year":"2022","journal-title":"Med Mycol"},{"key":"2026031619524862800_ciaf728-B7","doi-asserted-by":"crossref","first-page":"308","DOI":"10.3201\/eid2302.160505","article-title":"Risk factors for disseminated coccidioidomycosis, United States","volume":"23","author":"Odio","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"2026031619524862800_ciaf728-B8","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1056\/NEJMra2306821","article-title":"Coccidioidomycosis and histoplasmosis in immunocompetent persons","volume":"390","author":"Galgiani","year":"2024","journal-title":"N Engl J Med"},{"key":"2026031619524862800_ciaf728-B9","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.3201\/eid2509.190023","article-title":"Delays in coccidioidomycosis diagnosis and associated healthcare utilization, Tucson, Arizona, USA","volume":"25","author":"Donovan","year":"2019","journal-title":"Emerg Infect Dis"},{"key":"2026031619524862800_ciaf728-B10","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/j.amjmed.2024.04.028","article-title":"Access to urgent care practices improves understanding and management of endemic coccidioidomycosis: Maricopa County, Arizona, 2018-2023","volume":"137","author":"Galgiani","year":"2024","journal-title":"Am J Med"},{"key":"2026031619524862800_ciaf728-B11","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.15585\/mmwr.mm6942a2","article-title":"Valley fever (coccidioidomycosis) awareness\u2014California, 2016-2017","volume":"69","author":"Hurd-Kundeti","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026031619524862800_ciaf728-B12","doi-asserted-by":"crossref","first-page":"e0158122","DOI":"10.1128\/jcm.01581-22","article-title":"Review of clinical and laboratory diagnostics for coccidioidomycosis","volume":"61","author":"McHardy","year":"2023","journal-title":"J Clin Microbiol"},{"key":"2026031619524862800_ciaf728-B13","doi-asserted-by":"crossref","first-page":"e112-46","DOI":"10.1093\/cid\/ciw538","article-title":"2016 Infectious Diseases Society of America (IDSA) clinical practice guideline for the treatment of coccidioidomycosis","volume":"63","author":"Galgiani","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2026031619524862800_ciaf728-B14","doi-asserted-by":"crossref","first-page":"e364","DOI":"10.1016\/S1473-3099(21)00191-2","article-title":"Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European confederation of medical mycology in cooperation with the International Society for Human and Animal Mycology","volume":"21","author":"Thompson","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"2026031619524862800_ciaf728-B15","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.15585\/mmwr.mm6948a4","article-title":"Regional analysis of coccidioidomycosis incidence\u2014California, 2000-2018","volume":"69","author":"Sondermeyer Cooksey","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026031619524862800_ciaf728-B16","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1370\/afm.2502","article-title":"Primary care access to new patient appointments for California medicaid enrollees: a simulated patient study","volume":"18","author":"Melnikow","year":"2020","journal-title":"Ann Fam Med"},{"key":"2026031619524862800_ciaf728-B17","doi-asserted-by":"crossref","first-page":"354","DOI":"10.3390\/jof6040354","article-title":"Coccidioidomycosis: changing concepts and knowledge gaps","volume":"6","author":"Ampel","year":"2020","journal-title":"J Fungi (Basel)"},{"key":"2026031619524862800_ciaf728-B18","doi-asserted-by":"crossref","first-page":"e2022914","DOI":"10.1001\/jamanetworkopen.2020.22914","article-title":"Assessment of changes in rural and urban primary care workforce in the United States from 2009 to 2017","volume":"3","author":"Zhang","year":"2020","journal-title":"JAMA Netw open"},{"key":"2026031619524862800_ciaf728-B19","author":"HSRA warehouse"},{"key":"2026031619524862800_ciaf728-B20","author":"HRSA Ca workforce"},{"key":"2026031619524862800_ciaf728-B21","doi-asserted-by":"crossref","first-page":"116009","DOI":"10.1016\/j.socscimed.2023.116009","article-title":"Spatial availability of federally qualified health centers and disparities in health services utilization in medically underserved areas","volume":"328","author":"Lee","year":"2023","journal-title":"Soc Sci Med"},{"key":"2026031619524862800_ciaf728-B22","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1186\/s12913-022-07685-0","article-title":"Geographic access to federally qualified health centers before and after the affordable care act","volume":"22","author":"Behr","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"2026031619524862800_ciaf728-B23","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1111\/1475-6773.12397","article-title":"California's early coverage expansion under the affordable care act: a county-level analysis","volume":"51","author":"Sommers","year":"2016","journal-title":"Health Serv Res"},{"key":"2026031619524862800_ciaf728-B24","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/MLR.0000000000000855","article-title":"Insurance type and access to health care providers and appointments under the affordable care act","volume":"56","author":"Alcal\u00e1","year":"2018","journal-title":"Med Care"},{"key":"2026031619524862800_ciaf728-B25","doi-asserted-by":"crossref","first-page":"3338","DOI":"10.1007\/s11606-021-07383-3","article-title":"How has access to care for medi-cal enrollees fared relative to employer-sponsored insurance 4 years after the affordable care act expansion?","volume":"37","author":"Babey","year":"2022","journal-title":"J Gen Intern Med"},{"key":"2026031619524862800_ciaf728-B26","doi-asserted-by":"crossref","first-page":"e12855","DOI":"10.1111\/jrh.12855","article-title":"Health care access barriers among metropolitan and nonmetropolitan populations of eight geographically diverse states, 2018","volume":"41","author":"Zahnd","year":"2025","journal-title":"J Rural Health"},{"key":"2026031619524862800_ciaf728-B27","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.3201\/eid1910.130427","article-title":"Coccidioidomycosis-associated hospitalizations, California, USA, 2000-2011","volume":"19","author":"Sondermeyer","year":"2013","journal-title":"Emerg Infect Dis"},{"key":"2026031619524862800_ciaf728-B28","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1097\/MLR.0000000000000851","article-title":"Trends in preventable inpatient and emergency department utilization in California between 2012 and 2015: the role of health insurance coverage and primary care supply","volume":"56","author":"Cunningham","year":"2018","journal-title":"Med Care"},{"key":"2026031619524862800_ciaf728-B29","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1080\/1059924X.2021.2002223","article-title":"Coccidioidomycosis knowledge and behaviors of California Hispanic farm workers","volume":"27","author":"Sipan","year":"2022","journal-title":"J Agromedicine"},{"key":"2026031619524862800_ciaf728-B30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/13557858.2019.1606899","article-title":"Rural Latino health and the built environment: a systematic review","volume":"27","author":"Stone","year":"2022","journal-title":"Ethn Health"},{"key":"2026031619524862800_ciaf728-B31","doi-asserted-by":"crossref","first-page":"9223","DOI":"10.3390\/ijerph17249223","article-title":"Addressing health disparities in the rural United States: advocacy as caregiving among community health workers and Promotores de Salud","volume":"17","author":"Logan","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2026031619524862800_ciaf728-B32","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1111\/jrh.12483","article-title":"Overcoming barriers to health care access in rural Latino communities: an innovative model in the Eastern Coachella valley","volume":"37","author":"Tulimiero","year":"2021","journal-title":"J Rural Health"},{"key":"2026031619524862800_ciaf728-B33","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1177\/0033354920972699","article-title":"An innovative United States-Mexico community outreach initiative for Hispanic and Latino people in the United States: a collaborative public health network","volume":"136","author":"Flynn","year":"2021","journal-title":"Public Health Rep"},{"key":"2026031619524862800_ciaf728-B34","doi-asserted-by":"crossref","first-page":"976941","DOI":"10.3389\/fpubh.2022.976941","article-title":"Ventanillas de Salud (VDS) and mobile health units (MHU): a binational collaborative models","volume":"10","author":"Rangel G\u00f3mez","year":"2022","journal-title":"Front Public Health"},{"key":"2026031619524862800_ciaf728-B35","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1016\/j.mayocp.2023.07.031","article-title":"Community health partners in unexpected places","volume":"98","author":"Hole","year":"2023","journal-title":"Mayo Clin Proc"},{"key":"2026031619524862800_ciaf728-B36","doi-asserted-by":"crossref","first-page":"e2214163","DOI":"10.1001\/jamanetworkopen.2022.14163","article-title":"Integrating rapid diabetes screening into a Latinx focused community-based low-barrier COVID-19 testing program","volume":"5","author":"Kerkhoff","year":"2022","journal-title":"JAMA Netw open"},{"key":"2026031619524862800_ciaf728-B37","doi-asserted-by":"crossref","first-page":"e0287248","DOI":"10.1371\/journal.pone.0287248","article-title":"Feasibility and acceptability of CRiSOL: a pilot peer-based intervention to address syndemic health issues afflicting Latino immigrants in the U.S","volume":"18","author":"Martinez-Donate","year":"2023","journal-title":"PLoS One"},{"key":"2026031619524862800_ciaf728-B38","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1093\/jamia\/ocab155","article-title":"Meeting them where they are on the web: addressing structural barriers for Latinos in telehealth care","volume":"28","author":"Anaya","year":"2021","journal-title":"J Am Med Inform Assoc"},{"key":"2026031619524862800_ciaf728-B39","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/s12939-025-02603-2","article-title":"Barriers and facilitators of preventive healthcare access among immigrants in rural America: a scoping review","volume":"24","author":"Zeng","year":"2025","journal-title":"Int J Equity Health"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf728\/66387162\/ciaf728.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/3\/e497\/66387162\/ciaf728.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/3\/e497\/66387162\/ciaf728.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T23:53:00Z","timestamp":1773705180000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/82\/3\/e497\/8424092"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,1,22]]},"published-print":{"date-parts":[[2026,3,17]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf728","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3,15]]},"published":{"date-parts":[[2026,1,22]]}}}