Health Alerts

May 12, 2020

Advisory

Updated COVID-19 Testing Guidance for Alameda County

The following updated guidance for COVID-19 laboratory testing is intended to inform Alameda County Public Health Department (ACPHD) efforts to control the epidemic and aid decision-making by clinicians and other testing providers. The guidance sets out groups that should be prioritized for testing but it is not a requirement to test in these groups. Testing decisions and policies must be flexible to account for ongoing limitations in testing resources and protective equipment. Clinical judgment should be used to guide testing of symptomatic persons. ACPHD typically issues additional testing guidance for certain settings and situations, including outbreaks.

• COVID-19 ACPHD Health Advisory

April 08, 2020

Advisory

New COVID-19 Healthcare Provider Reporting Requirements for Alameda County

As of April 7, 2020, a total of 602 COVID-19 cases and 15 deaths have been reported among Alameda County residents, excluding the City of Berkeley. Although the Alameda County Public Health Department (ACPHD) continues to conduct individual COVID-19 case and contact investigations, we are prioritizing public health resources towards investigations in settings (e.g., long-term care facilities) or among persons (e.g., healthcare providers or first responders) where there is concern for ongoing transmission.

To ensure that ACPHD prioritizes resources for public health investigations, effective April 8, 2020 we have modified our County’s COVID-19 reporting requirements for healthcare providers as summarized in tjhis Health Advisory.

For more information on testing specifics, please see the full ACPHD Health Advisory:

• COVID-19 ACPHD Health Advisory

April 03, 2020

Advisory

Health Care Providers to Disseminate ACPHD Isolation and Quarantine Orders to Patients with Suspected COVID-19

The Alameda County Health Officer issued blanket isolation orders that will apply to all persons diagnosed with suspected or confirmed COVID-19 and blanket quarantine orders that will apply to close contacts of cases.  Effective 4/3/20, Alameda County Public Health Department directs Alameda County health care partners to disseminate blanket orders to all patients being tested for COVID-19 or who are presumptively diagnosed with COVID-19 without testing BEFORE they leave the health care facility.

Alameda County healthcare providers should use the procedure described in the Update to request COVID-19 testing by our Public Health Lab (ACPHL). Please limit testing requests by phone to the hours 9am-5pm, 7 days per week.

For more information on testing specifics, please see the full ACPHD Health Advisory:

• COVID-19 ACPHD Health Advisory

March 06, 2020

Update

COVID-19 Testing Changes

Alameda County healthcare providers should direct COVID-19 testing to commercial laboratories and other non-public health laboratories now offering COVID-19 testing. Providers may determine which patients are suspect COVID-19 cases using clinical judgement but should alert Alameda County Public Health Department (ACPHD) regarding the priority cases listed below. ACPHD approval is no longer needed for testing.

Alameda County healthcare providers should use the procedure described in the Update to request COVID-19 testing by our Public Health Lab (ACPHL). Please limit testing requests by phone to the hours 9am-5pm, 7 days per week.

For more information on testing specifics, please see the full ACPHD Health Update:

• COVID-19 ACPHD Health Update

March 06, 2020

Advisory

COVID-19 Testing Recommended for Symptomatic Persons Who Were Aboard the Grand Princess Cruise

Cases of COVID-19 have been detected among persons on the Grand Princess Cruise that departed San Francisco February 11 and returned on February 21.

The Alameda County Public Health Department (ACPHD) is advising County residents who were aboard the Grand Princess Cruise who have been symptomatic with fever, new cough or difficulty breathing since the cruise to be tested for COVID-19 by their healthcare provider. Testing is recommended even if symptoms resolved. Commercial testing is now available for COVID-19 without ACPHD approval. General updated COVID-19 testing guidance will be posted shortly.

For more information, including Actions Requested of Clinicians, please see the full ACPHD Health Advisory:

• COVID-19 ACPHD Health Advisory

March 03, 2020

Update

COVID-19 Update and Interim Guidance

A presumptive case of COVID-19 was detected in an Alameda County resident who had contact to a case in another jurisdiction. The Alameda County Public Health Department (ACPHD) is taking appropriate action. Cases of COVID-19 without travel history or links to known cases have been reported in our region and across the United States. These cases of COVID-19 in the Bay Area indicate local community transmission, and warrant public health and healthcare providers in Alameda County to continue preparing for increasing numbers of identified cases and a surge of patients.

On February 27, the Centers for Disease Control and Prevention (CDC) released updated guidance for evaluating persons under investigation (PUI) for COVID-19. For more information, please see the full ACPHD Health Update:

• COVID-19 ACPHD Health Update

February 19, 2020

Update

Novel Coronavirus Disease (COVID-19)

The disease caused by the 2019 Novel Coronavirus (2019-nCoV) has now been officially named COVID-19 by the World Health Organization. No COVID-19 cases have been identified in Alameda County.

On February 12, the Centers for Disease Control and Prevention (CDC) released updated guidance for evaluating possible persons under investigation (PUI) for 2019-nCoV in the following categories:

• Severely ill patients for whom a known source of exposure has not been identified
• Persons with fever and lower respiratory tract symptoms and travel to China within 14 days that are being regularly monitored by local health departments or referred for evaluation from border screening

For more information, please see the full ACPHD Health Update:

• Novel Coronavirus Disease (COVID-19) ACPHD Health Update

February 05, 2020

Update

Novel Coronavirus (2019-nCoV)

The emerging 2019 Novel Coronavirus (2019-nCoV) is now circulating in mainland China and cases have been reported in the United States and other countries. On January 31st, the Centers for Disease Control and Prevention (CDC) released updated criteria for persons under investigation (PUI) for 2019-nCoV and the U.S. government declared a Public Health Emergency. The declaration included restrictions for travelers entering the country from China, effective February 3.

For more information, please see the full ACPHD Health Update:

• Novel Coronavirus (2019-nCoV) ACPHD Health Update
• CDC Update and Interim Guidance on Outbreak of 2019-nCoV (2/1/2020)
• CDC 2019-nCoV Flowchart (2/1/2020)

January 22, 2020

Alert

Novel Corona Virus 2019 – Wuhan Pneumonia Outbreak

The Centers for Disease Control and Prevention (CDC) issued a health update on January 17, 2020 about the 2019 Novel Coronavirus (2019-nCov). This CDC HAN Update provides a situational update and guidance that supersedes the January 8, 2020 HAN. It adds guidance for evaluation of patients under investigation (PUI) for 2019-nCoV, prevention and infection control guidance, including the addition of a recommendation for eye protection, and additional information on specimen collection and testing.

The first confirmed case of 2019-nCoV in the United States is a healthy male in his 30s in Washington State, who arrived at Seattle-Tacoma Airport on January 15, 2020 after traveling to Wuhan.

Local suspect cases should be reported immediately by phone to Public Health. Resources for providers, including travel alert posters and a checklist for clinicians managing patients who may have 2019-nCoV, are available online from the CDC.

Reporting

Alameda County Acute Communicable Disease Control:

• Weekdays 8:30am–5pm Phone: (510) 267-3250
• After hours Phone: (925) 422-7595 and ask for the public health duty officer on call.

Berkeley Public Health Division:

• Weekdays 8am-5pm Phone: (510) 981-5292
• After hours: Phone: (510) 981-5911 and ask for the Health Officer on call.

For more information, please see the full CDC Heatlh Update and Alameda County Guidance Checklist:

• Full CDC Health Update (1/17/20)
• Alameda County Guidance Checklist (1/22/20)
• CDPH All Facilities Update and Interim Guidance (1/23/20)

January 03, 2020

Advisory

Fentanyl Overdose

The increased availability of illicitly-produced fentanyl, fentanyl-compounds, and fake pills is an emerging and ongoing threat to public health and safety. In 2019, 51 opioid-related deaths were reported in Alameda County from January 1, 2019 to December 16, 2019.

Many fentanyl overdoses occur among persons who may be aware that they are using fentanyl or a related substance. However, there have been recent anecdotal reports in Alameda County of an increasing number of suspected fentanyl overdoses among persons without a history of opioid use, such as cocaine and methamphetamine users. Many persons who choose to use stimulants are unaware of the emergence of fentanyl laced compound drugs in the overall Bay Area drug supply, and the powerful potency of fentanyl. In addition, many opioid pills, which are made to look like real prescription medications, are now made by counterfeiting organizations and may contain fentanyl.

Death from fentanyl toxicity can be more rapid than from other opioids, and overdoses may require more naloxone for reversal than other opioids – prompt peer response is essential. In addition, there are concerns regarding the increase in synthetic opioid and fentanyl derivatives that may be longer-acting, and may not be detected in routine urine toxicology screens. This alert provides awareness and actions for all health care providers in Alameda County to take when presented with a suspected or confirmed opioid overdose case at their facility.

Please see the full Health Advisory for more information, including actions requested of clinicians.

• Full Health Advisory

December 03, 2019

Update

Congenital Syphilis (CS) Screening Guidelines for Pregnant Women

Syphilis rates are rising in Alameda County, across California, and throughout the country. Nationally, the rate of congenital syphilis has risen 40% in the last year alone, to a rate of 33 per 100,000 live births in 2018. California has the fifth-highest rate of congenital syphilis in the country, with 68 cases per 100,000 live births in 2018. In Alameda County in 2017, the rate of congenital syphilis was 26 per 100,000 live births. Healthcare providers treating pregnant women can prevent congenital syphilis by following CDC recommended screening and treatment guidelines for pregnant women living in communities with high syphilis prevalence.

Please see the full Health Update for more information, including actions requested of clinicians.

• Full Health Update

October 02, 2019

Advisory

Mandatory Flu Vaccination or Masking of Health Care Workers During Every Influenza Season (SUSPENDED 9/20/23)

Health Officers for Alameda County and the City of Berkeley are reminding health care providers and their employers regarding their joint Health Officer order (originally dated Aug. 28, 2013) (SUSPENDED 9/20/23) 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, wear a mask during every influenza season while working in patient care areas. Influenza season dates are defined as November 1 to April 30 of the following year. This order is ongoing and applies to each influenza season, unless rescinded or modified.

• Influenza FAQ (CDC, 2019)
• Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the ACIP – United States, 2019–20 Influenza Season (MMWR, 2019)