Provider Advisories

 Orange County Health Care Agency
Health Advisories

Provider Advisory: First West Nile Virus Death of Season
October 6, 2017
The first West Nile Virus (WNV) death of the season has been confirmed in an elderly female resident of Anaheim who had neuroinvasive disease. New cases of WNV continue to be reported throughout Orange County. A total of 26 symptomatic cases and 5 asymptomatic blood donors have been reported so far this season.
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Provider Advisory: First Influenza Case 2017-2018 Season
October 6, 2017
The Orange County Health Care Agency (HCA) has confirmed the county’s first case of influenza for the 2017-18 season which began October 1st. The best way to prevent the flu is by getting vaccinated. Anyone who has not already received the flu vaccine should get it now before influenza season peaks.
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Provider Advisory: Two New Mumps Cases Indentified in Orange County
September 22, 2017
Two new cases of mumps have been identified in Orange County residents in the past ten days. The two cases are adults in their twenties and have no identified common contacts. Neither has a history of travel or contact with other mumps cases. They had symptom onset dates of September 6 and September 9.
Orange County has had 24 cases of mumps reported this year. This includes 13 cases associated with the Chapman University outbreak which ended in April, and five additional cases who have no history of travel and apparently acquired infection locally.
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Provider Advisory: Update Hepatitis A Outbreaks in Homeless
September 21, 2017
Outbreaks of Hepatitis A virus (HAV) infection have been identified in homeless and illicit drug user populations in San Diego, Santa Cruz, and Los Angeles Counties. San Diego County has identified 444 cases of HAV infection, including 16 deaths, since early in 2017; Santa Cruz County has had 69 cases since April. Earlier this week, the Los Angeles County Department of Public Health reported an outbreak of HAV infections in their homeless population. Two Los Angeles cases apparently acquired disease in that county; eight more have occurred there after exposure in San Diego or Santa Cruz.
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Influenza Activity Has Increased in Orange County Including an Influenza-Associated Death Under 65 Years of Age
August 30, 2017
Orange County Health Care Agency (HCA) has received an unusual volume of influenza reports for this time in the summer. Most notably, a large increase in influenza cases was reported during week 33 (week ending 8/19/2017). Seasonal influenza A/H3, A/(H1N1)pdm2009, and B viruses are still in co-circulation throughout the community. An influenza-associated death was also reported in a 50 year old male who had significant underlying medical conditions.
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Reports of West Nile Virus Infections are Increasing in Orange County
August 18, 2017
Five cases of West Nile Virus (WNV) infection have been identified in Orange County this year, including four new cases reported to the Orange County Health Care Agency (OCHCA) in the past week. Three of these four are WNV neuroinvasive disease. According to the Orange County Mosquito and Vector Control District, the highest concentrations of WNV-positive mosquitoes has been found in La Habra, Anaheim, and Fullerton. For California, 41 cases of WNV infection from nine counties have been reported so far this year.
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Hepatitis A Case in Orange County Related to San Diego Outbreak
July 26, 2017
An Orange County resident has developed hepatitis A virus (HAV) infection after spending time in San Diego during the apparent exposure period. The case has a history of homelessness, but no history of staying at Orange County homeless shelters, and no known exposure to homeless populations here. However, with the ongoing San Diego and Santa Cruz outbreaks, additional cases such as this are likely to occur.
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First West Nile Virus Infection Identified in Orange County
July 7, 2017
The first West Nile Virus infection in Orange County this year was identified this week, in a female resident of Laguna Beach in her 70s. Three additional West Nile Virus (WNV) cases have been reported in the state as of 6/30/17.
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Hep A in Homeless Population
June 22, 2017
As of June 20, 2017, San Diego County has had 181 cases of hepatitis A, including 4 deaths, reported since early 2017, primarily in homeless and/or illicit drug user populations. Santa Cruz County has also reported 12 cases of hepatitis A mainly in their homeless and/or illicit drug user population in the last two months.
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Hepatitis A Cases in Orange County Residents Without a History of Travel
June 13, 2017
Three cases of hepatitis A virus (HAV) infection have been diagnosed in Orange County residents in the last month. The cases are adult males aged 32-57, none with a history of travel or other apparent hepatitis A exposure. Illness onset dates ranged from May 2 to May 26. A common source for these infections has not been identified; Orange County Public Health is investigating the situation.
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Recall of Tuna Potentially Contaminated with Hepatitis A Distributed Nationally, Including Orange County
June 2, 2017
A recall has been issued of frozen tuna potentially contaminated with hepatitis A which was sourced from Sustainable Seafood Company, Vietnam, and Santa Cruz Seafood Inc., Philippines. This voluntary recall was issued as part of an ongoing Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) investigation. The complete recall advisory can be found at:
https://www.fda.gov/Food/RecallsOutbreaksEmergencies/Outbreaks/ucm561199.htm
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Two New Mumps Cases Identified in Orange County
May 18, 2017
Two new cases of mumps have been identified in Orange County residents. Both cases are young adults in their twenties with no history of travel or contact to other cases. They had symptom onset dates of April 17 and May 6. One case was confirmed by laboratory testing, the other is a probable case based on close contact with the confirmed case and illness compatible with mumps.
Neither case has a connection with the recent cluster of mumps cases associated with Chapman University. Thirteen cases have been identified in Chapman University students, with illness onset dates ranging from January 28-April 18, 2017.
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Legionnaire’s Disease Associated with a Local Pool and Hot Tub
May 12, 2017
Two persons have been diagnosed with Legionnaires’ disease in the last 60 days after using the Foothill Ranch Community pool and hot tub, located at 27021 Burbank in Foothill Ranch. Both infections occurred in adults and resulted in hospitalization. The pool and hot tub are currently closed. The Orange County Health Care Agency is working with the facility to assure that any possible Legionella source is addressed before the pool reopens.
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Two Foodborne Botulism Cases Identified in Orange County Residents
May 1, 2017
Two cases of foodborne botulism (one confirmed, one suspect with testing pending) have been identified in Orange County residents in the last 30 days. Both cases reported consumption of deer-antler tea. The tea was purchased in Los Angeles and has since been recalled.
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Measles Cases Identified in Orange County
April 4, 2017
Measles was recently confirmed in two Orange County residents with no known association to each other. The first case, an adult, reported recent international travel and was most likely infected while abroad. The second case, a high school student, reported no recent travel and had no known exposures to ill contacts.
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Update: Mumps Cases Identified in Chapman University Students
March 31, 2017
Nine cases of mumps have been reported in students of Chapman University in the city of Orange. Six of nine cases have been confirmed by laboratory testing; the other three had symptoms consistent with mumps infection and known contact to a confirmed case. Six are law school students, three are undergraduate students. Cases ages range from 19-34, and symptom onset dates extend from January 26 to March 26. The Orange County Health Care Agency is working with the University to identify any additional cases. Multiple mumps outbreaks have been seen in college and university campuses around the country in the last several years.
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Update: Mumps Cases Identified in Chapman University Students
March 27, 2017
Four confirmed and three probable cases of mumps have been reported in students of Chapman University in the city of Orange. Six of the seven are law school students, one is an undergraduate student. Symptoms onset dates range from January 26 to March 23. The Orange County Health Care Agency is working with the University to identify any additional cases. Multiple mumps outbreaks have been seen in campuses around the country in the last several years.
Mumps Cases Identified in Chapman University Students
February 24, 2017
One confirmed and three probable cases of mumps have been reported in students of Chapman University in the city of Orange. All four are law school students who belong to a common social group. Symptoms onset dates range from January 28 to February 17. The Orange County Health Care Agency is working with the University to identify any additional cases. Providers should consider the diagnosis of mumps in patients with an appropriate clinical presentation, particularly in college students, those with a history of international travel, or exposure to a known mumps case. Notify the Orange County Health Care Agency Epidemiology Program immediately at 714-834-8180 with any suspect cases.
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Update for Medical Providers: Apparent Mycobacterium abscessus Infections Associated with a Local Dental Clinic

February 1, 2017
Mycobacterium abscessus dental infections have been reported in patients who have undergone pulpotomy procedures at the 2156 East Lincoln Avenue office of Children's Dental Group in Anaheim.
The facility’s internal water system appears to have been the source of mycobacteria based on the Orange County Health Care Agency’s facility assessment and laboratory testing. The facility discontinued performing pulpotomy procedures from September 6-November 7, 2016 in order to replace their water system and install appropriate infection control safeguards. On December 15, 2016, after the facility had restarted performing pulpotomies, OCHCA’s Public Health Laboratory identified Mycobacterium mucogenicum growing from multiple clinical water samples obtained as part of follow up testing at the facility. Though M. mucogenicum is not known to pose the same risk to dental patients as M. abscessus, the identification of any mycobacterium (even at low levels) was of sufficient concern that the County Health Officer issued a second order requiring closure of the clinic pending further investigation of the situation.
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Infectious Syphilis Cases More than Quadruple in OC in Last 5 years;

January 12, 2017
Infectious Syphilis Cases More than Quadruple in OC in Last 5 years;
other STDs increase as well
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Measles Cases Identified in Los Angeles County
December 23, 2016
The Los Angeles County Department of Public Health is investigating nine confirmed measles cases within the County. Contact investigations are ongoing.
No suspect or confirmed measles cases have been identified thus far in Orange County. But providers should consider the diagnosis of measles in patients with an appropriate clinical presentation.
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Pediatric E. coli O157:H7 Infections in Santa Ana
November 21, 2016
The Orange County Health Care Agency has had an increase in reports of pediatric Escherichia coli (E. coli) O157:H7 infection since the start of November. Four cases have been reported with illness onsets ranging from November 4-9. The cases range from 5-8 years in age; all live in the city of Santa Ana. One child developed hemolytic uremic syndrome (HUS). An investigation into a potential source is ongoing. Providers should consider E. coli O157:H7 infection in patients with bloody or unusually severe diarrhea and when appropriate send stool for testing for shiga toxin-producing E. coli (STEC).
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Recall of Frozen Strawberries Potentially Contaminated with Hepatitis A Distributed Nationally, Including in Orange County
November 2, 2016
A large recall of frozen strawberries from Egypt has been issued due to the potential for hepatitis A contamination. This voluntary recall was issued as part of an ongoing Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) investigation of a multi-state hepatitis A outbreak linked to frozen strawberries mainly on the East Coast.
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New Orange County Immunization Recommendation for Meningococcal Disease for Men Who Have Sex with Men (MSM)
August 19, 2016
Health care providers who have clinical questions, wish to arrange testing for a patient, or have a suspect case to report, should call the Epidemiology and Assessment Program at 714-834-8180.
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Zika Virus Infection: Current Recommendations for Orange County Medical Providers
August 19, 2016
Health care providers who have clinical questions, wish to arrange testing for a patient, or have a suspect case to report, should call the Epidemiology and Assessment Program at 714-834-8180.
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Third Mumps Case Identified in College Student from Orange County
April 14, 2016
An Orange County college student was diagnosed with mumps last week, the third Orange County student diagnosed with mumps in the last two months. All three attend college outside of Orange County, but all three were in the County when they became ill and were diagnosed. Outbreaks of mumps have occurred at college campuses around the country since late 2015. As students travel to and from school during spring break, community exposure to mumps cases may occur.
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CDC Advisory: Zika Sexual Transmission Prevention
February 24, 2016
The Centers for Disease Control and Prevention (CDC) has issued interim guidelines for prevention of sexual transmission of Zika virus.
( View PDF )
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Zika Virus in Latin America
January 22, 2016
In response to the ongoing Zika virus outbreak in Latin America, and reports of microcephaly in newborns born to Zika-infected mothers, the Centers for Disease Control and Prevention (CDC) and California Department of Public Health (CDPH) recommend that pregnant women consider postponing travel to areas where Zika virus transmission is ongoing. Pregnant women who must travel to one of these areas should talk to their healthcare provider first and take measures to avoid mosquito bites during the trip. For more information, see the CDPH advisory.
Download Fact Sheet in English
Download Fact Sheet in Spanish
( View PDF )
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Chikungunya and Dengue in Mexico and Latin America
December 22, 2015
Chikungunya or Dengue infections continue to occur in Mexico and Latin America. Travelers who visit these areas during the holiday season should take appropriate precautions to avoid mosquito bites during the day and at night. For more information, the California Department of Public Health Advisory can be found by clicking here.
( View PDF )
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