Health Alerts

December 09, 2022

Advisory

Updated Mpox Guidance for Healthcare Providers

The purpose of the attached Health Advisory is to share updated guidance regarding JYNNEOS with healthcare providers. Actions requested of healthcare providers include:

1. Offer JYNNEOS vaccine to ANY person who may be at risk or believes they may be at risk and give vaccine to ANY person who requests it.
2. Routinely offer either subcutaneous (SC) or intradermal (ID) JYNNEOS administration to all persons who are eligible to receive either.
3. Ensure that ALL persons who get the JYNNEOS vaccine complete the vaccine series.

Please review the Health Advisory for further details.

November 21, 2022

Advisory

Respiratory and Influenza-Like Illnesses Guide

ACPHD is informing local healthcare providers about the early rise of respiratory diseases seen in all age groups, especially influenza and Respiratory Syncytial Virus (RSV) in addition to COVID-19 infection. Influenza and RSV have increased in incidence this fall, earlier by several weeks compared to recent years in the US and California which is significantly impacting healthcare; hospital censuses are increased by ~10% across California and pediatric healthcare delivery systems in California are stressed. Please review the attached advisory for detailed updates and requested actions of providers.

October 18, 2022

Alert

Ebola Virus Disease Preparedness

On October 7, 2022, the California Department of Public Health (CDPH) issued a health alert regarding the outbreak of Ebola Virus Disease (EVD) in Uganda caused by the Sudan virus. As of October 12, a total of 74 cases (54 confirmed, 20 probable) and 30 deaths (19 confirmed, 20 probable) have been identified from five affected districts (Mubende, Kyegegwa, Kassanda, Kagadi, Bunyangabu) in Uganda. CDPH, in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), is closely monitoring the outbreak and providing guidance and notification to local health jurisdictions receiving travelers returning from Uganda. To date, there are no suspected or confirmed cases reported in the United States. This Alert includes requested actions for Alameda County clinicians and healthcare facilities.

• ACPHD Health Alert

October 14, 2022

Advisory

JYNNEOS Expanded Eligibility, Severe Manifestations of MPX, and Screening suspected/confirmed MPX cases for HIV and STIs

The purpose of this Health Advisory is to update healthcare providers regarding: 1) JYNNEOS vaccine expanded eligibility criteria; 2) severe manifestations of MPX among people who are immunocompromised; and 3) screening suspected/confirmed MPX cases for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). The JYNNEOS expanded eligibility include:

• Gay and bisexual men and their sex partners
• Transgender people and their sex partners
• Sex workers and their sex partners
• People with multiple sex partners
• People living with HIV
• People who had sex at any sex venue
• Healthcare workers who are likely to collect laboratory specimens from persons with MPX (e.g., persons working in sexual health clinics or clinical settings that serve at risk populations)
• Laboratory workers who perform MPX testing

September 08, 2022

Advisory

JYNNEOS: Expanded Eligibility, Second Doses & Minor Consent

The purpose of this Health Advisory is to share updated guidance regarding JYNNEOS with healthcare providers. Actions requested of healthcare providers include:

• Expanding eligibility criteria for JYNNEOS vaccination to ALL gay and bisexual men, transgender people, or men who have sex with men or transgender people. Other eligibility criteria for MPX vaccination remain unchanged.
• Second doses of JYNNEOS vaccine should be administered to anyone who received a first dose at least 28 days prior.
• Vaccination sites run by Alameda County staff and contractors will allow all minors 12 to 17 years of age to receive the JYNNEOS vaccine without parent/guardian consent. ACPHD urges all healthcare facilities to also consider implementing a minor consent process for JYNNEOS.

Please review the Advisory for further details. Please also see the 9/6/22 letter from CDPH regarding recent Title 17 revisions.

September 02, 2022

Advisory

Monkeypox (MPX) Guidance for Healthcare Providers

The purpose of this Health Advisory is to share updated guidance regarding monkeypox (MPX) with healthcare providers. Actions requested of healthcare providers include:

• Report all suspect cases (e.g., epidemiologic risk factors and signs and symptoms of MPX) in children or youth < 18 years of age within 1 working day via the pediatric PUI form.
• For patients <18, submit a specimen to the Viral and Rickettsial Disease Laboratory (VRDL) at California Department of Public Health (CDPH) in addition to regular commercial lab testing.
• Follow up with patients about their MPX test results. The ACPHD contact tracing team has encountered several patients who were never informed that they tested positive.
• Healthcare providers should begin to utilize their vaccine allocations to give second doses, as there is now adequate supply.

Please review the Advisory for further details. Please also see the CAHAN: Healthcare Provider Health Advisory: Updates on Laboratory Testing and Treatment for Monkeypox (MPX) Virus Infection in California (8/30/22)

August 19, 2022

Advisory

Updated Clinical Provider Guidance for Monkeypox (MPX)

The Alameda County Public Health Department has issued a health advisory to provide clinicians with updated guidance regarding monkeypox. Specifically, this advisory provides updated guidance to County healthcare providers regarding monkeypox virus testing, reporting, vaccine administration, and treatment. Guidance provided in this Health Advisory will replace guidance issued on 7/27/2022 and will go into effect on 8/19/2022.

Please review the full health advisory for additional background and action requested of clinicians.

August 10, 2022

Advisory

Health Advisory Update: Outpatient COVID-19 Therapeutics

The purpose of the attached Health Advisory is to share current COVID-19 therapeutics information with clinicians in Alameda County.

Please see our full health advisory for complete information, including the most recent COVID-19 Therapeutics Program Update from CDPH

For questions about COVID-19 therapeutics, please contact Arnie Spanjers, MD, Alameda County Public Health Department at arnie.spanjers@acgov.org

August 01, 2022

Advisory

Clarification Regarding Monkeypox Health Advisory Released on July 27, 2022

On July 27, 2022, the Alameda County Public Health Department (ACPHD) released a health advisory providing updated clinical guidance for monkeypox. Since we released this health advisory, ACPHD has received several questions regarding our updated JYNNEOS vaccine prioritization criteria. To address these questions, we are providing further clarification regarding our vaccine prioritization criteria.

Please review full health advisory for additional background and action requested of clinicians.

July 27, 2022

Advisory

Updated Clinical Provider Guidance for Monkeypox

The Alameda County Public Health Department has issued a health advisory to provide clinicians with updated guidance regarding monkeypox. Specifically, this advisory provides updated guidance regarding monkeypox reporting, testing, vaccine prioritization, and treatment.

Please review the health advisory for additional background and action requested of clinicians.

July 21, 2022

Advisory

Make Evusheld Available to Eligible Patients

The purpose of this health advisory is to remind clinicians about thebavailability of Evusheld as pre-exposure prophylaxis (PrEP) for COVID-19 in certain adult and pediatric patients (12 years of age and older weighing at least 40 kg). Providers are encouraged to reach out to all patients eligible for Evusheld to discuss risks and benefits and ensure access to this medication. Please visit ACPHD’s Treatment webpage for more information.

For questions regarding the distribution of COVID-19 outpatient therapeutic products within ALCO, please contact Cynthia Frankel, RN, Alameda County Therapeutics Distribution Lead at cynthia.frankel@acgov.org

For clinical questions about COVID-19 therapeutics,please contact Arnie Spanjers, MD, Alameda County Public Health Department at arnie.spanjers@acgov.org

• ACPHD Health Advisory

May 25, 2022

Advisory

CDC-HAN: COVID-19 Rebound After Paxlovid Treatment

The CDC has issued a Health Advisory to provide an update on the potential for recurrence of COVID-19 or “COVID-19 rebound” after Paxlovid treatment. COVID-19 rebound has been reported to occur between 2 and 8 days after initial recovery and is characterized by a recurrence of COVID-19 symptoms OR a new positive viral test after having tested negative. A brief return of symptoms may be part of the natural history of SARS-CoV-2 infection in some persons, independent of treatment with Paxlovid and regardless of vaccination status. Available information suggests that persons treated with Paxlovid who experience COVID-19 rebound have had mild illness; there are no reports of severe disease. Please see the health advisory for recommendations for healthcare providers.

For questions regarding the distribution of COVID-19 outpatient therapeutic products within ALCO, please contact Cynthia Frankel, RN, Alameda County Therapeutics Distribution Lead at cynthia.frankel@acgov.org

For clinical questions about COVID-19 therapeutics, please contact Arnie Spanjers, MD, Alameda County Public Health Department at arnie.spanjers@acgov.org