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CD Health Alert

Critical time sensitive communicable disease information and updates for medical providers.

CD HEALTH ALERT: Orange County’s First Human West Nile Virus Case of the Season Reported

August 12, 2022

A man in his 60s has tested positive for West Nile Virus (WNV) infection, becoming the first human WNV infection in Orange County this year. As of August 5th, the California Department of Public Health has reported seven cases of human West Nile Virus infections statewide this season. 

CD HEALTH ALERT: Process to Obtain Tecovirimat (TPOXX) for Treatment of Monkeypox in Orange County

August 11, 2022

Tecovirimat (TPOXX) is an antiviral medication that is available for use to treat monkeypox under an expanded access investigational new drug (EA-IND) protocol (sometimes called “compassionate use”). It is the first-line medication to treat monkeypox in adults and children weighing 13kg or more. 

CD HEALTH ALERT: Monkeypox/Orthopoxvirus Testing via Commercial Laboratories

July 14, 2022

In the last week several commercial laboratories (Labcorp, Mayo Clinic Laboratories, Quest) have announced availability of monkeypox testing. Additional commercial laboratories are anticipated to offer monkeypox testing in coming weeks. Providers should check with the commercial labs they work with about availability and specific specimen collection requirements. OCHCA approval is not required to order testing via commercial labs, although it is still required to request testing through public health.

CD Health Alert: New Influenza Vaccine Recommendations for 2022-2023: Preference for High-Dose or Adjuvanted Vaccines for Those 65 Years and Older

July 6, 2022

On June 22, 2022, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) reviewed its recommendations for influenza vaccines for the 2022-2023 influenza season. The ACIP endorsed a preference for use of higher-dose or adjuvanted influenza vaccines for those 65 years and older whenever available. Last week the CDC endorsed the ACIP’s recommendation.

CD Health Alert: Probable Monkeypox Virus Case in Orange County

June 29, 2022

Orange County Health Care Agency (OCHCA) has been notified of its first probable monkeypox virus case. Probable cases are those who test positive for orthopoxvirus DNA by polymerase chain reaction (PCR) assay. Probable cases will be sent to the Centers for Disease Control and Prevention (CDC) for monkeypox virus confirmation. Probable cases are managed as monkeypox virus cases while awaiting laboratory confirmation.

CD Health Alert: Correction - Moderna and Pfizer Vaccines in Children 6 Months through 5 Years

June 27, 2022

In our health alert on June 20, 2022, an error was identified in the stated minimum interval when using Moderna COVID-19 vaccine in children 6 months through 5 years of age who are moderately to severely immunocompromised. The minimum interval between the second and third (additional) dose should be at least 4 weeks. 

CD Health Alert: Updated Guidance: Managing Monkeypox Virus Infection in California

June 24, 2022

Today, the California Department of Public Health (CDPH) released updated information and guidance on managing monkeypox virus infection through its California Health Alert Network (CAHAN). The Orange County Healthcare Agency (OCHCA) wants to make sure providers are aware of the potential for monkeypox virus infection in patients who meet epidemiologic criteria and/or a clinically consistent rash. As of this time no cases of Monkeypox virus infection have been identified in Orange County.

CD Health Alert: Moderna and Pfizer Vaccines in Children 6 Months through 5 Years

June 20, 2022

On June 18 the Advisory Committee on Immunization Practices (ACIP) recommended the use of Pfizer-BioNTech COVID-19 vaccine for children 6 months through 4 years of age and Moderna COVID-19 vaccine for children 6 months through 5 years of age. This recommendation was subsequently endorsed by the Western States Scientific Safety Review Workgroup and California Department of Public Health.

CD Health Alert: Updated Case-finding Guidance: Monkeypox Virus Infection

June 15, 2022

Yesterday, the CDC released through its Health Alert Network (HAN) Updated Case-Finding Guidance: Monkeypox Outbreak – United States, 2022. The Orange County Healthcare Agency (OCHCA) wants to make sure providers are aware of the potential for monkeypox virus infection in patients who meet epidemiologic criteria and/or a clinically consistent rash. As of this time, no cases of monkeypox virus infection have been identified in Orange County. While monkeypox remains rare, as of today 72 cases have been reported in 18 states and territories, including 15 cases in California. Globally, over 1,800 cases of monkeypox virus infection have been identified in 35 countries associated with the current outbreak.

CD Health Alert: First West Nile Virus Positive Mosquito Sample of the Season has been identified in Orange County

June 9, 2022

Orange County’s first West Nile Virus (WNV) positive mosquito sample of the season was identified through routine trapping and testing by the Orange County Mosquito and Vector Control District (OCMVCD). The sample was identified last week in La Habra. WNV positive mosquito samples have also been identified in Riverside County this year. No human infections of WNV or SLEV have been identified so far this season in Orange County.

CD Health Alert: COVID-19 Rebound After Paxlovid

May 24, 2022

Today, the Centers for Disease Control and Prevention released a Health Advisory with considerations around the phenomena of rebound, after treatment of patients with mild to moderate COVID-19, with Paxlovid (nirmatrelvir tablets; ritonavir tablets).

CD Health Alert: Monkeypox Virus Infection in the United States and Other Non-endemic Countries

May 23, 2022

The Orange County Healthcare Agency wants to make sure providers are aware of the potential for Monkeypox Virus infection in patients presenting with fever and clinically consistent rash. A case of Monkeypox has been identified in a US resident who travelled to Canada and in the last month multiple cases of Monkeypox have been identified in non-endemic countries among individuals without a travel history.

For additional details see the attached Health Advisory from the California Department of Public Health.

CD Health Alert: Increased Availability of COVID-19 Therapeutics

March 31, 2022

Throughout Orange County, rates of SARS-CoV-2 infection appear to be leveling off after declining for several weeks. The Omicron BA.2 sub-variant has been increasing in prevalence as cases decline.

Yesterday, the California Department of Public Health (CDPH) released a Health Alert (CAHAN) providing updated information on the status of therapeutics for COVID-19 disease. The key point of this CAHAN is that there is no longer limited supply of therapeutic treatments in most locations.

CD Health Alert: COVID-19 Testing, Treatment, and Vaccination for the Uninsured Deadlines for Claim Submission

March 22, 2022

Recently, the U.S. Department of Health and Human Services’ Health Resources & Services Administration (HRSA) issued cut-off dates for accepting claims for those without insurance for COVID testing, treatment, and vaccines. The Uninsured Program will stop accepting claims for reimbursement as follows:

  • Testing and Treatment claims: March 22, 2022, at 11:59 p.m. ET
  • Vaccine administration claims: April 5, 2022, at 11:59 p.m. ET

CD Health Alert: Increased Availability of Theraputics for COVID-19 in Orange County; Revised Evusheld Dosing

February 28, 2022

Cases of COVID-19 continue to decline across Orange County, although they are still at levels seen near the peak of the Delta Variant wave last summer. The current Orange County surveillance data can be found here.

While availability of both monoclonal antibodies and antiviral agents to treat COVID-19 were in very limited supply in January supplies are becoming more plentiful throughout the County.  

CD Health Alert: Modification of Health Care Providers and Laboratories COVID-19 Reporting Requirements

February 11, 2022

OCHCA wants to make all health care and laboratory providers aware of new temporary modifications to certain COVID-19 reporting requirements.

The California State Health Officer order issued today can be found here .

  • Health care providers must report hospitalization and/or death of a patient due to COVID-19 within one working day. Previously, health care providers were required to report all COVID-19 cases immediately.
  • Laboratories must report all COVID-19 test results within 24 hours from the time the laboratory notifies the health care provider or other person authorized to receive the report. Previously, laboratories were required to report more rapidly. 

CD Health Alert: Prevention of Invasive Pneumococcal Disease in Adults: CDC Publishes New Guidance for Use of 15 & 20 Valent Pneumococcal Vaccines

February 7, 2022

On January 28, 2022, the CDC’s Advisory Committee on Immunization Practices (ACIP) released its recommendations on the use of two new pneumococcal conjugate vaccines (PCV) in adults, the 15 valent PCV15 (VAXNEUVANCE) and the 20 valent PCV20 (PREVNAR 20). The new recommendations are as follows:

  • Adults aged ≥65 years: Adults aged ≥65 years who have not previously received PCV or whose previous vaccination history is unknown should receive 1 dose of PCV (either PCV20 or PCV15). When PCV15 is used, it should be followed by a dose of PPSV23.
  • Adults aged 19–64 years with certain underlying medical conditions or other risk factors: Adults aged 19–64 years with certain underlying medical conditions or other risk factors who have not previously received PCV or whose previous vaccination history is unknown should receive 1 dose of PCV (either PCV20 or PCV15). When PCV15 is used, it should be followed by a dose of PPSV23.

The updated guidance can be found here.

CD Health Alert: Update on Omicron Surge and Therapeutic Recommendations in Orange County

January 7, 2022

Variant surveillance using whole genome sequencing shows that the proportion of Omicron variant increased from 30% for the week ending December 21, 2021, to 83% for the week ending December 28, 2021. Cases across the county, state, and country, continue to rise exponentially. Hospitalizations in Orange County have risen as well, though at a slower rate.

CD Health Alert: Guidance on Quarantine for Health Care Personnel (HCP) Exposed to SARS-CoV-2 and Return to Work for HCP with COVID-19

December 31, 2021

On December 30, 2021, the California Department of Public Health issued AFL 21-08.6, which provides general acute care hospitals, acute psychiatric hospitals, and skilled nursing facilities with updated guidance on COVID-19 isolation and quarantine for healthcare personnel. OCHCA recommends that county healthcare facilities become familiar with and adhere to AFL 21-08.6.

CD Health Alert: Updated CDC Guidance for Management of Healthcare Personnel with SARS-CoV-2 Infection or Exposure

December 29, 2021

In the context of rapidly increasing COVID-19 case counts caused by the omicron variant, on December 23, 2021, the CDC updated its recommendations for management of healthcare staff exposed to or infected with SARS-CoV-2.

CD Health Alert: Oral Agents for the Treatment of COVID-19

December 27,  2021

The Food and Drug Administration (FDA) last week issued emergency use authorizations (EUA) for the use of Pfizer’s Paxlovid (nirmatrelvir tablets and ritonavir tablets, co-packaged for oral use), and Merck’s Molnupiravir, for treatment of COVID-19.

  • Patients eligible for treatment with Paxlovid or Molnupiravir are those who have mild-to-moderate COVID-19 and are at high risk for progression to severe disease.

CD Health Alert: Omicron Variant in Orange County - Correction

December 21, 2021

The California Department of Public Health mask mandate is in effect until January 15, 2022.

The first cases of illness caused by SARS-CoV-2 Omicron variant have been identified in the last week in Orange County, including at least one case that was acquired locally. Omicron case counts are rising in Southern California and around the country. Omicron has been shown to be very efficient at transmission with a doubling time of ~2-3 days compared to ~14 days for the Delta variant.

CD Health Alert: Congenital Syphilis and Perinatal HIV

December 20, 2021

In the attached Dear Colleague letter, the California Department of Public Health (CDPH) is asking for your assistance in responding to concerning increases in congenital syphilis and perinatal HIV in California. In 2019, 446 congenital syphilis cases were reported in California, the highest number of cases since 1993. In 2020 there were also six perinatal HIV transmissions in California, compared to four in 2019 and three in 2018. Most of the birthing parents of children with perinatal HIV were co-infected with or had a recent history of syphilis, one of the indications for offering HIV prevention medication (i.e., Pre-Exposure Prophylaxis or PrEP). This highlights the need for an integrated approach to these devastating and preventable infections. 

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CD Health Alert: Update on SARS-CoV-2 Omicron Variant of Concern 

December 6, 2021

The Omicron variant continues to spread and has now been identified in over 50 countries, and in 17 states within the US. No Omicron cases have been detected, at this time, in Orange County. The Delta variant continues to be the predominant variant of SARS-CoV-2 identified in the US. Available data continues to support the use of existing mitigation measures (vaccination, including boosters, masking, testing, and hand washing) against the Omicron variant.

CD Health Alert: Emergence of the SARS-CoV-2 Omicron Variant of Concern

November 30, 2021

On Friday, November 26, 2021 the WHO designated the a new SARS-CoV-2 Omicron variant as a Variant of Concern. It was first detected in South Africa and cases have subsequently been identified in Botswana and among travelers in more than a dozen countries around the globe. No cases have yet been identified in the US. There remains very limited data on the risk associated with the variant, though there is some early evidence that it may be more transmissible than currently circulating variants of SARS-CoV-2.

CD Health Alert: Update on Anti-SARS-CoV-2 Monoclonal Antibody Treatment

November 5, 2021

Earlier this week, the California Department of Public Health (CDPH) released updated recommendations for medical providers for the use of anti-SARS-CoV-2 monoclonal antibodies. This guidance outlines recommendations for the use of these products for treatment and post-exposure prophylaxis. In light of current national shortages, the advisory also details the current plans for product distribution by the U.S. Department of Health and Human Service to state and local jurisdictions.

CD Health Alert: Increased Disseminated Gonorrhea Infection (DGI) in California and Orange County

November 2, 2021

The California Department of Public Health (CDPH) and the Orange County Health Care Agency have been receiving increased reports of disseminated gonococcal infection (DGI). DGI is an uncommon but severe complication of untreated gonorrhea. DGI occurs when the sexually transmitted pathogen Neisseria gonorrhoeae invades the bloodstream and spreads to distant sites in the body leading to clinical findings such as septic arthritis, polyarthalgia, tenosynovitis, petechial and pustular skin lesions, bacteremia and on rare occasion endocarditis or meningitis.

CD Health Alert: COVID-19 Update for Orange County Medical Providers

November 1, 2021

Since the peak of the most recent wave of COVID-19 disease in early August, Orange County has seen a steady decline in cases of COVID-19. In the last two weeks, however, there has been a flattening of the curve, with a rate still substantially higher than was seen in the late spring. To date, 86% of those ≥ 65 years and 63% of the entire population of the County are fully vaccinated against COVID-19.

CD Health Alert: Orange County Reports Start of 2021-2022 Influenza Season

October 22, 2021

The Orange County Health Care Agency (HCA) has confirmed the county’s first case of influenza for the 2021-2022 season. Influenza activity remains low in Orange County at this time, but there are concerns about a more severe influenza season given both the relative dearth of disease and low influenza vaccine uptake during 2020-2021 season. This season will be further complicated by the ongoing COVID-19 pandemic. Providers should be considering testing for both influenza virus and SARS-CoV-2 in patients presenting with acute respiratory illness, as a positive test for one does not preclude a positive test for the other. Vaccination remains the best way to prevent both influenza and COVID-19 disease.

CD Health Alert: Booster Dose of Pfizer BioNTech Covid-19 MRNA Vaccine

September 24, 2021

The CDC’s Director recommended that the following groups of individuals for receipt of a single booster dose of Pfizer-BioNTech COVID-19 vaccine at least six-months after completing a primary series with the Pfizer-BioNTech COVID-19 vaccine.

  • people 65 years and older and residents in long-term care facilities (LTCF) should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
  • people aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
  • people aged 18–49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and
  • people aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

This recommendation comes after FDA modified the Emergency Use Authorizations (EUAs) on September 22, 2021 for Pfizer-BioNTech COVID-19 vaccine to allow for administration of a booster dose of an Pfizer-BioNTech COVID-19 vaccine at least six-months after an initial 2-dose primary Pfizer-BioNTech COVID-19 vaccine series.

CD Health Alert: Orange County's First Human West Nile Virus Case of the Season Reported

September 23, 2021

A Buena Park woman was diagnosed last week with West Nile Virus (WNV) infection, and was hospitalized but is recovering. This is the first human WNV infection identified in Orange County this season. As of Friday, the California Department of Public Health has reported 46 cases of human West Nile Virus infections statewide this season, including three in Los Angeles County. 

CD Health Alert:  Gonorrhea Treatment Failure: New Susceptibility Testing Service Available

September 11, 2021

Antibiotic-resistant Neisseria gonorrhoeae has been identified in the United States and in Orange County. The medical and public health communities need to prepare for management of infections. If you have reasonable concern of gonococcal treatment failure, susceptibility testing is available to support medical management as well as public health surveillance for resistant organisms.

CD Health Alert: FDA Approval of Pfizer BioNTech COVID-19 Vaccine for Ages 16 and Older

August 24, 2021

Yesterday, August 23, 2021, the US Food and Drug Administration (FDA) approved the first COVID-19 vaccine. The Pfizer BioNTech COVID-19 vaccine, to be marketed under the name Comirnaty, is fully approved for the prevention of COVID-19 Disease for those for those 16 years and older. 

CD Health Alert: Third Dose of COVID-19 mRNA Vaccine Recommended for Immunocompromised Persons

August 16, 0021

This recommendation comes after FDA modified the Emergency Use Authorizations (EUAs) on August 12, 2021 for Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine to allow for administration of a third dose of an mRNA COVID-19 vaccine after an initial 2-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people (i.e., people who have undergone solid organ transplantation or have been diagnosed with conditions that are considered to have an equivalent level of immunocompromise).

CD Health Alert: First West Nile Virus Positive Mosquito Sample has been Identified in Orange County

August 12, 2021

Orange County’s first West Nile Virus (WNV) positive mosquito samples of the season were identified last week in Fullerton through routine trapping and testing by the Orange County Mosquito and Vector Control District (OCMVCD). 

CD Health Alert: CDC Recommends COVID-19 Vaccination of Adolescents Age 12 and Older

August 6, 2021

COVID-19 cases and hospitalizations have increased significantly in Orange County. Cases are primarily occurring in those who are unvaccinated; in recent weeks, persons who are not fully vaccinated in Orange County have been over five times more likely to get COVID-19 compared to those who are fully vaccinated.

CD Health Alert : CDC Recommends COVID-19 Vaccinations of Adolescents Age 12 and Older

May  13, 2021

Following FDA approval earlier this week, on May 12, 2021 the CDC’s Advisory Committee of Immunization Practices (ACIP) recommended the use of the Pifzer-Biontech COVID-19 vaccine for children 12-15 years of age.

CD Health Alert: Guidance For Assessment Of Suspected COVID-19 Variant Cases And Breakthrough Disease In Vaccinated Persons 

March 3, 2021

COVID-19 variants pose a significant threat to worldwide efforts to end the pandemic; to date, 46 states have reported at least one case of a variant of concern, including cases caused by B1.1.7, B.1.351, and P.1 lineages. The B1.1.7 variant, first identified in the United Kingdom and associated with increased transmission and disease severity, has been identified in Southern California, including Orange County, for several weeks.

CD Health Alert: COVID-19 Update - Quarantine Recommendations For Vaccinated Persons

February 24, 2021
The CDC and the California Department of Public Health have recently updated their COVID-19 quarantine recommendations for persons who have been fully vaccinated. OCHCA will update its health order in accordance with this guidance

CD Health Alert: New Gonorrhea Treatement Guidelines From CDC

January 14, 2021
CDC has updated its recommendation for the treatment of uncomplicated gonorrhea in adults. Gonorrhea should now be treated with just one higher dose (500 mg) injection of ceftriaxone, and dual therapy is no longer the recommended approach.

CD Health Alert: First West Nile Virus Human Infection of the Season Reported in Orange County
December 21, 2020

The Centers for Disease Control and Prevention (CDC) recently published updated recommendations for quarantine of persons following exposure to a COVID-19 case, including options for a shortened quarantine period.

CD Health Alert: First West Nile Virus Human Infection of the Season Reported in Orange County
August 10, 2020
A child under the age of 18 years was diagnosed last week with West Nile Virus (WNV) infection, and was hospitalized but is recovering. This is the first human WNV infection identified in Orange County this season. As of Friday, the California Department of Public Health has reported 10 cases of human West Nile Virus infection statewide.
CD Health Alert: Orange County Candida auris Update
August 5, 2020
New cases of Candida auris continue to be reported in Orange County, and routine surveillance in county facilities has shown a recent spike in newly colonized patients.
CD Health Alert: COVID-19 Update for Orange County Providers
July 7, 2020
COVID-19 daily case counts and the number of those hospitalized with the disease have increased in Orange County in recent weeks. Over 14,000 cases have been reported in Orange County, with over 340 deaths. Approximately half of all county deaths have occurred in residents of skilled nursing facilities.
CD Health Alert: 2019 Novel Coronavirus: Orange County Update for Long Term Care Facilities (LTCFs)
May 14, 2020
Fifteen COVID-19 outbreaks have been identified in Orange County LTCFs over the past 4 weeks. These outbreaks have occurred despite good compliance with temperature and symptom screening of both staff and residents. Outbreaks can spread rapidly among residents and staff, and responding to and testing for these outbreaks strains resources.
CD Health Alert: 2019 Novel Coronavirus: Orange County Update
March 23, 2020
Orange County has now had over 125 cases of Novel Coronavirus 2019 (COVID-19) reported. There has been a rapid increase in daily reports of COVID-19 cases over the last several days and community transmission is becoming more widespread. At this point the Orange County Health Care Agency (OCHCA) will only be conducting investigations of cases identified in hospitalized patients, health care workers, and residents of congregate living facilities. Providers should inform their patients of test results and give them education on disease prevention and monitoring for worsening disease.
CD Health Alert: 2019 Novel Coronavirus: Orange County Updates
March 17, 2020
Orange County now has 22 cases of 2019 Novel Coronavirus Disease (COVID-19) reported; case numbers are increasingly rapidly and a number of cases resulting from community transmission have been reported.
CD Health Alert: 2019 Novel Coronavirus: Orange County Updates
March 13, 2020
Orange County now has thirteen cases of 2019 Novel Coronavirus Disease (COVID-19) reported, including one case that appears to have been locally transmitted. The Orange County Health Care Agency (OCHCA) is identifying and contacting close community exposures to these cases.
CD Health Alert: First Case of 2019 Novel Coronavirus in Orange County: Update for Providers
January 26, 2020
The first confirmed case of 2019 novel coronavirus (2019-nCoV) in Orange County was identified yesterday. A second case was also confirmed yesterday in Los Angeles County. Both occurred in non-resident travelers from Wuhan who acquired infection there and appear to be unrelated.
CD Health Alert: 2019 Novel Coronavirus: Update for Orange County
January 23, 2020
An outbreak of respiratory disease caused by 2019 Novel Coronavirus has been identified in Wuhan, Hubei Province, China.
CD Health Alert: Updated Zika and Dengue Virus Surveillance and Guidance
January 7, 2020
Due to the changing global epidemiology of Zika virus disease, the US Centers for Disease Control and Prevention (CDC) updated their serologic testing recommendations in November 2019 to no longer endorse routine serological IgM testing for Zika virus.
CD Health Alert: Increase in Mumps Cases in Orange County
November 8, 2019
Since the beginning of 2019, 20 cases of mumps have been identified in Orange County residents. Three cases had onset in October. Median age of cases was 25 years (range 10 to 68 years), 60% were male. 16 (80%) out of 20 cases self-reported mumps virus immunization. 11 (55%) out of 20 cases had no history of international travel or contact with a known case, indicating local spread of mumps virus.
CD Health Alert: Potential Public Exposures to Measles Case
October 23, 2019
The OC Health Care Agency (HCA) has confirmed that a Los Angeles resident vistited Disneyland Park while infectious with measles on Wednesday, October 16th. The Orange County Health Care Agency and the Los Angeles Department of Public Health are conducting a coordinated investigation to identify any potential exposures and cases.
CD Health Alert: Orange County Reports Season's First Influenza Case
October 9, 2019
The Orange County Health Care Agency (HCA) has confirmed the County's first case of influenza for the 2019-20 season. 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 activity increases.
CD Health Alert: Increase in Mumps Cases in Orange County
September 5, 2019
Since the beginning of June, nine cases of mumps have been identified in Orange County residents. Eight of nine cases were in adults with ages ranging 19-41 years, one case was diagnosed in a 10 year old child.
CD Health Alert: Orange County’s First West Nile Virus Human Infection of the Season Reported
August 19, 2019
A Tustin woman in her 50s was diagnosed last week with West Nile Virus (WNV) fever. This is the first human WNV infection identified in Orange County this season. Human infections have already been reported this season in the surrounding counties of Los Angeles and San Bernardino.
CD Health Alert: First West Nile Virus Positive Mosquito Sample has been Identified in Orange County
August 5, 2019
Orange County’s first West Nile Virus (WNV) positive mosquito sample of the season was identified last week in the city of Orange through routine trapping and testing by the Orange County Mosquito and Vector Control District (OCMVCD). No human infections have been identified so far this season in Orange County.
CD Health Alert: Consider MERS in Returning Travelers from the Arabian Peninsula
August 2, 2019
With the annual Hajj pilgrimage occurring from August 9 to 14, 2019, thousands of Americans will be joining approximately two million Muslims in Mecca, Saudi Arabia. Crowded conditions increase the risk of communicable diseases, including respiratory and diarrheal illnesses.
CD Health Alert: Ongoing Ebola Outbreak in the Democratic Republic of Congo
July 22, 2019
An outbreak of Ebola Virus Disease (EVD) in the Democratic Republic of Congo (DRC) was declared on August 1, 2018. The outbreak has been ongoing since then, with 2,578 confirmed and probable EVD cases and 1,737 deaths reported as of July 20, 2019.
CD Health Alert: Update: Candida auris in Orange County
July 2, 2019
Patients colonized or infected with Candida auris ( C. auris ) continue to be identified in Orange County.
Point prevalence surveys, with testing of all residents of a facility, have been completed in all long term acute care hospitals (LTACs) and skilled nursing facilities that provide ventilator (vSNFs) in Orange County.
CD Health Alert: Candida auris in OC: Update for Skilled Nursing Facilities
June 10, 2019
Multiple patients colonized or infected with Candida auris ( C. auris) have been identified in Orange County. This cluster of cases is the first identified in Southern California.
CD Health Alert: Update: Candida auris in Orange County
May 30, 2019
Patients colonized or infected with Candida auris ( C. auris ) continue to be identified in Orange County. In communities experiencing C. auris outbreaks in this country, colonization rates have consistently been highest in residents of long term acute care hospitals (LTACs) and skilled nursing facilities that provide ventilator care (vSNFs).
CD Health Alert: Update - Measles in Orange County
May 24, 2019
No additional cases of measles have been identified in Orange County since the last update.
CD Health Alert: Update: Measles Cases Confirmed in Orange County
May 17, 2019
One additional Orange County measles case was identified this week, a close contact of a previously identified case. In the last three weeks, four cases of measles have been identified who have Orange County connections: three Orange County residents and a Long Beach resident who is a student at the University of California-Irvine. Orange County clinicians should consider measles in patients who have the appropriate clinical presentation.
CD Health Alert: Update: Measles Cases Confirmed in Orange County
May 7, 2019
Two cases of measles infection have been diagnosed in Orange County (OC) residents in the last ten days. One is an adult who acquired measles through international travel, the other is a child under a year of age who has no history of travel. An additional case has been identified in an adult resident of Long Beach who is a student at the University of California, Irvine and has no travel history. None of the these cases have a known social connection to each other.
CD Health Alert - Orange County Infant Pertussis Death
April 19, 2019
Orange County Health Care Agency has recently confirmed a pertussis-related death in an infant. The case is the first pertussis-related death reported in Orange County since 2007.
CD Health Alert - Update: Candida auris in Orange County
April 16, 2019
Patients colonized with Candida auris ( C. auris ) have been identified recently at multiple healthcare facilities in Orange County. Colonized patients have been identified in Kindred Hospital, Santa Ana.
CD Health Alert - Measles on the Rise
April 15, 2019
Measles cases in the U.S. in the first three months of 2019 have already surpassed the year-end totals for every year except 2014 since ongoing transmission of measles was eliminated in this country nearly two decades ago.
CD Health Alert - Increase in Hepatitis A Cases With No History of Travel
March 7, 2019
The Orange County Health Care Agency has received 10 reports of acute hepatitis A virus (HAV) infection in Orange County residents since September 1, 2018. Median case age is 48 years (range 27-69 years); 5 females, 5 males; 50% self-report as Not-Hispanic or Latino/White. Eight of these cases reported no history of travel to areas with ongoing HAV transmission or exposure to a known case. One of the eight cases reported illicit drug use, none reported experiencing homelessness. No common social or geographic exposures have been identified. None reported receiving hepatitis A vaccination in the past. Four cases with no history of travel have had genotyping performed, all were found to be infected with distinct HAV strains, indicating repeated introduction of HAV into the County.
Provider Advisory: Legionnaire's Disease in Garden Grove
January 9, 2019
The Orange County Health Care Agency (OCHCA) has recently identified four cases of Legionnaire’s disease in residents of Garden Grove. The first case had an illness onset date of December 21, 2018. OCHCA is currently investigating the cases; a common exposure has not been identified.
Provider Advisory: Hepatitis A Case With History of Illicit Drug Use in Orange County
December 3, 2018
Orange County Public Health received a report last week of one case of hepatitis A virus (HAV) infection in a county resident with no history of travel outside the county or exposure to HAV. The case had a history of illicit drug use but no history of experiencing homelessness.
Provider Advisory: Orange County Reports Season's First Influenza Case
October 19, 2018
The Orange County Health Care Agency (HCA) has confirmed the county’s first case of influenza for the 2018-19 season. 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 activity increases.
Provider Advisory: Hepatitis A Cases With No History of Travel in Orange County
September 21, 2018
Orange County Public Health has received three reports in the last month of acute hepatitis A virus (HAV) illness in persons with no recent history of travel or exposure to a known case. All three cases are male, with an age range of 30 to 65 years and illness onset dates ranging from August 14 to September 15. The three have no identified common social contacts. None report a history of injection or noninjection drug use or homelessness; one has a history of having sex with men. None report receiving hepatitis A vaccine in the past.
Provider Advisory: Consider MERS in Returning Travelers from the Arabian Peninsula
September 7, 2018
With the annual Hajj pilgrimage to Mecca, Saudi Arabia, ending on August 24, the Orange County Health Care Agency reminds providers that Middle East Respiratory Syndrome Coronavirus (MERS-CoV or MERS) illness should be considered in returning travelers who present with symptoms consistent with lower respiratory tract infection.
Provider Advisory: Increase in Mumps Cases Among Young Adults in Orange County
August 23, 2018
Orange County Health Care Agency has received five reports of mumps cases among young adults since June 1, 2018. The cases ranged in age from 18-22, three of five were male.
Provider Advisory: Orange County's First West Nile Virus Human Infection of the Season Reported
August 8, 2018
A Tustin woman in her 70s was diagnosed this week with West Nile Virus (WNV) neuroinvasive disease.  This is the first human WNV infection identified in Orange County this season.  Human infections have already been reported this season in the surrounding counties of Los Angeles, Riverside, and San Bernardino.

Provider Advisory: First West Nile Virus Positive Mosquito Sample
July 10, 2018
The First West Nile Virus Positive Mosquito Sample has been Identified in Orange County

Provider Advisory: Update: Legionnaires' Disease Increase in the Anaheim area
November 8, 2017
The Orange County Health Care Agency has been notified of 11 individuals diagnosed with Legionnaires’ disease who live in or have visited the Anaheim area during the month of September. Eight have a history of visiting Disneyland Parks prior to developing illness; three have no history of Disneyland exposure. Case ages range from 52-94. Ten of the 11 ill were hospitalized, and one person died. OCHCA is currently investigating these cases, but have not yet identified a common exposure for all cases.
Legionnaire’s Disease Increase in the Anaheim area
October 27, 2017
HCA has recently been notified of 8 individuals diagnosed with Legionnaire’s disease who live in or have visited the Anaheim area during the month of September: 2 are Anaheim residents, 5 were visitors who stayed in Anaheim between 9/12 and 9/27, and one is employed in Anaheim but lives in another county. We are currently investigating the cases, but have not yet identified any common exposure for all cases.
Update: Hepatitis A Outbreaks in Homeless and Illicit Drug Using Populations in California
October 26, 2017
Outbreaks of Hepatitis A virus (HAV) infection have been identified in homeless and illicit drug using populations in multiple California counties. San Diego County has identified 516 cases of HAV infection, including 19 deaths, Santa Cruz County has had 73 cases, and Los Angeles County has had 14 cases. This week, the California Department of Public Health (CDPH) declared a statewide hepatitis A state of emergency. CDPH is advising that HAV vaccine be prioritized to communities that are experiencing active local spread of HAV.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.

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.

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

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.

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).

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.
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.
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.
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.
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 )
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 )
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 )