CDPH/Health Advisory - December 6, 2024 - The California Department of Public Health (CDPH) is issuing this Health Update to provide clinicians and local health departments updates on the avian influenza A(H5N1) current situation. Healthcare providers should consider avian influenza A in persons with acute respiratory symptoms and/or conjunctivitis and recent exposure in the last 10 days to animals suspected or confirmed to have avian influenza A or other recent exposure to raw milk or raw milk dairy products. If avian influenza A infection is suspected, providers should notify their local health department immediately. Additional information regarding specimen collection, testing, treatment, chemoprophylaxis and healthcare infection prevention and control is provided in this update.

Mycoplasma Pneumoniae Infections Among Children and Adolescents During Fall and Winter Respiratory Illness Season

First Case of Clade I Mpox Case Confirmed in California and the United States in a Returning Traveler

CDPH/Health Advisory - November 19, 2024 - On November 15, 2024, testing at the California Department of Public Health (CDPH) confirmed the first case of mpox infection from clade I monkeypox virus (MPXV) in the United States. The patient recently traveled from an affected country, where clade I MPXV is actively spreading. The patient has relatively mild illness and is recovering after seeking medical care for mpox symptoms. CDPH along with local health departments (LHD) and the U.S. Centers for Disease Control and Prevention (CDC) are investigating potential contacts to the patient; no additional cases have been detected to date. Historically, clade I has caused more severe illness than clade II, however, recent infections from clade I mpox may not be as clinically severe as in previous outbreaks, especially when cases have access to quality medical care. The overall risk of clade I mpox to the general population in California and the United States continues to be low. Health care providers are advised to follow infection prevention and control recommendations for all patients with mpox symptoms and have a heightened index of suspicion for clade I mpox in patients who present with signs and symptoms consistent with mpox and who report either: (1) recent international travel, or (2) sexual contact with someone who recently traveled internationally, particularly to Central or East Africa. If clade I mpox is suspected, providers should notify their LHD immediately and collect specimens for clade-specific testing; patients suspected to have mpox should be advised to isolate themselves from others. This California Health Advisory expands upon CDC Health Advisory 519 issued on November 18, 2024 and summarizes California specific guidance for mpox management.

First Case of Clade I Mpox Diagnosed in the United States

CDC/Health Advisory - November 18, 2024 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to provide information about the first case of clade I mpox diagnosed in the United States and recommendations to clinicians about preventing, diagnosing, treating, and reporting mpox cases. On November 15, 2024, the California Department of Public Health (CDPH) confirmed the first reported case of clade I mpox in the United States. This individual had recently traveled to areas experiencing clade I monkeypox virus (MPXV) transmission and sought medical care for mpox symptoms in the United States. Consistent with other recent clade I mpox cases, the patient has relatively mild illness and is recovering. CDC and the local and state health departments are investigating potential contacts; no additional cases in the United States have been detected as of November 18, 2024. The risk of clade I mpox to the public in the United States remains low. Since March 2024, CDC has been working with local, tribal, state, and territorial public health authorities to prepare for potential cases of clade I mpox in the United States by enhancing surveillance, detection, and reporting capacities of existing domestic public health systems and structures. This reported case demonstrates that these systems are working as intended. There is no change to CDC clinical or travel guidance on clade I mpox since HAN Health Update 516. Clinicians should be aware of mpox symptoms, ask patients with comparable signs and symptoms about recent travel history and other risk factors for mpox, and consider MPXV testing. Given the widespread outbreaks in Central and Eastern Africa, additional travel-associated cases may be reported in the future in the United States. Suspected and confirmed cases of clade I mpox should be reported to local, territorial, and state public health authorities as soon as possible. State, local, and territorial public health authorities should report cases to CDC promptly. This includes orthopoxvirus generic (i.e., non-variola orthopoxvirus) positive and clade II negative test results from a patient with travel history to country affected by clade I mpox. CDC recommends vaccination to people who are eligible for mpox vaccine, including those who may have a recent MPXV exposure.

California Department of Public Health (CDPH) Updates Syphilis Screening Recommendations

CDPH/Health Advisory - October 14, 2024 – The California Department of Public Health (CDPH) would like to share new and updated Syphilis Screening Recommendations in response to the rise in syphilis and congenital syphilis rates across California. These recommendations are applicable statewide, and inclusive of all of California, regardless of local case rates. In summary: 1) All sexually active persons 15-44 years old, regardless of gender identity or sexual orientation, should now be screened for syphilis at least once in their lifetime. Following the initial screen, CDPH recommends that syphilis screening be offered annually. 2) Syphilis testing should be included whenever a person of any age is tested for HIV or other sexually transmitted infections, including mpox. 3) All pregnant persons should now be screened for syphilis three times: i) at confirmation of pregnancy or first prenatal encounter, ii) early in the third trimester (at approximately 28 weeks gestation or as soon as possible thereafter), and iii) at delivery. 4) All persons 15-44 years old who enter a correctional facility should ideally be screened for syphilis, preferably at intake. 5) Emergency departments and hospital-affiliated urgent care clinics should screen all pregnant persons for syphilis prior to discharge if syphilis test results are not available for the current pregnancy. CDPH encourages healthcare providers to empirically treat for syphilis while awaiting confirmatory testing, if clinically indicated, among persons who have preliminary positive treponemal or non-treponemal test results –particularly if the likelihood of successful patient follow-up is uncertain.

First Marburg Virus Disease Outbreak in the Republic of Rwanda

Prevention Strategies for Mpox, including Vaccinating People at Risk via Sexual Exposure, for U.S. Travelers Visiting Countries with Clade I Mpox Outbreaks

CDPH/Health Advisory - September 4, 2024 - The California Department of Public Health (CDPH) is issuing this Health Advisory to notify clinicians and local health departments that avian influenza A(H5N1) has been confirmed in cows at three California dairies located in the Central Valley. Since March 2024, avian influenza A (H5N1) has been detected in multiple U.S. dairy herds. Since April 1, 2024, the Centers for Disease Control and Prevention (CDC) has confirmed four human influenza A(H5N1) infections among commercial dairy workers in other states, all of whom have had mild symptoms including conjunctivitis or respiratory symptoms. Healthcare providers should consider avian influenza A(H5N1) in persons with acute respiratory symptoms and/or conjunctivitis and recent exposure to animals suspected or confirmed to have avian influenza. If avian influenza infection is suspected, providers should notify their local health department immediately. Additional information regarding specimen collection, testing, and provider personal protective equipment (PPE) is provided in this update.

Increased Oropouche Virus Activity and Associated Risk to Travelers

CDC/Health Advisory- August 16, 2024 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and public health authorities of an increase in Oropouche virus disease in the Americas region, originating from endemic areas in the Amazon basin and new areas in South America and the Caribbean. Between January 1 and August 1, 2024, more than 8,000 cases of Oropouche virus disease were reported, including two deaths and five cases of vertical transmission associated with fetal death or congenital abnormalities. Countries reporting cases include Brazil, Bolivia, Peru, Colombia, and Cuba. In the United States and Europe in 2024, travel-associated cases have been identified in travelers returning from Cuba and Brazil. As testing and surveillance for Oropouche virus disease increase in the Americas, reports of cases from additional countries are expected. This Health Advisory advises on evaluating and testing travelers who have been in impacted areas with signs and symptoms consistent with Oropouche virus infection. It also raises awareness of the possible risk of vertical transmission (e.g., from gestational parent to fetus during pregnancy) and associated adverse effects on pregnancy and highlights prevention measures to mitigate additional spread of the virus and potential importation into unaffected areas, including the United States.

Increase in Human Parvovirus B19 Activity in the United States

CDC/Health Advisory- August 13, 2024 – The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify healthcare providers, public health authorities, and the public about current increases in human parvovirus B19 activity in the United States. Parvovirus B19 is a seasonal respiratory virus that is transmitted through respiratory droplets by people with symptomatic or asymptomatic infection. In the first quarter of 2024, public health authorities in 14 European countries observed unusually high numbers of cases of parvovirus B19. In the United States, there is no routine surveillance for parvovirus B19, and it is not a notifiable condition. Recently, CDC has received reports indicating increased parvovirus B19 activity in the United States. Data include increased test positivity for parvovirus B19 in clinical specimens and pooled plasma from a large commercial laboratory, and reports of clusters of parvovirus B19-associated complications among pregnant people and people with sickle cell disease. The proportion of people with IgM antibodies, an indicator of recent infection, increased among all ages from <3% during 2022–2024 to 10% in June 2024; the greatest increase was observed among children aged 5–9 years, from 15% during 2022–2024 to 40% in June 2024. Among plasma donors, the prevalence of pooled samples with parvovirus B19 DNA >104 IU/mL increased from 1.5% in December 2023 to 19.9% in June 2024.

Update on Clade I Mpox Geographical Spread in Africa: Recommendations for California Health Care Providers

CDPH/Health Update- August 12, 2024 - The California Department of Public Health (CDPH) Sexually Transmitted Diseases Control Branch is issuing this Health Update to notify clinicians and local health departments about the geographical spread of clade I mpox within Africa and recommendations for practice, diagnostic testing, and surveillance for mpox. Clade I mpox is associated with increased transmissibility and fatality rates compared to the currently circulating clade IIb mpox in the US. Healthcare providers are advised to have a heightened index of suspicion for clade I mpox in patients with recent travel to Africa and signs and symptoms consistent with mpox. If clade I mpox infection is suspected, providers should notify their local health department immediately to arrange clade-specific testing.

Rise in Extensively Drug-Resistant Shigella Strains-January to May 2024

CDPH/Health Advisory - August 9, 2024 - The California Department of Public Health (CDPH) is releasing this Health Advisory to alert healthcare providers and clinical laboratories of a rise in extensively drug-resistant (XDR) Shigella strains in California. From January to May 2024, 12% of California Shigella isolates have been identified as XDR based on whole genome sequencing and 75% of adult males with XDR Shigella isolates self-identified as men who have sex with men (MSM). Healthcare providers should tailor any shigellosis antibiotic treatment to available antimicrobial susceptibility testing (AST) data, and counsel patients at increased risk of infection on prevention and risk reduction practices. Clinical laboratories should perform complete antimicrobial susceptibility testing that includes azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole [TMP-SMX], and ampicillin, on available Shigella isolates as resources allow.

Mpox Caused by Human-to-Human Transmission of Monkeypox Virus in the Democratic Republic of the Congo with Spread to Neighboring Countries

CDC/Health Update - August 7, 2024 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to provide additional information about the outbreak of monkeypox virus (MPXV) in the Democratic Republic of the Congo (DRC); the first Health Advisory about this outbreak was released in December 2023. Since January 2023, the DRC has reported the largest number of yearly suspected clade I mpox cases on record. While clade I MPXV is endemic, or naturally occurring, in DRC, the current outbreak is more widespread than any previous DRC outbreak and has resulted in clade I mpox transmission to some neighboring countries. The Republic of the Congo (ROC), which borders DRC to the west, declared a clade I mpox outbreak in April 2024, and there have been confirmed cases in the Central African Republic (CAR). While clade I mpox is endemic in ROC and CAR, the epidemiologic pattern of recent cases suggests a possible link to DRC.

Disruptions in Availability of Becton Dickinson (BD) BACTEC™ Blood Culture Bottles

CDC/Health Advisory - July 23, 2024 - the Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform healthcare providers, laboratory professionals, healthcare facility administrators, and state, tribal, local, and territorial health departments of a critical shortage of Becton Dickinson (BD) BACTEC™ blood culture media bottles. This shortage has the potential to disrupt patient care by leading to delays in diagnosis, misdiagnosis, or other challenges in the clinical management of patients with certain infectious diseases. Healthcare providers, laboratory professionals, healthcare facility administrators, and state, tribal, local, and territorial health departments affected by this shortage should immediately begin to assess their situations and develop plans and options to mitigate the potential impact of the shortage on patient care.

Increased Risk of Dengue Virus Infections in the United States

CDC/Health Alert - June 25, 2024 - the Centers for Disease Control and Prevention (CDC) issued this Health Advisory to notify healthcare providers, public health authorities and the public of an increased risk of dengue virus (DENV) infections in the United States in 2024. Global incidence of dengue in 2024 has been the highest on record for this calendar year; many countries are reporting higher-than-usual dengue case numbers. In 2024, countries in the Americas have reported a record-breaking number of dengue cases, exceeding the highest number ever recorded in a single year. From January 1 – June 24, 2024, countries in the Americas reported more than 9.7 million dengue cases, twice as many as in all of 2023 (4.6 million cases). In the United States, Puerto Rico has declared a public health emergency (1,498 cases) and a higher-than-expected number of dengue cases have been identified among U.S. travelers (745 cases) from January 1– June24, 2024. In the setting of increased global and domestic incidence of dengue, healthcare providers should take additional steps.

Severe Acute Illness and Hospitalizations Linked to Diamond Shruumz ™ Chocolate Bars, Cones, and Gummies (microdose products)

CDPH/Health Alert - June 24, 2024 - CDPH, CDC, FDA, and Poison Control are investigating the Diamond ShruumzTM brand chocolate bars, cones, and gummies (all flavors and types). These products, known as microdose products, have been linked to severe acute illnesses and hospitalizations among consumers. As of June 17, 2024, the FDA has reported a total of 26 illnesses from 16 states including California. Twenty-five (25) of the 26 people have reported seeking medical care and 16 have been hospitalized. Health care providers should seek clinical advice from, and report suspected cases to, the California Poison Control System (1-800-222-1222). Providers should also consult the CDC Outbreak Summary for recommendations including diagnostic workup, testing and treatment. Patients/consumers should be advised not to eat, sell, or serve any flavor of Diamond Shruumz-brand Chocolate Bars, Cones, or Gummies. The marketing of these products may appeal to youth and young adults.

Reports of Rare, Severe Dermatophyte Infections Associated with Sexual Contact in the United States

CDPH/Health Advisory-June 19, 2024- The California Department of Public Health (CDPH) would like to inform health care providers that the first known United States (U.S.) case of sexually transmitted Trichophyton mentagrophytes genotype VII (TMVII) was reported in June 2024 in a patient who had recent travel to California. TMVII is a rare dermatophyte (e.g., ringworm or tinea) infection that causes highly inflammatory, painful, and persistent lesions, often affecting the anogenital or perioral areas, and may require weeks of oral antifungal treatment. Prior to this case, sexual transmission of TMVII had been reported in France, primarily among men who have sex with men (MSM), and among other persons in European countries returning from Southeast Asia who had engaged in sex tourism. Given the novelty of sexually transmitted dermatophyte infections and the potential for local spread in the United States, CDPH would like to inform clinicians of TMVII as a potential emerging public health concern and provide guidance on the clinical recognition, diagnosis, and treatment of patients who are suspected to have this infection.

Disrupted Access to Prescription Stimulant Medications Could Increase Risk of Injury and Overdose

CDC/Health Advisory-June 13, 2024- The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform public health officials, clinicians, and affected patients, their families, and caregivers about potential disrupted access to care among individuals taking prescription stimulant medications and possible increased risks for injury and overdose. On June 13, 2024, the U.S. Department of Justice announced a federal health care fraud indictment against a large subscription-based telehealth company that provides attention-deficit/hyperactivity disorder (ADHD) treatment to patients ages 18 years and older across the United States. Patients who rely on prescription stimulant medications to treat their ADHD and have been using this or other similar subscription-based telehealth platforms could experience a disruption to their treatment and disrupted access to care. A disruption involving this large telehealth company could impact as many as 30,000 to 50,000 patients ages 18 years and older across all 50 U.S. states. Patients whose care or access to prescription stimulant medications is disrupted, and who seek medication outside of the regulated healthcare system, might significantly increase their risk of overdose due to the prevalence of counterfeit pills (PDF) in the illegal drug market that could contain unexpected substances, including fentanyl. Given the national drug overdose crisis and threats associated with the illegal drug market, individuals struggling to access prescription stimulant medications are urged to avoid using medication obtained from anyone other than a licensed clinician and licensed pharmacy. Health officials and healthcare providers may need to assist affected patients seeking treatment for ADHD and should communicate overdose risks associated with the current illegal drug market as well as provide overdose prevention education and mental health support.

Severe Illness Potentially Associated with Consuming Diamond Shruumz(TM) Brand Chocolate Bars, Cones, and Gummies

CDC/Health Advisory-June 12, 2024 The Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), America’s Poison Centers, and state and local partners are investigating reports of severe acute illnesses potentially associated with consuming Diamond Shruumz(TM) brand chocolate bars, cones, and gummies marketed as containing a proprietary blend of mushroom. As of June 11, 2024, 12 total illnesses and 10 hospitalizations have been reported in eight U.S. states with ongoing efforts to identify other potential cases. The cause of the reported illnesses is not known at this time. Individuals should not eat, sell, or serve any flavors of Diamond Shruumz(TM) brand chocolate bars, cones, or gummies, and should discard products that have been purchased. CDC and FDA are working to determine whether other products from this company are associated with adverse health effects.

Influenza A Testing Guidance: Enhanced Surveillance During the Summer Months

CDPH/Health Update-June 12, 2024-In response to the global outbreak of influenza A (H5N1) in birds and recent infections in dairy cattle and humans in the United States, the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CPDH) are encouraging enhanced surveillance and continued testing for influenza this summer. Testing for influenza and subtyping all influenza A positives over the summer is key to maintaining visibility of the influenza A subtypes circulating in the community. Providers are also reminded regarding antiviral treatment and prophylaxis recommendations ( local public health departments.

Meningococcal Disease Cases Linked to Travel to the Kingdom of Saudi Arabia (KSA): Ensure Pilgrims are Current on Meningococcal Vaccination

CDC/Health Advisory–May 20, 2024–The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert healthcare providers to cases of meningococcal disease linked to Umrah travel to the Kingdom of Saudi Arabia (KSA). Umrah is an Islamic pilgrimage to Mecca, Kingdom of Saudi Arabia, that can be performed any time in the year; the Hajj is an annual Islamic pilgrimage this year taking place June 14–19, 2024. Since April 2024, 12 cases of meningococcal disease linked to KSA travel for Umrah have been reported to national public health agencies in the United States (5 cases), France (4 cases), and the United Kingdom (3 cases). Two cases were in children aged 18 and younger, four cases were in adults aged 1–44 years, four cases were in adults aged 45–64 years, and two cases were in adults 65 years or older. Ten cases were in patients who traveled to KSA, and two were in patients who had close contact with travelers to KSA. Ten cases were caused by Neisseria meningitidis serogroup W (NmW), one U.S. case was caused by serogroup C (NmC), and the serogroup is unknwon for one U.S. case. Of nine patients with known vaccination status, all were unvaccinated. The isolates from the one U.S. NmC case and two NmW cases (one U.S., one France) were resistant to ciprofloxacin; based on whole-genome sequencing, the remaning eight NmW isolates were all sensitive to penicillin and cirpofloxacin. Healthcare providers shuold also maintain increased suspicion for meningococcal disease in anyone presenting with symptoms of meningococcal disease after recent travel to KSA for Hajj or Umrah pilgrimage. U.S. health departments and healthcare providers should preferentially consider using rifampin, ceftriaxone, or azitrhomycin instead of profloxacin for chemoprophylaxis of close contacts of meningococcal disease cases associated with travel to KSA.

Adverse Effects Linked to Counterfeit or Mishandled Botulinum Toxin Injections

CDC/Health Advisory–April 23, 2024 – The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert clinicians about risks of counterfeit or mishandled botulinum toxin injections. CDC, the U.S. Food and Drug Administration (FDA), and state and local partners are investigating clusters of 22 people in 11 U.S. states reporting adverse effects after receiving injections with counterfeit botulinum toxin or injections administered by unlicensed or untrained individuals or in non-healthcare settings, such as homes or spas. Eleven patients were hospitalized and none have died. When botulinum toxin diffuses around the injection site, it can result in adverse effects. Botulism is the disease caused by botulinum toxin circulating in the blood and producing effects remotely from the injection site. There may be symptom overlap between the presentation of localized adverse effects from injection of botulinum toxin, especially in the head and neck, and the early symptoms of botulism. Information about the botulinum toxin injection (e.g., dose) can help distinguish between botulism and localized adverse effects but is challenging to obtain for counterfeit products. Clinicians and health departments should consider the possibility of adverse effects from botulinum toxin injections in patients presenting with localized paralysis. Clinicians should immediately contact their state, tribal, local, or territorial health department if they suspect botulism.

The California Department of Public Health is including this additional guidance specific to California:
The Centers for Disease Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and state and local partners are investigating 22 people from 11 states who report adverse effects after receiving injections with counterfeit botulinum toxin or injections administered by unlicensed or untrained individuals or in non-healthcare settings, such as homes or spas. The California Department of Public Health (CDPH) received reports of two California residents who are included in the investigation, one reported purchasing counterfeit “Botox” on the internet. Both patients received injections in non-health care settings.
Botulism is a medical emergency and requires immediate medical and public health response. Clinicians must immediately report any patients with suspected botulism to their local health department (LHD), and the LHD will notify the CDPH. CDPH staff are available 24/7 to provide technical consultation for botulism testing and to authorize botulism antitoxin (BAT) release in 60 of the 61 California LHDs; Los Angeles County (LAC) Department of Public Health authorizes the release of BAT for LAC residents hospitalized within their jurisdiction.

Fatality from Lead Poisoning Linked to Use of Hemorrhoid Ointment from Vietnam

CDPH/Health Advisory–April 9, 2024 – The California Department of Public Health is issuing this Health Advisory to notify health care providers, laboratories and public health departments that a woman in Sacramento developed severe lead poisoning and died in March 2024 after using a hemorrhoid ointment from Vietnam called, Cao Bôi Trĩ Cây Thầu Dầu. The woman purchased the product on Facebook and a relative in Vietnam shipped it to the U.S. Testing of the product found that it contained 4% lead (39,000 ppm), a highly dangerous amount of lead. If healthcare providers have patients that have used this hemorrhoid ointment, urge them to stop using it and order a venous blood lead level (BLL) test immediately. Contact California Poison Control at 1-800-222-1222 for clinical guidance on lead poisoning. See Health-Based Guidelines for BLL in Adults (PDF) for specific recommendations based on the patient's BLL results.

Highly Pathogenic Avian Influenza A(H5N1) Virus: Identification of Human Infection and Recommendations for Investigations and Response

CDC/Health Advisory – April 5, 2024 – The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians, state health departments, and the public of a recently confirmed human infection with highly pathogenic avian influenza (HPAI) A(H5N1) virus in the United States following exposure to presumably infected dairy cattle. The U.S. Department of Agriculture (USDA) recently reported detections of highly pathogenic avian influenza A(H5N1) virus in U.S. dairy cattle in multiple states. This Health Advisory also includes a summary of interim CDC recommendations for preventing, monitoring, and conducting public health investigations of potential human infections with HPAI A(H5N1) virus.

Increase in Invasive Serogroup Y Meningococcal Disease in the United States

CDC/Health Advisory – March 28, 2024 – The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert healthcare providers to an increase in invasive meningococcal disease, mainly attributable to Neisseria meningitidis serogroup Y (Figure). As of March 25, 2024, 143 cases have been reported to CDC for the current calendar year, an increase of 62 cases over the 81 reported as of this date in 2023. A specific meningococcal strain, sequence type (ST) 1466, is responsible for most (101 of 148, 68%) serogroup Y cases with available sequence type data that were reported across the United States in 2023. Cases caused by this strain are disproportionately occurring in people ages 30–60 years (65%), Black or African American people (63%), and people with HIV (15%). In addition, most cases of invasive meningococcal disease caused by ST-1466 in 2023 had a clinical presentation other than meningitis: 64% presented with bacteremia, and at least 4% presented with septic arthritis. Of 94 patients with known outcomes, 17 (18%) died; this case-fatality rate is higher than the historical case-fatality rate of 11% reported for serogroup Y cases in 2017–2021. Healthcare providers should 1) have a heightened suspicion for meningococcal disease, particularly among populations disproportionately affected by the current increase, 2) be aware that patients may present without symptoms typical of meningitis, and 3) ensure that all people recommended for meningococcal vaccination, including people with HIV, are up to date for meningococcal vaccines.

Increase in Global and Domestic Measles Cases and Outbreaks: Ensure Children in the United States and Those Traveling Internationally 6 Months and Older are Current on MMR Vaccination

CDC/Health Advisory – March 18, 2024 – The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and public health officials of an increase in global and U.S. measles cases and to provide guidance on measles prevention for all international travelers aged 6 months and older and all children aged 12 months and older who do not plan to travel internationally. Measles (rubeola) is highly contagious; one person infected with measles can infect 9 out of 10 unvaccinated individuals with whom they come in close contact. From January 1 to March 14, 2024, CDC has been notified of 58 confirmed U.S. cases of measles across 17 jurisdictions, including seven outbreaks in seven jurisdictions compared to 58 total cases and four outbreaks reported the entire year in 2023. Among the 58 cases reported in 2024, 54 (93%) were linked to international travel. Healthcare providers should ensure children are current on routine immunizations, including MMR. Given currently high population immunity against measles in most U.S. communities, the risk of widescale spread is low. However, pockets of low coverage leave some communities at higher risk for outbreaks.

Extension of Long-Acting Benzathine Penicillin G (Bicillin® L-A) Shortage

CDPH/Health Advisory – March 18, 2024 – The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) previously announced a long-acting benzathine penicillin G (Bicillin® L-A) shortage and estimated recovery of supplies in the second quarter of 2024. Unfortunately, the expected recovery time has now been extended to the fourth quarter of 2024. As such, CDPH is recommending the continued prioritization of Bicillin® L-A and Extencilline® for pregnant people with syphilis and certain infants exposed to syphilis in pregnancy. Furthermore, CDPH reminds providers that oral doxycycline is an appropriate alternative treatment for non-pregnant adults with primary, secondary, early/late latent syphilis and syphilis of unknown duration.

Immediate Respiratory Isolation Recommended for Persons with Suspected Measles

CDPH/Health Advisory – March 14, 2024 – The Centers for Disease Control and Prevention (CDC) is reporting an increase of measles in international travelers, resulting in at least 45 cases reported nationwide so far in 2024. Four cases have been reported in California, all of whom traveled overseas. CDPH recommends that healthcare providers suspect measles in patients with fevers, rash and any of the “3 Cs” (cough, coryza, or conjunctivitis) who have traveled internationally or interacted with international visitors in the last 3 weeks. In healthcare settings, to prevent spread if measles is suspected, isolate the patient immediately, in an airborne infection room (AIIR) if possible, and promptly telephone the local public health department to report suspected cases. Ensure that patients are up to date on measles vaccinations before traveling abroad.

Substantial Increase in Tuberculosis in California: Recommendations for California Healthcare Providers

CDPH/Health Advisory – February 26, 2024 – The California Department of Public Health (CDPH) is releasing this Health Advisory to inform healthcare providers about the recent increase in tuberculosis (TB) cases in California. CDPH encourages providers to consider tuberculosis in their differential diagnoses, to test persons with risk factors for tuberculosis, and to offer treatment to those with latent tuberculosis infection (LTBI) to prevent progression to active TB disease. Healthcare providers in California are required to report TB cases to their local public health department.

Fever and Rash? Consider Measles. Traveling Abroad? Protect against Measles.

CDPH/Health Advisory – February 2, 2024 – The California Department of Public Health (CDPH) reminds health care providers to consider measles in persons presenting with a febrile rash illness and other symptoms consistent with measles. Multiple measles cases have been confirmed in the United States in recent weeks, and have been linked to overseas travel, reflecting a global rise in measles cases. Airborne precautions should be immediately instituted to prevent nosocomial measles exposures, and patients should be up to date with measles vaccinations, especially if planning to travel abroad. Healthcare providers in California should report suspect measles cases to their local health department (LHD) by telephone, even before laboratory confirmation.

Substantial Rise in Coccidioidomycosis in California: Recommendations for California Healthcare Providers

CDPH/Health Advisory – January 18, 2024–The California Department of Health (CDPH) reminds healthcare providers to consider coccidioidomycosis in the differential diagnosis of community acquired pneumonia (CAP) or other respiratory illnesses in endemic or emerging areas. A total of 9280 cases of coccidioidomycosis (PDF) with illness onset dates in 2023 have been reported in California to date, which is higher than any other year on record, and is an increase that is likely to continue this winter due to heavy rainfall last winter after years of drought. Providers should maintain strong suspicion of pulmonary coccidioidomycosis in a patient with CAP who does not respond to an initial course of antibiotics, who has significant exposure to dust or dirt, or whose symptoms last more than 1–2 weeks. Negative serology in a patient with compatible symptoms may not rule out the diagnosis, and culture and polymerase chain reaction (PCR) test, if available, should be considered in patients with severe disease. Healthcare providers in California should report cases to their local public health department.

Update on COVID-19 Medications and Transition to Commercial Marketplace

CDPH/Health Advisory - December 18, 2023 - Once a high-risk individual is diagnosed with COVID-19, early treatment with antivirals is the best existing strategy to decrease the risk of serious illness and prevent hospitalization. All available COVID-19 oral antivirals have now transitioned to the commercial market after almost two years of being available free of charge through the US government, representing a significant change for patients and providers alike. This health alert will outline the broad changes in the transition, give several resources for more information, as well as how to obtain free or lower-cost medication for patients who qualify, and highlights the importance of continuing to offer and prescribe therapeutic agents for COVID-19 when appropriate.

Urgent Need to Increase Immunization Coverage for Influenza, COVID-19, and RSV Immunizations and Use of Authorized/Approved Therapeutics in the Setting of Increased Respiratory Disease Activity During the 2023 – 2024 Winter Season

CDC/Health Advisory - December 14, 2023-The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert healthcare providers to low vaccination rates against influenza, COVID-19, and RSV (respiratory syncytial virus). Low vaccination rates, coupled with ongoing increases in national and international respiratory disease activity caused by multiple pathogens, including influenza viruses, SARS-CoV-2 (the virus that causes COVID-19), and RSV, could lead to more severe disease and increased healthcare capacity strain in the coming weeks. Healthcare providers should administer influenza, COVID-19, and RSV immunizations now to patients, if recommended. Healthcare providers should recommend antiviral medications for influenza and COVID-19 for all eligible patients, especially patients at high-risk of progression to severe disease such as older adults and people with certain underlying medical conditions.

Clade I Mpox Virus with Geographic Spread in the Democratic Republic of the Congo: Recommendations for California Health Care Providers

CDPH/Health Advisory - December 11, 2023-The California Department of Public Health (CDPH) is issuing this California Health Alert Network (CAHAN) Health Advisory to notify clinicians and local health departments (LHD) about the occurrence, geographic spread, and sexually associated human-to-human transmission of Clade I Monkeypox virus (MPXV) in the Democratic Republic of the Congo (DRC). This is a more severe form of mpox with higher fatality rates than Clade IIb, which is currently circulating in the US. MPXV has two distinct genetic clades (subtypes), and cases of Clade I MPXV have not been reported in the United States at this time. However, clinicians should be aware of the possibility of Clade I MPXV in travelers or close contacts (including sexual contacts) of travelers who have been in DRC.

Clinicians should notify their LHD if they have a patient with mpox-like symptoms, which may include rash, sores, fever, and/or lymphadenopathy, in a traveler or close contacts (including sexual contacts) of travelers returning from the DRC. The CDPH VRDL offers MPXV testing that will discriminate between Clade I and Clade II. Healthcare providers are advised to contact their Local Health Department and CDPH VRDL to coordinate MPXV testing. Please refer to the VRDL Test page for mpox virus testing guidance at this link: Contact information for CDPH VRDL: (510) 307-8585 or VRDL.Submittal@cdph.ca.gov.

Severe and Fatal Confirmed Rocky Mountain Spotted Fever among People with Recent Travel to Tecate, Mexico

CDC/Health Advisory– December 8, 2023-The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify healthcare providers and the public about an outbreak of Rocky Mountain spotted fever (RMSF) among people in the United States with recent travel to or residence in the city of Tecate, state of Baja California, Mexico. RMSF is a severe, rapidly progressive, and often deadly disease transmitted by the bite of infected ticks, although many patients do not recall being bitten by a tick. Doxycycline is the treatment of choice for patients of all ages. Healthcare providers should consider RMSF in their differential diagnosis of patients who have reported recent travel to Tecate, Mexico, or other areas of northern Mexico and subsequently develop signs or symptoms of an unexplained severe febrile illness. Consider initiating doxycycline based on presumptive clinical and epidemiologic findings, and do not delay treatment pending the result of a confirmatory laboratory test. Early treatment with doxycycline saves lives. Healthcare providers in California should report cases to their local public health department.

Mpox Caused by Human-to-Human Transmission of Monkeypox Virus with Geographic Spread in the Democratic Republic of the Congo

CDC/Health Advisory– December 7, 2023-The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and health departments about the occurrence, geographic spread, and sexually associated human-to-human transmission of Clade I Monkeypox virus (MPXV) in the Democratic Republic of the Congo (DRC). MPXV has two distinct genetic clades (subtypes), and cases of Clade I MPXV have not been reported in the United States at this time (a clade is a broad grouping of viruses that has evolved over decades and is a genetic and clinically distinct group). However, clinicians should be aware of the possibility of Clade I MPXV in travelers who have been in DRC. Clinicians should notify their state health department if they have a patient with mpox-like symptoms, which may include a diffuse rash and lymphadenopathy, and recent travel to DRC. Clinicians should also submit lesion specimens for clade-specific testing for these patients.

High Blood Lead Levels in Children Consuming Recalled Cinnamon Applesauce Pouches

CDC/Health Advisory– November 13, 2023-Multiple states have reported potential cases to the U.S. Food and Drug Administration (FDA) of high blood lead levels (BLLs) in children consuming recalled cinnamon-containing applesauce products that have high levels of lead. The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to advise clinicians and health departments to consider the possibility of illness due to lead exposure and report cases to their local health authorities.

Increase in Mpox Cases in California: Updates on Identification, Laboratory Testing, Management and Treatment, and Vaccination for Mpox

CDPH/Health Advisory– October 30, 2023-The California Department of Public Health (CDPH) is releasing this Health Advisory to inform healthcare providers about the recent increases in mpox cases. CDPH encourages providers to consider mpox in their differential diagnoses, to test persons with suspected mpox, to treat mpox, and to offer vaccines to populations at increased risk to prevent severe mpox disease and reduce the number of new infections.

Dengue in California

CDPH/Health Advisory– October 30, 2023 - The California Department of Public Health (CDPH) is releasing this Health Advisory to alert healthcare providers that the first locally acquired case of dengue in California was detected in a Pasadena resident; no other locally acquired dengue cases have been identified in California. To date, local vector control agency surveys have not identified dengue-infected mosquitoes in Los Angeles County. Healthcare professionals should report any dengue virus infection to their local public health department within one working day from identification.

Early Respiratory Syncytial Virus (RSV) Activity and Use of RSV Prevention Products

CDPH/Health Advisory– October 27, 2023 - The California Department of Public Health (CDPH) is releasing this Health Advisory to bring awareness to the October 23, 2023 Centers for Disease Control and Prevention (CDC) issued Health Alert Network (HAN) Health Advisory which provides options and prioritization guidance for clinicians to protect infants from respiratory syncytial virus (RSV) in the context of a limited supply of nirsevimab, a long-acting monoclonal antibody immunization product recommended for preventing RSV-associated lower respiratory tract disease in infants. Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia in infants and a cause of severe disease in older adults.

Limited Availability of Nirsevimab in the United States—Interim CDC Recommendations to Protect Infants from Respiratory Syncytial Virus (RSV) during the 2023–2024 Respiratory Virus Season

CDC/Health Advisory– October 23, 2023 -The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to provide options for clinicians to protect infants from respiratory syncytial virus (RSV) in the context of a limited supply of nirsevimab, a long-acting monoclonal antibody immunization product recommended for preventing RSV-associated lower respiratory tract disease in infants.

Preparation for Respiratory Virus Season (COVID-19, Influenza and RSV)

CDPH/Health Advisory– October 10, 2023 - The California Department of Health (CDPH) is releasing this Health Advisory to provide guidance to healthcare providers who are planning for and responding to an anticipated surge in illnesses due to respiratory viruses, particularly in response to recent rises in SARS-CoV-2 transmission and anticipated seasonal rises in other respiratory pathogens. While local influenza and RSV transmission remain low at this time, and SARS-CoV-2 hospitalizations may be plateauing, seasonal activity of those viruses is expected to increase in the coming weeks to months.

Severe Vibrio vulnificus Infections in the United States Associated with Warming Coastal Waters

CDC/Health Advisory– September 1, 2023 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify healthcare providers, laboratories and public health departments about recent reports of fatal Vibrio vulnificus (V. vulnificus) infections including wound and foodborne infections. Healthcare professionals are urged to consider V. vulnificus as a possible cause of infected wounds that were exposed to coastal waters, particularly near the Gulf of Mexico or East Coast, and during periods with warmer coastal sea surface temperatures. Healthcare providers in California should report cases to their local public health department.

Important Updates on Locally Acquired Malaria Cases Identified in Florida, Texas and Maryland

CDC/Health Update– August 28, 2023 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update to share new information with clinicians, public health authorities, and the public about locally acquired malaria cases identified in the United States. On August 18, 2023, a single case of locally acquired malaria was reported in Maryland in the National Capital Region. This case was caused by the Plasmodium falciparum (P. falciparum) species and is unrelated to the cases involving local transmission of Plasmodium vivax (P. vivax) malaria in Florida and Texas described in the HAN Health Advisory 494 issued on June 26, 2023. As an update to that report, to date, Florida has identified seven cases and Texas has identified one case of locally acquired P. vivax malaria, but there have been no reports of local transmission of malaria in Florida or Texas since mid-July 2023.

Outbreak of Aeromonas Skin Infections Associated with an Adventure Race, Sonoma, California

CDPH/Health Advisory – August 28, 2023 - The Sonoma Department of Health Services (SDHS) and California Department of Public Health (CDPH) are investigating an Aeromonas outbreak linked to Tough Mudder adventure race events at the Sonoma Raceway on August 19 and 20, 2023. Numerous race participants have experienced skin and soft tissue infections (SSTIs, most frequently described as a pustular rash), along with other symptoms such as fever and headache. Healthcare providers should ask patients presenting with SSTIs about whether they participated in a Tough Mudder race at the Sonoma Raceway and should report cases to their local public health department.

Listeria Associated with Soft Serve Ice Cream distributed to Long-term Care Facilities

CDPH/Health Advisory – August 15, 2023 - In response to the U.S Food and Safety Administration recall announcement, the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH) are encouraging healthcare providers to remain vigilant for possible Listeria infections. On August 9, Real Kosher Ice Cream recalled all flavors of their “Soft Serve On The Go” ice cream cups. Recalled ice cream cups were distributed nationwide to multiple long-term care facilities. There has been one sick person in this outbreak that was served this ice cream cup while residing in a long-term care facility. California long term care facilities and healthcare providers should contact their local health department immediately if they identify a case in a resident of a long-term care facility or if there are multiple suspected cases.

Global Epidemic Comes to California: Silicosis in Countertop Workers

CDPH/Health Advisory – June 25, 2023 - Since 2010, more than 1,000 cases of silicosis in workers who fabricate countertops have been reported worldwide. Workers in this industry can inhale crystalline silica dust as they cut and finish countertops, which places them at risk for silicosis, a severe, incurable lung disease. In California, more than 70 cases of silicosis and at least 10 deaths have been identified among countertop fabrication workers. Workers with silicosis are characterized as young (median age of 45), immigrant men; many have experienced delayed diagnoses and accelerated disease course. California health care providers should ask patients about their occupation and suspect silicosis in countertop workers. To report cases to CDPH, call 1-800-970-6680 or email silicosis@cdph.ca.gov.

Wildfire Smoke Exposure Poses Threat to At-Risk Populations

CDC/Health Advisory – June 30, 2023 – The Centers for Disease Control and Prevention (CDC) is reminding healthcare professionals seeing patients affected by wildfire smoke to be alert to the possible adverse effects of smoke exposure, particularly among individuals at higher risk of severe outcomes. The acute signs and symptoms of smoke exposure can include headache, eye and mucous membrane irritation, dyspnea (trouble breathing), cough, wheezing, chest pain, palpitations and fatigue. Wildfire smoke exposure may exacerbate respiratory, metabolic, and cardiovascular chronic conditions like asthma, chronic obstructive pulmonary disease (COPD) and congestive heart failure.

Updates on Identification, Laboratory Testing, Management and Treatment, and Vaccination for Mpox Virus Infection in California
CDPH/Health Advisory - April 4, 2023 - The California Deparment of Public Health (CDPH) are alerting healthcare providers of the need to identify and test, including testing for HIV and STDs in people with mpox. This advisory includes information on management, treatment, vaccination and updates to information and recommendations about severe mpox, including recent CDC interim clinical treatment considerations for severe mpox.

CDC/Health Advisory - December 22, 2022 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to notify clinicians and public health authorities of a recent increase in pediatric invasive group A streptococcal (iGAS) infections, the increased seasonal risk of iGAS disease for all age groups, and the importance of early recognition, diagnosis, and appropriate treatment of these diseases in children and adults.

CDC/Health Update - December 20, 2022 - This Health Alert Network (HAN) Health Update provides health care professionals, public health officials, and the public with guidance on improving use of therapeutics for treatment of COVID-19 and strategies to prevent serious outcomes of COVID-19.

Interim Guidance for Clinicians to Prioritize Antiviral Treatment of Influenza in the Setting of Reduced Availability of Oseltamivir

CDC/Health Advisory - December 14, 2022 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to provide clinicians and public health officials with guidance for prioritizing oseltamivir for treatment and information on other influenza antivirals that are recommended for treating influenza in areas where oseltamivir is temporarily unavailable.

Evaluating and Managing Travelers Returning from Ebola Outbreak Areas with Infectious Disease Symptoms

CDPH/Health Advisory - December 13, 2022 - This alert provides updated information for California healthcare providers in the evaluation and management of patients suspected of having Ebola virus disease (EVD).

Updated Reminder to Lower Barriers to Prescribing COVID-19 Therapeutics to Mitigate Impact of COVID-19
CDPH/Health Advisory - December 2, 2022 - Once an individual is diagnosed with COVID-19, early treatment with COVID-19-specific agents is the only existing strategy to markedly decrease risk of serious illness.

CDC/Health Alert - November 17, 2022 - Monkeypox cases have declined since mid-August 2022 in the United States; however, new cases—including clinically severe cases—continue to occur.

CDPH/Health Alert - November 12, 2022 - As RSV and other respiratory virus activity continues to evolve and new evidence emerges, California Department of Public Health (CDPH) will collaborate with local health departments to assess and provide additional updates as they become available.

CDPH/Health Alert - November 8, 2022 - On October 27, 2022, the Centers for Disease Control and Prevention (CDC) issued a call for cases through the Epidemic Information Exchange (Epi-X), for a multistate cluster of VIM-producing carbapenem-resistant Pseudomonas aeruginosa (VIM-CRPA) under investigation with state and local public health departments.

Update on Ebola Virus Disease (Sudan ebolavirus) Outbreak in Central Uganda

CDC/Health Alert - November 7, 2022 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Update as a follow-up to a HAN Health Advisory (Outbreak of Ebola virus disease (Sudan ebolavirus) in Central Uganda) issued on October 6, 2022.

Increased Respiratory Virus Activity, Especially Among Children, Early in the 2022-2023 Fall and Winter

CDC/Health Alert - November 4, 2022 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory about early, elevated respiratory disease incidence caused by multiple viruses occurring especially among children and placing strain on healthcare systems.

Outbreaks of Nontuberculous Mycobacteria Infections Highlight Importance of Maintaining and Monitoring Dental Waterlines

CDC/Health Alert - October 31, 2022 -The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to emphasize the importance of following existing recommendations for maintaining and monitoring dental waterlines.

CDPH/Health Alert - October 7, 2022 - The California Department of Public Health (CDPH), in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), has been closely monitoring an outbreak of Ebola virus disease (EVD) due to Sudan virus (species Sudan ebolavirus) in Central Uganda.

CDPH/Healthcare Provider Advisory - October 6, 2022 - This Health Advisory outlines that health care providers (HCP) are required to report cases of Coronavirus disease 2019 (COVID-19) pursuant to provisions of title 17, California Code of Regulations sections 2500.

CDC/Health Alert - October 6, 2022 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory about a recently confirmed outbreak of Ebola virus disease (EVD) in Uganda caused by Sudan virus (species Sudan ebolavirus) to summarize CDC’s recommendations for U.S. public health departments and clinicians, case identification and testing, and clinical laboratory biosafety considerations.

Guidance for Safe Specimen Collection From Monkeypox (MPX) Lesions: Reminder to NOT De-roof Lesions and NOT Use Sharps

CDPH/Healthcare Provider Advisory - October 5, 2022 - This Advisory reminds California healthcare providers of Centers for Disease Control and Prevention (CDC) recommendations to reduce risk of MPX virus transmission to healthcare personnel (HCP) during collection of specimens from lesions for laboratory diagnosis of MPX.

Early Respiratory Syncytial Virus Activity and Use of Palivizumab
CDPH/Health Advisory - October 3, 2022 - Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia in infants and a cause of severe disease in adults older than age 65 years.

Hurricanes Fiona and Ian—Clinical Guidance for Carbon Monoxide (CO) Poisoning
CDC/Health Alert - October 3, 2022 - The Centers for Disease Control and Prevention (CDC) is reminding healthcare professionals seeing patients from areas affected by Hurricanes Fiona or Ian to maintain a high index of suspicion for carbon monoxide (CO) poisoning.

Severe Manifestations of Monkeypox among People who are Immunocompromised Due to HIV or Other Conditions (PDF)
CDC/Health Alert - September 29, 2022 - Since May 2022, more than 25,000 monkeypox cases have been identified in the United States.

CDPH/Health Advisory - September 28, 2022 - The California Department of Public Health (CDPH) has updated several state public health officer orders to align with the most current Centers for Disease Control and Prevention (CDC) recommendations that screening testing is no longer recommended in general community settings.

CDPH/Health Alert - September 22, 2022 - Fentanyl (an extremely potent and dangerous synthetic opioid) continues to be a major contributor to drug overdoses in California, including among youth.

Vigilance for Acute Flaccid Myelitis (AFM) Warranted - Recent Detections of Enterovirus D68 and Poliovirus in the United States

CDPH Health Advisory - September 15, 2022 - The California Department of Public Health (CDPH) requests healthcare providers and local health departments to be vigilant for acute flaccid myelitis (AFM), which typically presents with sudden limb weakness in children that can lead to permanent paralysis.

Healthcare Provider Health Advisory: Updated Guidance on Laboratory Testing of Pediatric Patients for MPX Virus Infection in California

CDPH Health Advisory - September 9, 2022 - This alert provides updated information for California healthcare providers with regard to testing of pediatric patients for MPX.

Severe Respiratory Illnesses Associated with Rhinoviruses and/or Enteroviruses Including EV-D68 –Multistate, 2022

CDC/Health Alert - September 9, 2022 - Healthcare providers and hospitals in several regions of the United States notified the Centers for Disease Control and Prevention (CDC) during August 2022 about increases in pediatric hospitalizations in patients with severe respiratory illness who also tested positive for rhinovirus (RV) and/or enterovirus (EV).

Title 17 Revisions, Section 2500 of the California Code of Regulations

CDPH/Health Alert - September 6, 2022 - The California Department of Public Health, in consultation with the California Conference of Local Health Officers, recently updated Title 17 section 2500 of the California Code of Regulations.

Candida auris in Nevada State Healthcare Facilities September 2022

CDPH/Health Advisory - September 6, 2022 - CDPH and local public health partners are alerting healthcare providers of the continued identification of Candida auris (C. auris) cases in Southern California, and the emergence of C. auris cases linked to hospitals and skilled nursing facilities (SNF) in Southern Nevada since August 2021.

CDPH/Health Advisory - August 31, 2022 - This alert provides updated information for California healthcare providers for testing of suspected MPX cases and treatment of suspected, probable, and confirmed MPX cases at risk for severe outcomes.

CDPH/Health Advisory - August 31, 2022 - The California Department of Public Health was notified by the California State Warning Center that California has now entered Phase II of the State Contingency Plan for Excessive Heat Emergencies.

CDC/Health Alert - July 29, 2022 - The Centers for Disease Control and Prevention (CDC) and state and local public health partners are reporting 5,189 cases of Monkeypox virus infections in the United States across 47 states, Washington, D.C., and Puerto Rico.

CDC/Health Alert - July 28, 2022 - The Centers for Disease Control and Prevention (CDC) and state and local public health partners are reporting 4,907 cases of monkeypox in the United States across 46 states, Washington, D.C., and Puerto Rico.

Melioidosis Locally Endemic in Areas of the Mississippi Gulf Coast after Burkholderia pseudomallei Isolated in Soil and Water and Linked to Two Cases – Mississippi, 2020 and 2022 (PDF)

CDC/Health Alert - July 27, 2022 - The Centers for Disease Control and Prevention (CDC) identified the bacterium Burkholderia pseudomallei (B. pseudomallei) for the first time in the environment in the continental United States.

CDC/Health Alert - July 12, 2022 - The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and public health departments that parechovirus (PeV) is currently circulating in the United States.

CDPH/Health Advisory - June 23, 2022 - The California Department of Public Health (CDPH) continues to work with local health departments (LHDs) and California healthcare providers on the ongoing monkeypox situation impacting the United States and other countries not usually endemic for monkeypox.

Updated Case-finding Guidance: Monkeypox Outbreak—United States, 2022

CDC/Health Alert - June 14, 2022 - This Health Alert Network (HAN) Health Update serves to alert clinicians to clinical presentations of monkeypox seen so far in the United States and to provide updated and expanded case definitions intended to encourage testing for monkeypox among persons presenting for care with relevant history, signs, and symptoms.

Health Update on Recurrence of COVID-19 Symptoms After Treatment with Paxlovid (nirmatrelvir/ritonavir)

CDPH/Health Advisory - May 27, 2022 - The California Department of Public Health (CDPH) continues to work with local health departments (LHDs) and California healthcare providers on the ongoing domestic monkeypox situation.

Monkeypox Virus Infection in the United States and Other Non-endemic Countries- Enhancing Surveillance in California as of May 20, 2022

CDPH/Health Advisory - May 20, 2022 - The California Department of Public Health (CDPH) is issuing this advisory to supplement the information contained in the Health Alert issued by the U.S. Centers for Disease Control and Prevention(CDC) to provide additional guidance to California local health jurisdictions (LHJs) and health care providers.

Seasonal Influenza Activity is Increasing in California May 17, 2022

CDPH/Health Advisory - May 17, 2022 - CDPH is notifying health care providers that seasonal influenza activity is gradually increasing, with elevated activity in Central California.

CDPH/Health Advisory - May 13, 2022 - The impacts of the ongoing pandemic and the recent 2022 Abbott recall of certain powdered infant formula has led to periodic location- and product-based shortages of major brands of infant formula.

Individuals with Chronic Conditions in California Disproportionately Impacted by COVID-19

CDPH/Health Alert December 11, 2020 - The California Department of Public Health (CDPH) is issuing this health alert for healthcare providers, local health departments, and hospitals for individuals with chronic conditions. ​​​​​​​​​​​​​