The California Department of Public Health (CDPH) would like to inform health care providers that the first known United States (U.S.) case of sexually transmitted Trichophyton mentagrophytes genotype VII (TMVII) was reported in June 2024 in a patient who had recently traveled to California. TMVII is a rare dermatophyte (e.g., ringworm or tinea) infection that causes highly inflammatory, painful, and persistent lesions, often affecting the anogenital or perioral areas, and may require weeks of oral antifungal treatment. Prior to this case, sexual transmission of TMVII had been reported in France, primarily among men who have sex with men (MSM), and among other persons in European countries returning from Southeast Asia who had engaged in sex tourism. Given the novelty of sexually transmitted dermatophyte infections and the potential for local spread in the United States, CDPH would like to inform clinicians of TMVII as a potential emerging public health concern and provide guidance on the clinical recognition, diagnosis, and treatment of patients who are suspected to have this infection.

Please see the full CDPH Health Advisory here:  
https://www.cdph.ca.gov/Programs/OPA/Pages/CAHAN/Reports-of-Rare-Severe-Dermatophyte-Infections-Associated-with-Sexual-Contact-in-the-United-States.aspx

Don’t let foodborne illness steal the joys of your holiday season. Staying healthy and food safe can be easy if you follow the right steps.

Who’s at risk for foodborne illness?

The Centers for Disease Control and Prevention (CDC) reports an estimated 1 in 6 Americans (or 48 million people) get sick, 128,000 are hospitalized, and 3,000 die from foodborne diseases every year. 1

Pregnant people 

Pregnant people are at increased risk of getting sick from food poisoning. Some foods pregnant people should avoid are:

• Raw or undercooked poultry or meat
• Unheated deli meat and cold cuts like hot dogs or dry sausages
• Unpasteurized and raw milk and dairy products made from raw milk
• Soft cheeses like queso fresco, queso blanco, brie, feta, and blue veined cheese
• Raw or undercooked seafood
• Smoked seafood (except in a cooked dish)
• Unpasteurized juice or cider
• Uncooked flour, including raw dough or batter
• Any holiday punches or eggnogs that are alcoholic (due to effects of alcohol on the fetus, not because of foodborne illness)

Children under 5 years old

Growing bodies with developing immune systems can’t fight off illnesses like adults can. This puts children under 5 years old at higher risk for foodborne illness. Some foods children should avoid are:

• Raw or undercooked foods including meat, poultry, and eggs
• Unpasteurized milk or juice
• Raw or undercooked oysters and seafood
• Honey (if your child is under 1 year old)

Learn more about people at higher risk for foodborne illness:

• CDC: Safer Food Choices for Pregnant People English | Spanish
• FoodSafety.gov: People at Risk: Children Under Five English | Spanish
• HealthyChildren.org (American Academy of Pediatrics [AAP]): Food-Borne Illnesses Prevention English | Spanish

Food Poisoning Warning Bells

Food poisoning symptoms can last a few hours and up to a few days. Some common symptoms to look out for are:

• Diarrhea
• Stomach pain or cramps
• Nausea
• Vomiting
• Fever

Call your doctor if you/your child have any of these severe food poisoning symptoms:

• High fever (over 102°F)
• Bloody diarrhea
• Diarrhea for more than three days
• Frequent vomiting
• Dehydration (dry mouth and throat, feeling dizzy when you stand up, decreased urine)

Resources

• U.S. Food and Drug Administration: Holiday Food Safety English | Spanish
• CDC: 10 Dangerous Food Mistakes English | Spanish
• HealthyChildren.org (AAP): Food Poisoning & Contamination: Information for Families English | Spanish
• https://www.cdc.gov/food-safety/prevention/index.html

References

1 https://www.cdc.gov/foodborneburden/index.html

In the United States, the leading cause of death for infants 1 month to 1 year is Sudden Unexpected Infant Death (SUID). This includes sleep related deaths such as accidental suffocation and Sudden Infant Death Syndrome (SIDS).

There are about 3,400 sleep related deaths among US infants each year [1]. Infant deaths from accidental suffocation and strangulation in bed have been increasing due to unsafe sleeping practices [2]. In Orange County from 2010-2021, 104 babies died with SUID [3].

You can drastically reduce the risk by following the ABCs of safe sleep. Babies should sleep:

• Alone
• On their back
• In a crib, bassinet or pack n’ play with no pillows, blankets or toys

Other recommendations to reduce the risk of SUID/SIDS are:

• Use a firm and flat sleep surface such as a mattress covered by a fitted sheet in a safety approved crib or bassinet.
• Do not put any other bedding or soft items in the sleep area.
• Share your room, but NOT your bed, with your baby. Keep the baby’s bassinet or crib in your bedroom for at least the first 6 months.
• If the baby falls asleep in a car seat, stroller, swing or infant carrier, move them to their crib or bassinet as soon as you can.
• Don’t let babies sleep on a couch, armchair or nursing pillow – it’s dangerous.
• Breastfeed your baby.
• Consider offering a pacifier, with nothing attached, at nap time and bedtime.
• Avoid putting hats on your baby when indoors to avoid overheating.
• Give your baby “tummy time” for short periods of time while awake and someone is watching them.
• Don’t smoke in the home or allow others to smoke around your baby.

For more information, see:

• Orange County Health Care Agency: Safe Sleep and Sudden Infant Death Syndrome
• California Department of Public Health: Safe Sleep for Babies, English | Spanish
• HealthyChildren.org: How to Keep Your Sleeping Baby Safe: American Academy of Pediatrics (AAP) Policy Explained, English | Spanish
• National Institutes of Health Safe to Sleep®: Benefits of Tummy Time, English | Spanish
• American Academy of Pediatrics: SUID and Safe Sleep Overview
• First Candle: Bereavement Support

References:

1. www.cdc.gov/reproductivehealth/feautures/baby-safe-sleep/(9/30/3023)
2. www.cdc.gov/sids/data.htm (9/30/2023)
3. Data source: California Comprehensive Death File. Population source: CA Dept of Finance, P-3 estimates. 2022 estimate downloaded 8/6/2023. 2021 and prior estimates from Conditions of Children supplemental tables. Orange County Health Care Agency.

As the air becomes crisper and the days become shorter, influenza (“flu”) season is entering its peak. During the fall and winter months, pregnant people, infants, and children under the age of 5 years or with special health care needs are among the most vulnerable to getting seriously ill. Preventing influenza is easier than treating it.

Why Get Vaccinated Against Influenza?

Flu can be a serious illness. Every year the flu causes millions of people to be ill, hundreds of thousands of hospitalizations and thousands of deaths.

• Getting a flu vaccine is the first and most important action in reducing your risk of flu and its serious outcomes. Flu vaccine can keep you and your child from getting very sick from flu and lower your chances of serious illness, complications, and hospitalization.
• Pregnant people are at high risk for flu complications. Flu vaccine during pregnancy can help protect pregnant people AND their baby from complications, such as
  • preterm birth
  • low birth weight
  • stillbirth
  • pneumonia
  • hospitalization
• Babies younger than 6 months old have the highest rates of hospitalization and death but are unable to get a flu vaccine because they are too young. Giving flu vaccines to everyone in contact with these young babies helps protect the babies.
• Certain children and adults have a higher risk of hospitalization for flu complications. It is especially important that these high risk people get a flu vaccine every year:
  • Children under 5 years of age, especially those under 2 years old.
  • Children and adults that have chronic health conditions like asthma, diabetes, or heart disease
  • People 65 years of age and older.

Everyone six months of age and older should receive the flu vaccine every year.

For more information on flu in pregnant people:

MotherToBaby: Seasonal Influenza (the flu) English | Spanish

For more information on children with higher risk for flu complications:

HealthyChildren.org (American Academy of Pediatrics): Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions English | Spanish

For more information on flu in infants and young children:

HealthyChildren.org (American Academy of Pediatrics): Protecting Babies & Young Children From Flu: What Parents Need to Know English | Spanish

Are flu vaccines safe for pregnant people, their developing babies, and children?

• YES! Flu vaccines are safe.  They have been studied extensively in hundreds of millions of Americans over more than 50 years and have an excellent safety record.
• The flu vaccine is safe for pregnant women and their babies. Safety of flu vaccines for pregnant people and their babies is supported by several large studies.
  • Getting a flu shot while pregnant does NOT increase the risk of miscarriage or stillbirth
  • The American College of Obstetricians and Gynecologists (ACOG) recommends that people who are or will be pregnant during influenza season receive a flu shot
  • There is no need to get special permission or written consent from your doctor to get vaccinated against flu at a worksite clinic, pharmacy, or other location outside of your doctor’s office
  • Getting a flu shot while pregnant protects mom and the baby.  It is the most important action a person can take to protect against flu and its complications.
  • For more information, see the Center for Disease Control and Prevention (CDC)’s Flu Vaccine Safety and Pregnancy English | Spanish
• What about if someone has an egg allergy?
  • People with egg allergy, even with severe egg allergy, may get ANY flu vaccine that is otherwise appropriate for their age and health status.
  • No additional safety measures are needed beyond those recommended for receipt of any vaccine.
• For more information, see CDC’s Flu Vaccine Safety Information English | Spanish

What Everyday Steps Can I Take to Help Protect Against the Flu?

The flu is spread from person to person when an infected person coughs, talks or sneezes.  In addition to getting a yearly flu vaccine, you (and your family) should:

• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand rub.
• Cover your nose and mouth when sneezing or coughing.  Wearing a mask around others if you are sick (and over age 2 years) can help protect others.
• Avoid touching your eyes, nose, or mouth.  
• Keep their distance from people who are sick. 
• Stay home if sick.  Sharing is not caring when it comes to the flu.
  • For flu, the CDC recommends that people stay home for at least 24 hours after their fever is gone (except to get medical care or other necessities), without using fever-reducing medicine.
• Breastfeed your baby if you are able to.
  • Breastfeeding baby is a great way to help protect your baby! Breastmilk has antibodies and other substances in it that can help protect your baby from the flu and other infections.
• Clean and disinfect objects and surfaces in the home often. 

To learn more about proper handwashing: 

Centers for Disease Control and Prevention: Stop Germs! Stay Healthy! Wash Your Hands English | Spanish

To learn more about flu vaccines for children:

HealthyChildren.org (American Academy of Pediatrics): Which Flu Vaccine Should Children Get? English | Spanish

To learn about flu vaccines during pregnancy:

HealthyChildren.org (American Academy of Pediatrics): Is It Safe To Get A Flu Shot If I Am Pregnant? English | Spanish

Where Can I Find a Flu Vaccine?

• Ask your healthcare provider.
• Go to a pharmacy.
• If you’re uninsured or don’t have a doctor, visit: Orange County Health Care Agency: Easy Ways to Get a Flu Shot English | Spanish | Chinese | Arabic |Vietnamese | Korean | Farsi

If you don’t have a provider, call the Health Referral Line (1-800-564-8448) or see http://www.coccc.org for information about free or low cost medical services in Orange County.

By the age of 2 years, most children have had RSV infection. RSV is a virus that usually causes mild respiratory illness, such as runny nose, cough and cold symptoms. Some children, especially young babies, are more likely to get severe RSV. Last year, Orange County saw record levels of respiratory syncytial virus (RSV) hospitalizations among children. The Centers for Disease Control and Prevention (CDC) reports that every year 58,000 to 80,000 children under the age of 5 years end up in the hospital because of RSV. No one wants to see their child sick in the hospital.

Why is RSV Dangerous to My Child?

RSV is the most common cause of hospitalization for children under 1 year old.

• Some RSV complications include:
  • Difficulty breathing
  • Bronchiolitis
  • Pneumonia
  • Other infections, like ear infections.
• Some children are high risk for severe RSV, including:
  • Babies under 1 year old, especially under 6 months old
  • Premature babies
  • Children younger than 2 years old born with a heart condition or who have chronic lung disease
  • Children with weakened immune systems or neuromuscular disorders, especially those who can’t swallow or clear mucus on their own.

To learn more about RSV:

• HealthyChildren.org: RSV: When It’s More Than a Cold English | Spanish
• CDC: RSV in Infants and Young Children English | Spanish

To learn more about RSV warning signs in babies:

• American Lung Association: Understanding RSV English | Spanish

What Should My Family Do to Stay Protected Against RSV?

• Get vaccinated if you are pregnant and your baby will be born during RSV season
  • RSV vaccine is recommended for all pregnant people who are 32-36 weeks pregnant during RSV season (generally September through January).
  • American College of Obstetricians and Gynecologists: Should I get the RSV vaccine during pregnancy? English
• Talk to your pediatrician about whether your baby is eligible for the new RSV antibody shot (nirsevimab) and if it is available. The RSV antibody shot is recommended for:
  • Babies younger than 8 months of age who are born during or entering their first RSV season.
  • Children aged 8-19 months entering their second RSV season who are at increased risk for severe RSV, including:
    • Children who have chronic lung disease from being born prematurely and who require medical therapy for their lung disease
    • Children who are severely immunocompromised
    • Children with severe cystic fibrosis
    • American Indian and Alaska Native children.
  • Since the nirsevimab RSV immunization is new, supply is limited this season and will be given to those most likely to have severe RSV. Those eligible include babies who:
    • Weigh less than 11 pounds and are eligible for the lowest dose
    • Are younger than 6 months old
    • Are 6 to 7 months old and have a medical condition that makes them more likely to have severe RSV
    • Identify as American Indian and Alaska Native (AI/AN) and:
      • are younger than age 8 months, OR
      • are 8 through 19 months old AND live in a remote region.
  • Babies at higher risk who can’t get the new RSV immunization this season may be able to get a different RSV immunization, palivizumab, for the 2023–2024 RSV season.
•  
  • For more information on RSV immunization in infants, visit HealthyChildren.org Is the RSV Immunization Available for Infants? English | Spanish
• Breastfeed your baby, if you’re able to.
• Follow these every day steps to reduce the spread of illnesses:
  • Wash your hands for at least 20 seconds and help your children do the same.
  • Cover your nose and mouth when coughing or sneezing.
  • Keep your child away from people who are sick.
  • Wear a mask around your child if you or other family members are feeling sick.
  • Frequently clean and disinfect surfaces in your home.

Where Can I Get an RSV Vaccine or Immunization?

For pregnant people :

• Contact your health care provider for more information about the RSV vaccine.
• Visit your local pharmacy.
• If you don’t have a provider, call the Health Referral Line (1-800-564-8448) or see http://www.coccc.org for information about free or low cost medical services in Orange County.

For babies under 8 months old or infants/toddlers who are at high risk for severe RSV disease:

• The nirsevimab RSV immunization is in limited supply this season. Contact your pediatrician for more information.
• If you don’t have a provider, call the Health Referral Line (1-800-564-8448) or see http://www.coccc.org for information about free or low cost medical services in Orange County.

References

Centers for Disease Control and Prevention. (2023, August 4). RSV in Infants and Young Children. Centers for Disease Control and Prevention. https://www.cdc.gov/rsv/high-risk/infants-young-children.html

Set to open in 2025, campus will serve children, adolescents, adults and families

(Santa Ana, CA) – The County of Orange Board of Supervisors unanimously approved a Master Services Agreement (MSA) with Mind OC, the 501C3 nonprofit organization which is the fiscal agent for public and private funds to support Be Well OC, on May 21, 2024. The approval allows Be Well OC to expand its provision of a wide range of critical and comprehensive mental health and substance use disorder services to Orange County residents in collaboration with the OC Health Care Agency’s (HCA) Behavioral Health System.
 
“Orange County is a place where community members can find support, resources, and hope on their journey to mental health wellness. I am grateful we can extend the reach of our County’s Behavioral Health System,” said, Chairman Donald P. Wagner, OC Board of Supervisors, Third District. “Our expanding partnership with the Be Well campuses will provide best-in-class clinical services for mental health and substance use for children, adolescents, adults and families.”
 
Services funded under the MSA that will be provided at Be Well’s Irvine campus include:

• Sobering Center
• Adult Clinically Managed Withdrawal Management
• Adult Substance Use Disorder (SUD) Residential Treatment
• Adult Co-Occurring Residential Treatment
• Adolescent Residential SUD Treatment
• Perinatal SUD Residential Treatment
• Adult Crisis Stabilization Unit (CSU)
• Children’s Crisis Stabilization Unit (CSU)

“Orange County is leading the way in Behavioral Health with the expansion of Be Well OC, co-locating mental health care and substance use disorder services all under one roof -- something not yet done in the state,” said Vice Chairman Doug Chaffee, OC Board of Supervisors, Fourth District. “We are breaking down barriers towards accessing mental health services and serving as a model for other counties to build upon.”
 
The Irvine campus, currently under construction and scheduled to open in May 2025, has been supported through a variety of stakeholders and partners. The Board of Supervisors approved $40 million for the construction of the Irvine campus. In addition, $15 million was approved by the CalOptima Health Board of Directors, $37.6 million in Behavioral Health Continuum Infrastructure Program (BHCIP) grant funding from the State of California (secured by the OC Health Care Agency), $12 million for capital was secured by Assemblywoman Cottie Petrie-Norris, $2 million in Federal dollars was secured by Congressman Lou Correa (CA-46) in the Fiscal Year 2023 (FY23) omnibus appropriations bill, along with additional investments from MemorialCare, Hoag and Kaiser Permanente. 
 
“In 2015, through the Orange County Board of Supervisors Mental Health Ad Hoc Committee, we reexamined local mental health services, leading to the creation of the first Be Well OC campus in Orange,” said Supervisor Andrew Do, First District. “With this second, substantially larger facility in Irvine, Be Well OC has solidified its place as a public-private partnership model for our state and the rest of the country.”
 
The Be Well OC Irvine campus is located on 22 acres of county-owned property that was deeded to the County of Orange as part of on the former Marine Corps Air Station El Toro. The long-term vision for the Irvine Campus is to provide a full continuum of mental health, substance use, and wellness services for children, adolescents, families and adults in Orange County, from urgent care to residential treatment to community wellness support.
 
“Orange County has become a leader in transforming behavioral health care,” said Supervisor Vicente Sarmiento, Second District. "The new campus in Irvine, developed in partnership between the Orange County Health Care Agency and Mind OC, will help us fulfill our commitment to providing the quality treatment every patient deserves, regardless of their financial circumstances. I am pleased to see the expansion of these services, which will increase accessibility for everyone in need.”
 
The Campus will be developed in three areas, beginning with Area 1 which includes approximately 75,000 square feet of building space to house an array of adult services, including crisis stabilization mental health urgent care, a sobering center, and residential and outpatient programs. The community has been instrumental in identifying the types of services and programs needed to help children, adults and families reach their optimal mental health. 
 
“Hope starts here in Orange County. Our vision for transforming the mental health system of care for South County’s children, youth and families continue to grow at the Be Well Irvine Campus,” said Supervisor Katrina Foley, Fifth District. “With doors opening next year, residents of all economic levels will soon have access to critical mental health and substance use treatment while offering a place for families to support their loved ones in crisis. This latest expansion of services at the Be Well Irvine Campus proves Orange County’s commitment to fostering health, wellness, and resiliency programs for our community.”  
 
Area 2 is planned for child, youth, and perinatal specialty programming, expanding both residential and outpatient services capacity while supporting the entire family. Area 3 will expand opportunities for community connections by providing space for educational programs and classrooms, centralized support and navigation services, community meetings, faith and culture event space, and youth and senior centers. 
 
“Be Well OC represents systems change that makes mental health care accessible to all,” said Rick Afable, MindOC Board Chair. “We appreciate County of Orange and the OC Health Care Agency leadership and the support of our many public, private, academic and faith-based partners who are part of the Be Well movement. The Board’s approval of the MSA accelerates the expansion of Be Well’s programs and services, building upon the success of those offered at our Orange campus. By incorporating additional mental health and substance use disorder programs tailored for children, adolescents, pregnant women and families, we will continue to change the conversation about mental health and wellness in Orange County and beyond.”
 
In addition to much needed clinical services, the Irvine location will provide wrap-around wellness support to families and the entire community, including a multi-entity health care collective integrating public and private health systems across Orange County with youth and community education and enrichment. Services will be available to all Orange County residents regardless of insurance or ability to pay.
 
"Our Be Well OC collaboration represents yet another crucial step forward in our continuing commitment to comprehensive mental health and substance use disorder services for Orange County residents,” said, Dr. Veronica Kelley, OC Health Care Agency Director. “Partnering to provide a wide range of programs tailored to various age groups and needs, we are fostering a community where support and resources are readily accessible to all."
 
The Campus’ design is intentional - low density, modern, simple, warm and inviting—creating a sense of dignity, belonging and hope to those seeking help.

Press Release in: Arabic | Chinese | Farsi | Korean | Spanish | Vietnamese

Source

The Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), America’s Poison Centers, and state and local partners are investigating reports of severe acute illnesses potentially associated with consuming Diamond Shruumz™ brand chocolate bars, cones, and gummies marketed as containing a proprietary blend of mushroom. As of June 11, 2024, 12 total illnesses and 10 hospitalizations have been reported in eight U.S. states with ongoing efforts to identify other potential cases. The cause of the reported illnesses is not known at this time. Individuals should not eat, sell, or serve any flavors of Diamond Shruumz™ brand chocolate bars, cones, or gummies, and should discard products that have been purchased. CDC and FDA are working to determine whether other products from this company are associated with adverse health effects.

Please see the full CDC Health Advisory here: 
https://emergency.cdc.gov/han/2024/han00509.asp

In response to the global outbreak of influenza A (H5N1) in birds and recent infections in dairy cattle and humans in the United States, the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CPDH) are encouraging enhanced surveillance and continued testing for influenza this summer. Testing for influenza and subtyping all influenza A positives over the summer is key to maintaining visibility of the influenza A subtypes circulating in the community. Providers are also reminded regarding antiviral treatment and prophylaxis recommendations (CDC guidance regarding antiviral treatment and prophylaxis) in the event of suspected influenza A (H5N1) human cases and exposures; these recommendations should be implemented in consultation with local public health departments.

Please see the full CDPH Health Update here: 
https://www.cdph.ca.gov/Programs/OPA/Pages/CAHAN/Influenza-A-Testing-Guidance-Enhanced-Surveillance-During-the-Summer-Months.aspx

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert healthcare providers to cases of meningococcal disease linked to Umrah travel to the Kingdom of Saudi Arabia (KSA). Umrah is an Islamic pilgrimage to Mecca, Kingdom of Saudi Arabia, that can be performed any time in the year; the Hajj is an annual Islamic pilgrimage this year taking place June 14–19, 2024. Since April 2024, 12 cases of meningococcal disease linked to KSA travel for Umrah have been reported to national public health agencies in the United States (5 cases), France (4 cases), and the United Kingdom (3 cases). Two cases were in children aged ≤18 years, four cases were in adults aged 18–44 years, four cases were in adults aged 45–64 years, and two cases were in adults aged 65 years or older. Ten cases were in patients who traveled to KSA, and two were in patients who had close contact with travelers to KSA. Ten cases were caused by Neisseria meningitidis serogroup W (NmW), one U.S. case was caused by serogroup C (NmC), and the serogroup is unknown for one U.S. case. Of nine patients with known vaccination status, all were unvaccinated. The isolates from the one U.S. NmC case and two NmW cases (one U.S., one France) were resistant to ciprofloxacin; based on whole-genome sequencing, the remaining eight NmW isolates were all sensitive to penicillin and ciprofloxacin.

Please see the full CDC Health Advisory here: https://emergency.cdc.gov/han/2024/han00508.asp

National public health surveillance has recently detected an increase in invasive Neisseria meningitidis (N men) disease caused by isolates that are resistant to ciprofloxacin. In February 2024, the CDC addressed this issue in a report Selection of Antibiotics as Prophylaxis for Close Contacts of Patients with Meningococcal Disease in Areas with Ciprofloxacin Resistance — United States, 2024. In Southern California, six cases of invasive disease caused by ciprofloxacin-resistant N men (including one case in Orange County) have been identified in the last year, representing >20% of all N men cases in the region during that time.

Based on this data, and in conjunction with the California Department of Public Health and surrounding counties, OCHCA no longer recommends use of ciprofloxacin for chemoprophylaxis for close contacts of persons with invasive meningococcal disease in Orange County. More info...