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.

March 28, 2014

Advisory

Measles Cases in Alameda County and California

As of February 18, 2014, 14 confirmed cases of measles have been reported to the California Department of Public Health (CDPH) with onsets since January 1, 2014. This is a higher number of cases than expected early in the year; from 2008-2013, 8 to 31 confirmed measles cases were reported annually. Most cases have involved contact with international visitors or unimmunized Californians who got measles after travelling in the Philippines, Europe, Asia, Africa, or India. It is more important than ever for children and adults to make sure that they are either immune or have been vaccinated. Alameda County Public Health Department has been actively involved in case and contact investigation and disease control activities.

January 17, 2014

Advisory

Influenza Activity in Alameda County

Statewide flu activity has been upgraded to "widespread." Across the country and within California and Alameda County, influenza A (pH1N1), which is in all formulations of the 2013-14 flu vaccine, has been the predominant strain this season. Since its emergence in 2009 pH1N1 has been observed to cause more illness in children and young adults, compared to older adults, although severe illness was seen in all age groups. As of 1/16/14, we have confirmed three deaths in persons <65 years of age due to pH1N1. Vaccination and good hygiene and infection control practices remain the best prevention strategies. Future updates/information will be posted here:

January 06, 2014

Advisory

FDA expects temporary shortage of liquid oseltamivir

Increased demand and manufacturing delays are expected to cause a temporary shortage of the liquid form of the influenza drug oseltamivir (Tamiflu) in coming days, the Food and Drug Administration (FDA) announced on its Web site. The oral suspension formulation is intended for small children and others who can't swallow capsules.

"Genentech is experiencing temporary delays in manufacturing of Oral Suspension. A brief shortage of Oral Suspension is expected in early to mid-January," the FDA said on its "Current Drug Shortages" page. The agency also listed increased demand as a reason for the shortage. The company expects to have more of the product in mid-January, officials said.

Oseltamivir remains available in capsules at all three doses (30, 45, and 75 milligrams), the FDA reported. It said children over 1 year old can be dosed correctly with 30- or 45-mg capsules. For those who can't swallow capsules, a capsule can be opened and mixed with chocolate syrup or some other liquid as directed by a health professional. Also, professionals can use 75-mg capsules to make a liquid form of the drug.

Scattered shortages of the liquid drug were reported in several recent years, including 2013, 2011, and the 2009 pandemic, prompting pharmacies to compound it from capsules.

September 04, 2013

Update

Recurrent Nationwide Shortage of Tuberculin Skin Test Antigen Solutions

In April 2013, CDC reported that TUBERSOL®, a product of Sanofi Pasteur Limited, was in shortage nationwide. Although supplies were restored in early June 2013, TUBERSOL® is in shortage again until at least the middle of October 2013. At the current time, the 5 tuberculin units/0.1 mL, 5 mL (50 tests), multiple dose vials are unavailable. The 5 tuberculin units/0.1 mL, 1 mL (10 tests), multiple dose vials are in limited supply. This CDC notice advises public health officials, clinicians, and workers in occupational health and infection control about how to adapt testing protocols to the recurrent shortage.

August 28, 2013

Advisory

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

Alameda County Health Officer has updated the joint order with the Berkeley Health Officer 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 the influenza season while working in patient care areas.

August 27, 2013

Advisory

Tuberculin Skin Test Solution Shortages

Ongoing shortages of Tubersol and limited availability of Aplisol, the purified protein derivative (PPD) solutions used for tuberculin skin testing (TST) may impact provider ability to assess patients for latent tuberculosis infection (LTBI). In April 2013, the Centers for Disease Control and Prevention (CDC) issued information regarding nationwide shortages of Tubersol and Aplisol solutions. The current projection for restoration of normal production of Tubersol is this fall. The shortage of Tubersol has created increased demand for Aplisol and shortages of both PPD solutions. See Advisory for information on prioritization and substitutions for TST tests.

June 07, 2013

Advisory

Hepatitis A: Multistate Outbreak Linked to Frozen Berry Product and Alameda County Pharmacy Exposure

As of June 7, 2013, the CDC reports 79 people from 8 states with hepatitis A virus (HAV) infections that may be linked to consumption of Townsend Farms Organic Antioxidant Blend frozen berry and pomegranate mix widely distributed in Costco stores. As of June 7, the California Department of Public Health reports 33 California residents from 15 local health jurisdictions (including 1 Alameda County case) are part of this outbreak. Costco has removed the product from their stores and is notifying customers who bought the product. The manufacturer has recalled the product.

In Alameda County, a case of HAV infection was identified in an employee of Target store pharmacies in San Leandro and in Hayward on Whipple Road.

June 03, 2013

Update

Multistate Outbreak of Hepatitis A

As of May 31, 2013, the Centers for Disease Control and Prevention have reported 30 people ill with acute hepatitis A from five states, including California. Illnesses may be linked to consumption of contaminated “Townsend Farms brand Organic Antioxidant Blend”, a frozen berry and pomegranate seed mix, sold from late February 2013 until late May 2013 at Costco stores. Health care providers evaluating patients with acute hepatitis should ask about exposure to this product and report suspected cases to Alameda County Public Health Department at 510-267-3250. Health care providers should provide hepatitis A postexposure prophylaxis to patients who are susceptible to hepatitis A infection within two weeks of their last exposure to this berry product.

May 01, 2013

Update

Human Infections with Novel Influenza A (H7N9)

As of April 29, 2013, Chinese public health officials have reported to the World Health Organization (WHO) a total of 126 human cases of laboratory-confirmed avian influenza A (H7N9) in China, including 24 deaths. Dates of illness onset range from February 19 to April 27, 2013. Very limited person-to-person transmission or epidemiologic link between a few of the cases has been identified.

April 09, 2013

Update

Human Infections with Novel Influenza A (H7N9)

As of April 7, 2013, Chinese public health official have reported to the World Health Organization (WHO) a total of 21 human cases of laboratory-confirmed avian influenza A (H7N9) in China, including 6 deaths, 12 cases with severe respiratory illness, and three mild cases. These are the first known human infections with this influenza strain. No cases of human infection with novel influenza A (H7N9) have been detected in the U.S.

February 04, 2013

Advisory

Doxycycline and Tetracycline Shortage

On February 4, 2013 the State of California Department of Public Health released a notification about recent shortages of Doxycycline and Tetracycline, which may impact your ability to treat or provide prophylaxis for patients.

The Food and Drug Administration (FDA) reported a shortage of doxycycline on January 18, 2013. Doxycycline is a recommended therapy for some sexually transmitted infections and syndromes including Chlamydia, nongonococcal urethritis, epidiymitis and pelvic inflammatory disease. It is also an alternative therapy for syphilis in patients with a penicillin allergy. Reports were also received of a shortage of tetracycline, which is an alternative to doxycycline for treating certain conditions.

For additional information about the availability of doxycycline or tetracycline including expected dates of resolution for different manufacturers and current distribution allotments please visit the FDC Drug Shortage website and for CDC-recommended and additional STD alternative regimens please consult the 2010 STD Treatment Guidelines or visit this CDC site for updates.

January 25, 2013

Advisory

Nationwide Shortage of Isonizaid (INH)

There is currently a nationwide shortage of INH, one of the most important drugs to treat tuberculosis (TB) disease and latent TB infection (LTBI). The low inventory is attributed to a shortage of the active ingredient for making INH and shipping delays.

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