CDPH/Health Advisory- March 25, 2025 - Multiple measles cases have been confirmed in California in recent weeks. All cases have been linked to international travel, reflecting a global rise in measles cases. Health care providers should consider measles in persons presenting with a febrile rash illness and other symptoms consistent with measles.
On March 14, 2025, the Food and Drug Administration (FDA) issued a Consumer Advisory advising consumers not to inhale nitrous oxide products from any size canisters, tanks, or chargers as inhaling nitrous oxide recreationally can lead to serious health effects, including death.
Under direction from the Board of Supervisors, Dr. Chinsio-Kwong (Orange County’s Health Officer) is drafting a report on Nitrous Oxide Use/Misuse in Orange County and is encouraging clinicians and first responders serving Orange County residents and visitors to complete a short anonymous survey by March 31, 2025. Insights gathered from the survey will be reviewed and incorporated into a county report.
Measles - more comprehensive resources are included in this edition with the rising risk of exposure with travel and ongoing outbreaks in the US. It is important to communicate the potential for non-immune to be contract measles given recent outbreaks across the United States and other countries. Clinicians must review common symptoms and presentations, how to protect the community and staff, and are reminded to immediately contact our CDCD team when measles is suspected. HCA’s PHS team is working with CDPH for specific messaging to the Vietnamese community as all 5 cases identified across California in 2025 returned from Vietnam (a country currently experiencing a surge of measles cases) before returning to California. MMR vaccines are widely available throughout the county. Those seeking MMR vaccines can still utilize myturn.ca.gov to find a vaccine.
The Protecting Against Measles Flyer is available on our website and is translated in different languages (see bottom of the page – Resources https://www.ochealthinfo.com/measles).
World TB Day is March 24 and HCA’s very own TB Controller – Dr. Helene Calvet is providing a webinar on World TB Day to review evaluation, diagnosis, and treatment.
National Nutrition Month- March is National Nutrition Month and this year’s theme is Food Connects US. Clinicians who are interested in engaging in county wide efforts for sustainable change are encouraged to join the CHIP Diabetes and Obesity workgroup.
Nitrous Oxide - The FDA issued an alert on March 14th advising consumers not to inhale nitrous oxide products as recreational use can lead to serious health effects, including death. Just last month, the Orange County Board of Supervisors passed an Ordinance banning the sale of nitrous oxide for recreational use and directed for a County Report on the Misuse of Nitrous Oxide in Orange County to be created. I am still gathering information but need insights from Clinicians and 1st responders - EMT/Paramedics as well as Law Enforcement across Orange County. Clinicians, EMT/Paramedics, Sheriffs and Police Officers that serve Orange County are encouraged to complete a short survey. The Survey will be available from March 18 through March 31. Findings will be reviewed and included in the Orange County report. Links to the surveys are available on the newsletter.
CDC Alert - Dengue- With Dengue transmission remaining high in the US and locally acquired cases reported in Florida, California and Texas, as well as in other countries, the public as well as clinicians are advised to be on alert, take preventive efforts to control mosquitos in the environment, prevent mosquito bites, and maintain clinical suspicion when evaluating cases.
Respiratory Virus Season updates - Flu, RSV and COVID-19 are decreasing, however flu, RSV and COVID-19 is still present in our community. Vaccines are still recommended especially for those who are vulnerable and have not yet received updated vaccines.
H5N1 (Bird Flu) - More poultry and dairy farms are affected across the US, however human cases have remained stable. At this time those in close contact with infected animals are at higher risk than the general public. To date, there has been no human-to-human transmission. Those in close contact with infected animals are urged to take precautions, use recommended PPE, monitor for development of symptoms and are advised to seek medical care if they do develop symptoms. More cats have been identified with H5N1 after consuming raw milk or raw pet food. Pet owners are advised to refrain feeding pets raw milk or raw pet food and to consult veterinarians if their pets become ill.
Safety Recall - Rebecca’s Toys & Prizes Bowling Pin Sipper Cups were recalled because of elevated lead levels found in the red tape of the product.
FDA recalls/safety Alerts from March include Raw Pet food contaminated with H5N1, certain prepared vegetable, canned seafood chowder product for concern of listeria or clostridium, and an herbal product contaminated with lead and arsenic.
March and early April Observances including: National Social Work Month, National Colorectal Cancer Awareness Month, National Poison Prevention Week, Doctor’s Day, and multiple other health professional observances, World Health Day and upcoming Public Health Week.
Providers can now sign up to directly receive the monthly County Health Officer newsletter by entering email information to a listserv.
The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to provide additional information to healthcare providers, public health departments, and the public about the ongoing risk of dengue virus (DENV) infections and updates to testing recommendations in the United States. Dengue activity remains high in some parts of the United States and globally, with many countries reporting higher-than-usual number of dengue cases in 2024 and 2025. Healthcare providers, public health departments, and the public are urged to continue to take steps to prevent, detect, diagnose, and respond to dengue as described in the June 2024 HAN Health Advisory (CDCHAN-00511) on dengue in the United States. Updates include:
Dengue virus transmission remains high in the Americas region, including in the U.S. territories of Puerto Rico and the U.S. Virgin Islands. Spring and summer travel coincide with the peak season for dengue in many countries, increasing the risk of both travel-associated and locally acquired cases in the United States.
The OC Health Care Agency (HCA) has confirmed a case of measles in an infant returning home to Orange County (OC) following international travel. The affected traveler arrived at Los Angeles International Airport (LAX) on Wednesday, February 19.
Additional information regarding this traveler’s activity at LAX can be found in the County of Los Angeles Public Health Newsroom.There were no additional community exposures.
Anyone who may have been exposed and who are at increased risk of severe outcomes, such as infants, pregnant women, and those with compromised immune systems should:
Review whether they are immune to measles or not. People who are not fully immunized against measles or who don’t know if they are immune to measles already should talk with a health care provider about receiving the Measles, Mumps and Rubella (MMR) vaccine.
Monitor themselves for illness with fever and/or an unexplained rash from 7 days to 21 days after their exposure (the time period when symptoms may develop); if symptoms develop, stay at home and call a health care provider immediately for guidance.
“Measles is a highly contagious virus that can cause severe illness such as pneumonia, brain swelling and even death, especially young kids who are not protected,” said Dr. Regina Chinsio-Kwong, County Health Officer. In recent years, 25% of identified measles cases in the United States were hospitalized. Common symptoms include fever, rash, cough, and red, watery eyes and it spreads very easily by air and by direct contact with an infected person. People are contagious from approximately four days before the rash begins through four days after the rash appears. Anyone suspecting that they have measles should call their medical provider before arriving at the medical office, to avoid exposing others to the measles virus. Immunization provides the best protection.”
About measles immunization:
Safety of MMR vaccines: Over 800 million doses of MMR vaccine have been given worldwide, with studies consistently showing that vaccination prevents serious illness with minimal risks. The benefits far outweigh any risks. Side effects are usually mild, such as soreness where the shot was given.
Infants should receive their first MMR vaccine at 12-15 months of age. The second dose of MMR is given at 4 to 6 years of age before going to school.
Immunizing household members including children, adolescents and adults is the best way to protect infants who are too young to receive the MMR vaccine.
Measles is found in many parts of the world, including Europe, Asia, Africa, and the Middle East. Receiving an MMR vaccine before international travel is recommended for those who have not already received two doses. Children 6 to 12 months of age who are traveling internationally are recommended to receive a dose of MMR vaccine prior to travel, to decrease their risk of infection.
(Santa Ana, CA) — The Orange County Crisis Intervention Team (CIT) Program has been awarded Gold Level Certification through CIT International, recognizing its outstanding commitment to regional crisis response system development and collaboration between law enforcement and behavioral health professionals. Orange County is the first county in the state to achieve this rating.
The CIT Program is a community regional partnership among law enforcement/first responders, behavioral healthcare providers, clients/families, consumer advocacy groups and Fire/EMS. The program is guided by the CIT Steering Committee whose objective is providing more effective community responses to individuals and families impacted by mental illness, substance use disorder, intellectual and developmental disabilities and behavioral health crises. The program improves crisis response, advocates for essential services, trains first responders, and strengthens partnerships across the community.
The OC Health Care Agency (HCA) and the Orange County Sheriff’s Department (OCSD) have played a vital role in ensuring the success of the county’s CIT program by integrating behavioral health expertise with public safety efforts. Through this collaborative approach, the CIT program has enhanced crisis de-escalation strategies, increased access to mental health resources and reduced unnecessary law enforcement involvement in behavioral health crises.
"The Gold Certification is a testament to the strength of our collaborative efforts between law enforcement and behavioral health professionals," said Ian Kemmer, HCA’s Director of Behavioral Health Services. "By integrating clinical expertise with law enforcement response, we are creating a safer and more effective crisis response system for our community."
“Together with our dedicated health care partners, we are building a safer and more compassionate community by ensuring those in crisis receive the care and support they need,” said Captain Christine Berryman, OC Sheriff’s Behavioral Health Bureau. “We are honored by this recognition of the rigorous training we have collaboratively developed and plan to continue finding ways to enhance crisis response services in Orange County.”
The Gold Certification recognizes Orange County’s leadership in crisis response and underscores the strong partnership between law enforcement and behavioral health professionals in improving outcomes for individuals experiencing behavioral health crises. The recognition highlights Orange County CIT’s outstanding model including:
Multidisciplinary leadership team
Strong partnerships on the steering committee with good structure to manage and sustain the CIT program
Robust integrated crisis response system
Strong connection to agency programs
CIT International is a 501(c)(3) nonprofit corporation dedicated to assisting communities worldwide in crisis response system reform by developing CIT programs. Certification levels reflect how closely aligned a CIT program is with best practice standards. Gold denotes Orange County’s program meeting outstanding best practice criteria. For more information about the International CIT Program, please visit citinternational.org.
ABOUT THE OC HEALTH CARE AGENCY
The OC Health Care Agency (HCA) is a regional interdisciplinary health jurisdiction and an accredited health department, charged with protecting and promoting individual, family and community health through partnership and coordination of public and private sector resources. Visit www.ochealthinfo.com to learn more about services and resources.
The Centers for Disease Control and Prevention (CDC), in collaboration with state and local health departments, is investigating reports of serious adverse events, including deaths, following receipt of injectable ceftriaxone. To date, events have not been associated with a single product manufacturer or lot, and a definitive causal link to ceftriaxone has not been established. CDC is requesting reports of serious adverse events following the administration of ceftriaxone to assist with the ongoing investigation.
Please report to CDC adverse events that meet the following criteria, occurring after September 1, 2024:
Occurred within 6 hours after receipt of injectable* ceftriaxone in a non-ICU setting, and
Resulted in death or required cardiopulmonary resuscitation**, and
Not attributed by the treating provider(s) to a cause other than ceftriaxone administration***
*including both intramuscular and intravenous routes of administration
**cardiopulmonary resuscitation defined as the use of chest compressions and mechanical ventilation or provision of rescue breaths to maintain circulatory flow and oxygenation during cardiac arrest
***such as known infection, other underlying medical condition, or exposure to a medication or medical product other than ceftriaxone
Please make reports to HCA's Communicable Disease Control Division at 714-834-8180. Healthcare providers should report serious adverse events that might be associated with a medical product to FDA’s MedWatch Program and to the product manufacturer.
