The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory in response to recent reports of increases in human exposures to rabid or possibly rabid animals and rabies post-exposure prophylaxis (PEP) administration errors. Since July 2026, multiple United States jurisdictions have reported local increases in human rabies exposures involving known rabies vectors or animals in which rabies is less commonly reported. Several high-profile rabies outbreaks and mass rabies exposure events have highlighted the importance of performing careful rabies risk assessments and following evidence-based recommendations for administering PEP. Health departments can help clinicians who provide rabies vaccination in their jurisdictions stay aware of the importance of rabies risk assessments before administering PEP. Clinicians and healthcare facilities can work to make sure that PEP is administered only when appropriate and that human rabies immune globulin (HRIG) and rabies vaccines are administered according to Advisory Committee on Immunization Practices (ACIP) recommendations.
In honor of recovery month, I would like to celebrate the millions of Americans recovering from substance use disorders as well as their loved ones supporting them along the way.
I am grateful to work with the OC Health Care Agency as a double board certified in Psychiatry and Family Medicine physician, treating patients in the Substance Use Disorders program as well as Adult Mental Health Services. Every day I see how substance use disorders affect my patients as well as their whole families.
Watching a loved one struggle with a substance use disorder can cause immense pain, anger, and grief which leave families feeling powerless. Family members can provide support on the journey, but ultimately the person suffering with a substance use disorder must be willing to accept help. If you love someone with a substance use disorder, the following tips might be helpful.
Care for yourself – Supporting a loved one struggling with drug or alcohol use can be physically and emotionally draining. It is important that you prioritize sleep, nutrition, exercise and social connection.
Be a role model – Substance use disorders often run in families. If you yourself have experienced problems with drug or alcohol use, engaging in your own treatment plan is one of the best things you can do to support others in your life. Many families chose to keep drugs and alcohol completely out of the house.
Understand the signs of a medical emergency – Substance use can be deadly. If you are worried about your loved one’s health, you can support them in accessing medical care. Do not hesitate to call 911 if your loved one is unconscious, having trouble breathing, or severely confused. Families can be prepared for early intervention in opioid overdose by learning how to use naloxone – an easy to administer lifesaving medication that can reverse an opioid overdose. Get Naloxone – Fentanyl is Forever OC
Set boundaries – There is no one-size-fits-all strategy for creating an environment of consistent consequences and accountability around substance use. Boundaries should be put in place to keep everyone safe. Although you love someone and have empathy for what they are going through, substance use is never an excuse for someone to be abusive. Crisis intervention is needed if your loved one’s behaviors become dangerous to themselves or others. OC/Links Crisis line (855) 625-4657.
Highlight the positives and embrace opportunities for change – Many families touched by addiction, notice more bad days than good. If there is a moment of light, where your loved one expresses interest in change, it helps to know about treatment options. There are many ways that someone can start their recovery journey. You can support your loved one in calling OC/Links (855) 625-4657 to get more information.
Understand their treatment plan – Once your loved one enters a recovery program it is helpful to know their plan so that you can best support their recovery. Treatment for substance use disorders can be different from person to person and may involve: medical withdrawal management, residential treatment, outpatient groups, individual therapy, and medications that help support their recovery. If your loved one allows, you may be able to connect with their treatment team to further understand the plan.
Supporting a loved one with a substance use disorder is a difficult journey affecting millions of families. While we unfortunately hear about more and more families losing loved ones to substance use disorders, I want to encourage that there is hope. As a doctor I have seen my patients recover from substance use disorders and rebuild their lives and relationships. I have been inspired by the spouses, parents, siblings and friends who act with love even when it means making hard choices. Substance use disorders are not destined to end in tragedy. Recovery is possible.
Resources
Family Support Groups
Nar-Anon Family Groups: Find a 12-step program for family and friends of people with a substance use disorder.
SMART Recovery Family & Friends: Meetings, podcasts, and blogs available for family members of people with a substance use disorder.
Al-Anon: A mutual support program for people whose lives have been affected by someone else’s drinking.
About Dr. Kelly Moquin Dr. Kelly Moquin is initially from New York where she completed medical school at Albany Medical College. She became board certified in both Psychiatry and Family Medicine following combined residency training at UC Davis. After working as a clinical professor of family medicine at UC Irvine, she joined the OC Health Care Agency as a bilingual Psychiatrist in both departments of Substance Use Disorders and Adult Mental Health Services. Dr. Moquin is passionate about education, advocacy, team-based care and treating patients as whole people within their system of support.
(Santa Ana, CA) - The OC Health Care Agency (HCA) has extended recruitment for the CalOptima Health Board of Directors. As a County-Organized Health System, CalOptima Health serves over 829,000 low-income children, adults, seniors and people with disabilities. CalOptima Health launched in 1995 in response to the local health care system’s difficulty in meeting the needs of vulnerable Orange County residents. Today, CalOptima Health is the single largest health insurer in Orange County and recognized statewide for delivering quality care. CalOptima Health’s mission is to serve member health with excellence and dignity, respecting the value and needs of each person.
The HCA seeks applicants who represent the diverse backgrounds, interests and demographics of Orange County residents and have the experience and expertise to operate a public health care system.
Applications are being accepted for the following seat on the CalOptima Health Board of Directors:
One (1) person who is a licensed physician in current practice and who is also a representative of a contracted independent physician’s association or provider network.
To apply for a seat on the CalOptima Health Board of Directors, please complete an application by 5:00 pm (PT) on September 18, 2026. Applications are available on the HCA’s website at ochealthinfo.com/caloptima. The HCA may reopen or extend this recruitment in its sole discretion.
Please send a completed application and resume to:
OC Health Care Agency Attention: James Kim 405 W. 5th Street, Suite 724 Santa Ana, California 92701
Please note that all applications are public records. The selected applicants will serve only after appointment by the County of Orange Board of Supervisors. CalOptima Health Board meetings are typically held on the first Thursday of each month at 2 p.m. at CalOptima Health, located at 505 City Parkway West, Orange, California 92868.
For additional information, please contact James Kim at (714) 834-3883 or via email at jameskim@ochca.com.
Summer in Southern California brings sunshine, outdoor fun—and a hidden health risk few expect: Valley Fever. With Valley Fever Awareness Month, this is a great time to learn how to recognize it, reduce your risk, and protect your loved ones.
What is Valley Fever?
Valley Fever, or coccidioidomycosis (“cocci”) is an infection caused by breathing in a fungus that lives in the soil of dry, dusty areas. When soil is disturbed, tiny fungal spores can become airborne and be inhaled.
This fungus is found in parts of:
Central and Southern California
Arizona, Nevada, New Mexico, Texas, Utah, and Southeast Washington
Mexico, Central America, and South America
Who is at Risk?
Anyone who lives, works, or spends time in areas where the fungus is common can get Valley Fever. Certain activities and conditions increase the risk:
People who work outdoors or disturb soil such as:
Construction crews, agricultural workers, firefighters, geologists, military personnel
Outdoor enthusiasts, including:
dirt bikers, ATV riders, hikers
Certain groups are at higher risk of developing more severe illnesses including:
People of African American or Filipino descent Individuals with weakened immune systems
People with diabetes
Older adults
Real Stories: Valley Fever Hits Close to Home
Valley Fever can feel distant—until it impacts someone close to home. Here are examples showing how varied and unexpected exposures can be:
Central Valley Resident: One woman living in the Central Valley—an area where Valley Fever is common—began experiencing a lingering cough and worsening fatigue over several weeks. Although she spent most of her time indoors, caring for animals and occasional outdoor work created exposure. After multiple medical visits, she was finally diagnosed more than a month after symptoms began.
First Responder Experiences: Local first responders have faced Valley Fever firsthand. While responding to cleanup efforts related to earthquake aftermath, wildfires across the state or in other states, first responders - have been known to develop Valley Fever. Several have reported long delays before receiving a correct diagnosis, highlighting how easy Valley Fever is to miss.
A Severe Case: A Filipina woman in her 40s developed confusion, severe headaches, neck stiffness, and fever. She was initially treated for bacterial meningitis, but her condition worsened and she required specialized hospital care. Tests eventually revealed Valley Fever affecting her brain and spinal cord. Despite months of treatment, her illness was extremely severe, and she tragically passed away.
These stories are a reminder that Valley Fever can affect anyone—especially when activities or conditions stir up dusty soil where the fungus lives.
How Does It Spread?
When soil is disturbed, tiny fungal spores become airborne. Breathing them in can lead to infection in the lungs—and sometimes, other organs. Valley Fever is not contagious; you can’t catch it from another person.
What Are the Symptoms?
Symptoms usually appear 1–4 weeks after exposure and may include:
Fatigue
Cough
Chest pain
Fever
Rash
Headaches
Joint aches
Night sweats
Most people (about 60%) have mild or no symptoms. For others, symptoms can linger and may require medical treatment.
How Serious is Valley Fever?
Many infections are mild, but certain groups can develop severe or widespread disease. People of African or Filipino descent, older adults, those with diabetes, and individuals with weakened immune systems should receive treatment even for mild infection.
Severe or “disseminated” Valley Fever is rare but very serious. It can affect the brain (causing meningitis), bones, skin, or other organs and often requires lifelong treatment.
Why Is Valley Fever Often Missed?
Valley Fever can look like other types of pneumonia, but antibiotics do not help because it’s caused by a fungus. If symptoms persist, especially after dust exposure or travel to affected areas, ask your healthcare provider about Valley Fever. Blood tests, imaging, and a detailed exposure history help confirm the diagnosis.
Valley Fever in California
Cases are rising statewide. Wildfires disturb soil and create dust, increasing risks to those in affected areas where coccidiomycosis spores are in the soil. First responders and outdoor workers returning from endemic areas should be evaluated for Valley Fever if they develop symptoms.
Protect Yourself
Avoid dusty areas, when possible, especially during windy conditions.
On windy and dusty days, keep windows and doors closed.
When driving through dusty areas, keep car windows closed and use recirculated air.
Control dust in your yard by covering open dirt areas with grass, plants or other ground cover.
Wear a mask or respirator if you work or play outdoors in endemic regions.
Seek medical advice if you develop symptoms after dust exposure.
Valley Fever is a part of life in many areas of California—but awareness and early care can make a big difference. As you enjoy the season, stay informed, take precautions, and look out for friends and family who may be at risk.
About Dr. Regina Chinsio-Kwong Regina Chinsio-Kwong, DO (Dr. CK) is the County Health Officer for the OC Health Care Agency, where Dr. CK leads efforts to protect and improve community health. A board‑certified family physician with experience in primary care, integrative medicine, and Navy medicine Dr. CK transitioned from clinical practice to public health during the COVID‑19 pandemic and helped direct Orange County’s mass vaccination response. Dr. CK continues to focus on prevention and strengthening partnerships with clinicians and community organizations.
About Dr. Helene M. Calvet Dr. Helene M. Calvet received her MD from UCLA and is board-certified in both internal medicine and infectious diseases. She has worked in the field of public health for over 25 years, having served in Long Beach as Health Officer and TB controller and in Orange County as Deputy Health Officer. Most recently, she worked in COVID response, leading a team that dealt with more than 500 outbreaks in Long Term Care Facilities, but since 2022, she has focused on TB Control.
Currently, she serves as TB Controller and Medical Director of the TB Control Program in Orange County, and as TB Clinician in the Long Beach Health Department. She has published several articles, served on two Centers for Disease Control and Prevention Expert Panels and taught providers throughout Region IX and in 6 countries on public health topics.
