The Alameda County Public Health Department sends out Health Alerts, Advisories, and Updates regarding communicable disease outbreaks, immunization updates, and other public health concerns to Alameda County clinicians and other partners. See recent releases below.

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Health Alerts

ALERT conveys the highest level of importance; warrants immediate action or attention.
ADVISORY provides important information for a specific incident or situation; may not require immediate action.
UPDATE provides updated information regarding an incident or situation; unlikely to require immediate action.

September 29, 2017


Mandatory Influenza Vaccination or Masking of Health Care Workers During Every Influenza Season

As Health Officers for Alameda County and the City of Berkeley, we are updating our joint Health Officer orders (originally dated Aug. 28, 2013) mandating that all licensed health care facilities in Alameda County and the City of Berkeley require their health care workers (HCWs) to receive an annual influenza vaccination or, if they decline, to wear a mask during every influenza season while working in patient care areas. This order applies to all facilities regardless of documented HCW influenza vaccination rate. The 2017update defines Influenza Season as November 1 to April 30 of the following year. This order is ongoing and applies to each influenza season, unless rescinded or modified.

September 29, 2017


Joint Hepatitis A Outbreak Prevention Advisory

Alameda County Public Health and Berkeley Public Health
Joint Hepatitis A Outbreak Prevention Advisory

Outbreaks of hepatitis A are currently ongoing in San Diego, Santa Cruz and Los Angeles counties in persons who are homeless and/or using illicit drugs. The outbreak in San Diego is the largest person-to-person hepatitis A outbreak in the US since hepatitis A vaccine became available in1996, and has a mortality rate of ~3.6%.  To prevent and control hepatitis A outbreaks, the California Department of Public Health (CDPH), the Alameda County Public Health Department (ACPHD) and Berkeley Public Health Department (BPH) recommend offering Hepatitis A vaccine to persons who are homeless or who might be using illicit injection or non-injection drugs.  Although there have been no reported cases of hepatitis A in Alameda County or the City of Berkeley associated with these outbreaks or among known homeless or illicit drug users, both ACPHD & BPH encourage hepatitis A virus (HAV) vaccination to prevent an outbreak from occurring locally.

Actions Requested of Clinicans:

  1. PROVIDE HAV vaccine to persons who are homeless and/or who use illicit drugs and to persons who have frequent close contact with the homeless or drug-using populations. This includes those who provide personal care, food service, janitorial, maintenance, or sanitation services to these populations. Serologic testing for HAV immunity is not recommended prior to vaccination. Vaccinate with either single antigen HAV vaccine or the combined HAV/HBV (Twinrix) vaccine.
  2. CONTINUE routine HAV vaccination for:
  3. REPORT immediately all suspect and confirmed HAV cases in homeless or illicit drug users to ACPHD Acute Communicable Disease section by calling 510-267-3250, M-F 8:30a-5p, or after hours call: 925-422-7595. For Berkeley residents only, contact the Berkeley Communicable Disease program by calling 510-981-5292.

August 09, 2017


Updated Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure

On August 2, 2017 the California Department of Public Health released

Updated Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure. This guidance differs from CDC’s 7/28/17 guidance update, which extends discretion to states where regional epidemiology and travel patterns may deviate from patterns seen in other parts of the country. The Alameda County Public Health Department is adopting the new CDPH guidance.

As of 8/4/2017,) there have been 37 cases of Zika virus infection in Alameda County (and an additional 3 in Berkeley), many of whom were pregnant women. Providers should continue to screen pregnant women for possible Zika virus exposure and continue advising women who are pregnant or who want to conceive in the near future to avoid unnecessary travel to areas where Zika is circulating and to follow the appropriate recommendations for preventing sexual transmission. When indicated, testing should be ordered through commercial labs for patients with Zika virus exposure related to travel or sexual contact and either uncomplicated clinical illness (regardless of pregnancy status) or who are asymptomatic pregnant women.

July 31, 2017


Immunize to Prevent and Control Hepatitis A Outbreaks in Homeless and Illicit Drug Users

Hepatitis A Outbreak Situation Update

Outbreaks of hepatitis A are occurring among persons who are homeless and/or using illicit drugs in San Diego County and Santa Cruz County. To prevent and control hepatitis A outbreaks, the California Department of Public Health (CDPH) and the Alameda County Public Health Department (ACPHD) recommend offering Hepatitis A vaccine to persons who are homeless or who might be using illicit injection or non-injection drugs.  Although there has been no increase in reported hepatitis A cases in Alameda County, ACPHD encourages hepatitis A vaccination to prevent an outbreak from occurring locally.  Please see the CDPH advisory for more details about the outbreaks and immunization recommendations.

Hepatitis A Prevention by Immunization

Hepatitis A Vaccine
While two doses of Hepatitis A vaccine separated by 6 months are recommended for full disease protection, high levels of protection are reached from just one dose.  Any person needing vaccine should be referred first to their regular source of primary care. If the client’s regular source of primary care does not have the vaccine in stock (which would, hopefully, be unusual), they should be able to refer to a local pharmacy.

Medi-Cal (both fee for service and Medi-Cal managed care) covers hepatitis A vaccine without need for any prior authorization.  If a client has Medi-Cal and their regular source of primary care does not carry the vaccine, they can be referred to an in-network pharmacy.  To determine an in-network pharmacy, the client can call the member services phone number on the back of their Medi-Cal card.

Uninsured clients can find hepatitis vaccine a few different ways.  Uninsured clients who are registered patients at the clinics participating in the Vaccines for Adults (VFA) program can be vaccinated there.  Other uninsured clients who are not registered with a participating VFA program clinic can receive free vaccines at the Family Justice Center immunization clinic held on Thursday afternoons from 1-4pm in Oakland, or other clinics listed here.  We request that if clients will be referred to get vaccinated at Family Justice Center, that the referring provider call in advance to 510-267-3230 to ensure the clinic is prepared to receive adults during back-to-school clinics in August.  
The Alameda County Public Health Department is also working on securing additional Hepatitis A vaccine doses to be able to respond quickly should there be any increased disease activity in our community.

June 13, 2017


Alameda County Health Officer Order for Reporting Carbapenem-Resistant Enterobacteriaceae

Carbapenem-Resistant Enterobacteriaceae (CRE) are untreatable or difficult to treat bacteria that are resistant to carbapenem antibiotics and nearly all available antibiotics. They can cause serious illness and death; bloodstream infections are fatal in 40% -50% of cases. CRE was designated by the CDC in 2013 as one of the three most urgent drug resistant threats in the United States. CRE are easily spread between infected or colonized patients by health care workers and equipment, unless rigorous infection prevention precautions are taken. Cases and outbreaks of CRE have been increasingly recognized in recent years in Northern California, including Alameda County. On June 13, 2017, the Alameda County Public Health Department (ACPHD) issued a Health Officer Order for reporting CRE and submitting CRE isolates to the Alameda County Public Health Laboratory, effective June 15, 2017.

May 26, 2017


Increased Norovirus Activity in School Settings

Alameda County and California are experiencing an unusually large proportion of reported gastrointestinal illness outbreaks among students and staff in school settings. This has been attributed to a new strain of
Norovirus that has been circulating in Europe and Asia since last year and is now in the US and CA. Infection spreads quickly in settings where people are in close contact with each other, such as cruise ships, health care facilities, daycare centers, schools and summer camps. The most important steps to prevent the spread of Norovirus in schools are to ensure that:

  1. Ill persons stay home while sick and for another 48 hours after symptoms go away.
  2. Everyone regularly washes hands especially after using the bathroom and before eating.
  3. Contaminated and frequently-touched objects and surfaces are thoroughly and frequently cleaned with an approved disinfectant, as Norovirus can survive for many days on surfaces.

May 17, 2017


Foodborne Botulism Outbreak

From mid-April through May 16, 2017, 10 cases of foodborne botulism have been reported to Sacramento, San Joaquin, Colusa and Solano county public health departments. Cases consumed nacho cheese sauce from the Valley Oak Food and Fuel gas station in Walnut Grove (Sacramento County). No cases of botulism from this outbreak have been reported in Alameda County residents, but Alameda County residents who consumed prepared food at the Valley Oak Food and Fuel gas station in Walnut Grove until May 6 may still develop symptoms. Providers are asked to consider botulism in patients with compatible neurological symptoms and to report suspected cases immediately to the Alameda County Health Department.

March 02, 2017


ACPHD and BPH Joint Zika Virus Update

Alameda County Public Health Department (ACPHD) and Berkeley Public Health (BPH) are now encouraging providers to route Zika virus testing through commercial labs for uncomplicated situations.  Routing directly to authorized commercial labs does not compromise quality and improves turnaround time by up to five weeks.

Clinicians should continue to obtain testing through Public Health (ACPHD or BPH) in complex or questionable situations, such as:

  • A fetus or infant with microcephaly or signs of congenital Zika virus syndrome whose mother was potentially exposed to Zika virus;
  • A person with Guillain-Barré syndrome and potential exposure to Zika virus; or
  • When sexual, local mosquito-borne, laboratory, or blood transfusion/organ transplant exposure is suspected.

If there are clinical circumstances where it is unclear whether a specimen should be routed through ACPHD or a commercial lab, clinicians should consult with the ACPHD Acute Communicable Disease section during normal business hours M-F 9am – 5pm by calling 510-267-3250. For Berkeley residents only, contact the Berkeley Communicable Disease program by calling 510-981-5292.

November 02, 2016


Recall of Frozen Strawberries from Egypt Potentially Contaminated with Hepatitis A

CA Department of Public Health has issued a Health Advisory on 11/2/16 providing Post-Exposure Prophylaxis Recommendations for persons who may have consumed recalled Frozen Strawberries potentially contaminated with Hepatitis A.

A large recall of frozen Egyptian strawberries that have been distributed widely in the United States, including California, has been issued due to the possibility of hepatitis A virus (HAV) contamination. The U.S. Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and state and local officials have been investigating an outbreak of HAV linked to frozen strawberries imported from Egypt. Alameda County Environmental Health & Public Health are conducting follow-up notifications of all Alameda County Facilities known to receive this product, and will work with facilities to ensure any remaining product has been destroyed and identify any persons with potential exposures that occurred within the last 14 days that are recommended to receive Post-exposure Prophylaxis (PEP).

Additional detailed guidance regarding Hepatitis A PEP are in attached advisory.

October 24, 2016


Zika Virus Disease Updated Advisory

As of 9/16/16, the CDC has described the characteristics of 2,382 confirmed or probable cases of Zika virus disease with symptom onset during January 1–July 31, 2016. Most (99%) cases were travel-associated, with 98% reporting travel to an area with Zika transmission, and 1% reporting sexual contact with a returning traveler. United States acquired cases included 26 mosquito-borne cases, one laboratory-acquired infection, and one patient with unknown transmission mode. Sixty-five (3%) patients were hospitalized, and one died. For details, please see

Alameda County has reported 20 cases of Zika virus infections & California has reported 348 (including 43 pregnant women, and 2 infants with birth defects, and 3 due to sexual transmission) as of 10/21/16. All California cases are travel-associated, with no locally acquired mosquito borne transmission.

Local Case Counts

For updated information on Zika cases in Alameda County and California, please refer to ACPHD Zika website. Case counts will be updated weekly on Fridays.

Areas with Active Mosquito-Borne Zika Transmission

For information on areas of the world, including parts of the United States, with active Zika virus transmission, please refer to

This Zika health advisory summarizes key updates since the last Zika health advisory on 8/6/16. The key updates include new information and guidance for prevention of sexual and travel- associated Zika transmission, Zika testing criteria and availability, and specialty society clinical practice guidelines for managing pregnant women, fetal evaluation, and evaluating and managing infants with possible congenital Zika virus infection. We will be issuing further health advisory updates as relevant information becomes available.

August 10, 2016


Zika Virus Disease Updated Advisory

As of 8/3/2016, CDC reports 1818 travel-associated Zika infections in the continental U.S., including 479 infections in pregnant women, 16 sexually transmitted infections, and 5 patientswith Guillain-Barré syndrome. One laboratory-acquired infection has been reported. Florida has reported 6 non-travel associated Zika cases due to local mosquito transmission. As of 7/28/16, 15 liveborn infants with birth defects and 6 pregnancy losses associated with Zika have been reported in the continental U.S.

As of 8/5/16 California reports 134 cases including 1 due to sexual transmission, 23 pregnant women, and 2 infants with birth defects. All CA cases have been travel associated; 10 of the 134 cases are in Alameda County. See for weekly updated case counts.  See for current list of Zika-affected areas.

New information on Zika infection continues to emerge and guidelines for Zika virus testing have been updated by the CDC on 7/25/16. This health advisory summarizes key updates since the last Zika health advisory on 4/1/16 and includes new information and guidance for Zika virus testing in pregnant women in Alameda County as well as updates in interim guidance for prevention of sexual transmission of Zika virus for couples in which one partner has traveled to or resides in an area with active Zika transmission.

For health care providers:

June 27, 2016


Meningococcal Outbreak in Southern California

Since May 2016, nine confirmed cases of Meningococcal disease, including one death, have been reported in men living in Southern California, most of who were men who have sex with men (MSM). Six of the cases are known to be caused by serogroup C and one additional case is awaiting serogroup identification. This represents a substantial increase above the typical number of reported cases. Persons with HIV infection are known to be at risk of Meningococcal disease and vaccines are urged for adult gay and bisexual men at risk, and for all people with HIV. This advisory provides background information and Meningococcal vaccine recommendations to help clinicians safely address the current Meningococcal disease outbreak.

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