Advisory

November 30, 2021

Advisory

Increasing Influenza A (H3N2) Activity

On November 24, 2021, The Centers for Disease Control and Prevention (CDC) issued a Health Alert Network (HAN) Health Advisory about increased influenza A(H3N2) activity that could mark the beginning of the 2021-2022 influenza season. The purpose of this HAN Health Advisory is to:

1. Remind public health practitioners and clinicians to recommend and offer the current seasonal influenza vaccine to all eligible persons aged six months and older (Flu vaccine and COVID-19 vaccine can be given at the same visit).
2. Remind clinicians to consider testing for both influenza virus and SARS-CoV-2 in patients with influenza-like illness (ILI).
3. Advise clinicians that antiviral treatment is recommended as early as possible for any patient with confirmed or suspected influenza who is: a) hospitalized; b) at higher risk for influenza complications; or c) developing progressive illness. In patients with suspected influenza, decisions about starting antiviral treatment should not wait for laboratory confirmation of influenza, however COVID-19 should be excluded if a rapid assay is available.
4. Remind public health practitioners and clinicians to consider mitigation measures including antiviral post-exposure prophylaxis during influenza outbreaks in institutions (e.g., long-term care facilities, university dormitories) in the setting of co-circulation of SARS-CoV-2.
5. Remind the public to use non-pharmaceutical interventions (NPI) or everyday preventive actions, in addition to getting a flu vaccine. Everyday preventive actions include staying home when sick, covering coughs and sneezes, and washing hands often.

Please review the full health advisory for detailed recommendations on testing, treatment, post-exposure prophylaxis, public education and additional resources for clinicians.

November 29, 2021

Advisory

Legionella Amidst Reopening of Businesses & School Facilities

Legionella bacteria are aerobic, gram negative, intracellular pathogens found in water and soil, generally in small numbers insufficient to cause disease.

Legionellosis refers to any clinical syndrome associated with Legionella infection, and can present as Pontiac fever, which is an acute, self-limited febrile illness as well as the more severe Legionnaire’s disease which refers to pneumonia. Even during outbreaks, only a minority of people develop disease, and associated risk factors include age>50, smoking history, and underlying medical conditions such as chronic lung disease, cardiovascular disease, kidney or liver failure, diabetes, malignancy, and immune system disorders. More recently, there have also been increasing cases of Legionella co-infections in patients diagnosed with COVID-19.

Please see the full health advisory for a situation update and action requested of clinicians.

November 22, 2021

Advisory

COVID-19 Vaccine Booster Eligibility

On Friday, November 19^th, the CDC expanded COVID-19 vaccine booster eligibility to all adults. This aligns with CDPH’s letter released on November 9^th, which emphasizes that no one seeking a booster dose should be turned away if:

• The patient is 18 or over AND has met the 6-month original vaccination series time period for the Moderna or Pfizer vaccine OR it has been at least 2 months since their J&J vaccine

It is recommended that healthcare providers proactively outreach to all patients who are eligible for a booster with information about their eligibility, locations for receiving booster doses, and instructions for how to make an appointment/walk-in. In addition, providers should not miss any opportunity to vaccinate the unvaccinated or provide boosters, by offering vaccine during routine or nonroutine visits to medical offices, clinics, pharmacies, and hospitals.

For more information about helping patients choose the appropriate booster type, please see the CDC’s Interim Clinical Considerations. For information about providing booster doses to those patients who received their primary series with a vaccine not authorized in the U.S. OR as part of a clinical trial, please see the CDC’s Emergency Use Instructions.

October 04, 2021

Advisory

COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes

The Centers for Disease Control and Prevention (CDC) recommends urgent action to increase COVID-19 vaccination among people who are pregnant, recently pregnant (including those who are lactating), who are trying to become pregnant now, or who might become pregnant in the future. CDC strongly recommends COVID-19 vaccination either before or during pregnancy because the benefits of vaccination outweigh known or potential risks.

In addition to the risks of severe illness and death for pregnant and recently pregnant people, there is an increased risk for adverse pregnancy and neonatal outcomes, including preterm birth and admission of their neonate(s) to an intensive care unit (ICU). Other adverse pregnancy outcomes, such as stillbirth, have been reported.

• ACPHD Health Advisory
• CDC Health Advisory

September 29, 2021

Advisory

Respiratory Syncytial Virus and Influenza Activity and Guidance for Clinicians

Respiratory syncytial virus (RSV) and other respiratory viruses besides SARS-CoV-2 are circulating in California causing potentially serious illnesses in infants and older adults. Testing for influenza and RSV is recommended, and testing for other respiratory pathogens should be considered, especially in patients with respiratory illnesses who test negative for SARS-CoV-2. Continue to vaccinate patients 6 months and older against influenza. Influenza vaccine and COVID-19 can be co-administered. Encourage parents and caregivers to keep young children with acute respiratory illnesses out of childcare, even if they have tested negative for SARS-CoV-2. Discourage health care personnel, childcare providers, and staff of long-term care facilities from working while acutely ill, even if they have tested negative for SARS-CoV-2.

• CDPH Health Advisory

September 28, 2021

Advisory

Increases in Availability of Cannabis Products Containing Delta-8 THC

On September 14, 2021, the CDC issued a health advisory notice in response to the increase in availability of enhanced delta-8 tetrahydrocannabinol (THC) cannabis products and the rise of serious adverse health events (e.g., vomiting, hallucinations, and loss of consciousness) that occurred after ingesting the enhanced delta-8 THC products. While delta-8 THC naturally contains less THC, the chemical property responsible for creating the “high” feeling that consumers experience when ingesting traditional delta-9 THC products, delta-8 THC products are now being synthetically enhanced or altered by some manufacturers to contain higher levels of THC.

Recently, these practices have led to serious adverse health events, including among pediatric patients younger than 18 years old. These products have not been approved by the FDA. Retailers/consumers are advised to research delta-8 products thoroughly before selling and/or consuming them.

Additional information about the delta-8 and the serious adverse health events can be found below:

• CDC Health Advisory
• FDA 5 Things to Know about Delta-8 THC

September 21, 2021

Advisory

Maintain Vigilance for Vaccine Preventable Diseases

Due to the need for evacuation, individuals from Afghanistan are being resettled in the United States including California. The Alameda County Public Health Department (ACPHD) asks clinicians caring for this vulnerable community to remain vigilant for signs and symptoms of measles, polio, and other vaccine-preventable diseases such as mumps, varicella and pertussis among persons recently resettled from Afghanistan. Clinicians are urged to contact the local health department to report suspected cases of these vaccine-preventable diseases.

See advisory for additional details, guidance, and recommendations.

• ACPHD Health Advisory
• Guidance for Clinicians Caring for Individuals Recently Evacuated from Afghanistan (CDC Health Advisory)y

September 15, 2021

Advisory

Health Recommendations for Asylees and Refugees

After recent evacuation, individuals from Afghanistan are being resettled in the United States. The California Department of Public Health (CDPH) asks that clinicians remain vigilant for signs and symptoms of measles, polio, and other vaccine-preventable diseases such as mumps, varicella and pertussis among persons in California who were recently in Afghanistan. Clinicians are urged to contact their local health department to report suspected cases of these vaccine-preventable diseases.

• Health Screening Guidelines for Physicians Who Serve Asylees (CDPH)
• Health Recommendations and Considerations for Arrivals from Afghanistan (US Department of Health and Human Services)

August 31, 2021

Advisory

Recent State Orders and All Facilities Letter

The California Department of Public Health (CDPH) has recently released multiple Health Officer Orders and new/revised All Facility Letters. Please be familiar with the requirements for your facility, staff and patients.

July 20, 2021

Advisory

Guillain-Barré Syndrome after J & J COVID-19 Vaccine

On July 13, 2021, the FDA announced an update to the Johnson & Johnson (J&J) COVID-19 vaccine EUA fact sheet to include a warning about Guillain-Barré syndrome (GBS). Based on an analysis of Vaccine Adverse Event Reporting (VAERS) data, there have been 100 preliminary reports of GBS following vaccination with the J & J vaccine. These cases have largely been reported about two weeks after vaccination and mostly in males, many aged 50 years and older.   

Clinicians should inquire about recent J & J COVID-19 vaccination in any patient presenting with signs or symptoms consistent with GBS (i.e. weakness or tingling sensations, especially in the legs or arms, that are worsening and spreading to other parts of the body; difficulty walking or with facial movements, including speaking, chewing or swallowing; double vision or inability to move the eyes; difficulty with bladder control or bowel function).

July 08, 2021

Advisory

Excessive Heat Warning for the Bay Area

The National Weather Service has posted an excessive heat warning and temperatures in parts of Alameda County are expected to exceed 100 degrees Fahrenheit this weekend. Providers are encouraged to remind their clients to stay hydrated and stay indoors, if possible, and monitor for warning signs of health-related illness.

• Heat and Health webpage

July 06, 2021

Advisory

Multistate Investigation of Non-travel Associated Burkholderia pseudomallei Infections (Melioidosis)

On June 30, 2021, the Centers for Disease Control and Prevention (CDC) issued a health advisory to notify clinicians and caregivers that they, the Kansas Department of Health and Environment, the Texas Department of State Health Services, and the Minnesota Department of Health are investigating three cases of Burkholderia pseudomallei (melioidosis) infections. Symptoms of melioidosis are varied and nonspecific and may include pneumonia, abscess formation, and/or blood infections. Due to its nonspecific symptoms, melioidosis can initially be mistaken for other diseases such as tuberculosis, and proper treatment may be delayed.