%0 Journal Article
%T Risk Stratification With Coccidioidal Skin Test to Prevent Valley Fever Among Inmates, California, 2015
%A Charlotte Wheeler
%A Gordana Derado
%A Janet C. Mohle-Boetani
%A Kimberley D. Lucas
%A Orion McCotter
%A R. Steven Tharratt
%A Tom Chiller
%J Journal of Correctional Health Care
%@ 1940-5200
%D 2018
%R 10.1177/1078345818792679
%X Two California state prisons (A and B) have very high rates of coccidioidomycosis (Valley Fever). The prison health care service sought to improve their prevention strategy by risk stratification with a newly available spherulin-based Coccidioides delayed-type hypersensitivity test. Of the 36,789 voluntarily screened inmates, 4.7% experienced adverse reactions. A positive test (8.6% of those tested) was independently associated with (1) incarceration at prisons A and B, (2) admission to prison from a Coccidioides-endemic county, (3) length of stay at prisons A and B, and (4) increasing age. These findings suggest that the test is safe and performing well at risk stratification; the prison system now restricts inmates with negative tests from prisons A and B. This novel use of the test might benefit other coccidioidomycosis prevention programs
%K Valley Fever
%K coccidioidomycosis
%K Coccidioides
%K spherulin
%K hypersensitivity
%K prisoners
%U https://journals.sagepub.com/doi/full/10.1177/1078345818792679