Health Alerts

The list below provides information gathered from press releases and other public notices about certain recalls of FDA-regulated products that affect Alameda County residents.


ALERT conveys the highest level of importance; warrants immediate action or attention.
ADVISORY provides important information for a specific incident or situation; may not require immediate action.
UPDATE provides updated information regarding an incident or situation; unlikely to require immediate action.

October 29, 2014 Health Advisory

Ebola Virus Disease

West Africa continues to experience the largest known outbreak of Ebola Virus Disease, with high case fatality rates, in three countries: Liberia, Guinea and Sierra Leone. Spread of Ebola was contained in Nigeria, and it has been declared Ebola-free by the World Health Organization. A small number of Ebola cases continue to be diagnosed in travelers returning from West Africa to the United States, and two cases of Ebola were diagnosed in health care workers who cared for a patient with Ebola while he was critically ill in Texas. To date, other persons with a known exposure to confirmed cases in the US have not developed Ebola. As of 10/11/14, CDC is screening all travelers coming into the US from the three impacted countries, and notifying local health departments in their final destination of their arrival.  Alameda County Public Health Department (ACPHD) is actively monitoring travelers arriving from these 3 countries with widespread Ebola transmission, including health care workers, for 21 days after date of departure from West Africa. All healthcare providers, including those in primary care and other outpatient settings, should be prepared to identify and temporarily isolate a patient presenting with fever and recent travel from one of the Ebola-affected areas. Early recognition and appropriate infection control precautions continue to be critical for disease control.

October 8, 2014 Health Advisory

Ebola Virus Disease

The first case of Ebola Virus Disease (Ebola) diagnosed in the United States (US) was confirmed by the Centers for Disease Control and Prevention (CDC) on 9/30/14 and occurred in a traveler from Liberia to Dallas, Texas. The patient fell ill on 9/24/2014, sought medical care at a Dallas hospital on 9/26/14 and was released despite a reported history of recent travel to Liberia. On 9/28/14, he returned to the same hospital and was admitted for treatment. The CDC issued a Health Advisory on 10/2/14 to advise clinicians to identify, isolate, and immediately report suspected Ebola cases to their local health department.  Early recognition and appropriate infection control precautions are critical for disease control.
October 1, 2014 Health Advisory

Enterovirus D68 (EV-D68) Respiratory Illness & Acute Flaccid Paralysis Surveillance

As of September 30, 2014, 472 cases of EV-D68 have been confirmed in 41 states, including seven cases in California: six in southern California residents, and one case has been identified in northern California.  In addition, the Centers for Disease Control & Prevention (CDC) are investigating a cluster of pediatric patients hospitalized with acute flaccid paralysis and spinal cord lesions in Colorado; the possible linkage of these to the respiratory illness outbreak is still under investigation.  Some of the Colorado cases with neurologic illness had respiratory specimens test positive for EV-D68.
August 19, 2014 Update

Ebola Virus and West Nile Virus Update

There is currently a large outbreak of Ebola Virus Disease (EVD) in the West African countries of Guinea, Sierra Leone, Liberia, and most recently, Nigeria. As of August 19, the World Health Organization has reported a cumulative total of 2240 suspect and confirmed cases and 1229 deaths. CDC has advised travelers to avoid all non-essential travel to Guinea, Sierra Leone, and Liberia, and has issued a lower level alert for Nigeria.  As of August 19, 2014, there are no EVD cases acquired in the United States. While the risk of importation of Ebola into the United States is considered to be very low, Alameda County Public Health Department (ACPHD) is working with the California Department of Public Health (CDPH) to prepare in the event that a returning traveler from these countries develops illness that may be concerning for EVD. Early identification of such cases and prompt infection control implementation will be key components to containment and prevention of spread.

As of August 13, 2014, Alameda County reported 51 dead birds and 10 mosquito pools positive for West Nile Virus (WNV); this is an unusually high number and  already higher than all prior years. Mosquito Abatement has undertaken precautions to treat mosquitoes in areas where activity is highest in Livermore. There are currently no reported symptomatic cases of human WNV in Alameda County this year, and there are 57 reported human cases in CA from 36 jurisdictions.

June 10, 2014 Update

Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV)

The CDC had previously reported on May 17, 2014 that an individual from Illinois who had extended face-to-face contact with the Indiana case had become infected with MERS CoV but had no symptoms. After further laboratory testing on May 28, the CDC announced that they have now concluded that the Illinois resident was not infected with MERS CoV

May 22, 2014 Advisory

Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV)

As of May 2, 2014, the CDC confirmed that the first case of Middle Eastern Respiratory Syndrome Coronavirus (MERS CoV) has been reported in a US citizen in Indiana. On May 11 a second case was confirmed in Florida. The cases are unrelated. Both were healthcare workers who had returned from the Middle East. On May 16, 2014 the first domestic secondary case was reported in Indiana. This case was exposed to the first case and remains asymptomatic, but lab testing indicates exposure and immune response to MERS-CoV. The CDPH and CDC have provided guidelines for healthcare providers.

March 28, 2014 Advisory

Measles Cases in Alameda County and California

As of March 28, 49 confirmed cases of measles have been reported to the California Department of Public Health (CDPH) with onsets since January 1, 2014; an additional case is reported today by Alameda County. This is a higher number of cases than expected early in the year; from 2008-2013, 8 to 31 confirmed measles cases were reported annually. Most cases have involved contact with international visitors or unimmunized Californians who got measles after travelling in the Philippines, Europe, Asia, Africa, or India. It is more important than ever for children and adults to make sure that they are either immune or have been vaccinated. Alameda County Public Health Department has been actively involved in case and contact investigation and disease control activities.

February 19, 2014 Advisory

Measles Cases in Alameda County and California

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

January 17, 2014 Advisory

Influenza Activity in Alameda County

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

January 6, 2014 Advisory

FDA expects temporary shortage of liquid oseltamivir

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

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

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

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

September 4, 2013

Update

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

August 28, 2013

Advisory

Mandatory Influenza Vaccination or Masking or Health Care Workers During Every Influenza Season
Alameda County Health Officer has updated the joint order with the Berkeley Health Officer mandating that all licensed health care facilities in Alameda County and the City of Berkeley require their health care workers (HCWs) to receive an annual influenza vaccination or, if they decline, to wear a mask during the influenza season while working in patient care areas.

August 27, 2013

Advisory

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

June 7, 2013

Advisory

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

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

June 3, 2013

Update

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

May 1, 2013

Update

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

April 9, 2013

Update

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

February 4, 2013

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

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

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

January 25, 2013

Advisory Nationwide Shortage of Isonizaid (INH)
There is currently a nationwide shortage of INH, one of the most important drugs to treat tuberculosis (TB) disease and latent TB infection (LTBI). The low inventory is attributed to a shortage of the active ingredient for making INH and shipping delays.
December 14, 2012 Advisory

Meningococcal Vaccine Recommendations for Men Who Have Sex with Men

Meningococcal Disease is a severe infection caused by the bateria Neisseria meningitidis. It can cause either meningococcal meningitis or meningococcemia (septic infection). If it is untreated, it leads to death in 50% of people who catch it. Even with early diagnosis it causes death in 5-15% of the people who become ill. Neisseria meningitidis is spread through contact with the saliva, phlegm, or other fluids from the nose or mouth of an infected person. Close contact includes: kissing, sneezing or coughing on someone, living in a crowded space together (e.g. in a dormitory), sharing food, drinking from the same cup, eating with the same utensils, sharing a cigarette or pipe.

Currently there is an outbreak of meningococcal disease happening in NY among men who have sex with men. These cases are all the same serogroup -C. There was 1 case in August 2010, 4 cases in 2011, and 11 cases in 2012. 9 have been HIV+. These men have contacted each other online, using phone apps, and at parties and bars. This type of meningococcal disease is vaccine preventable. At this time, persons who wish to reduce their risk of meningococcal disease, including MSM, may choose to receive meningococcal vaccine, which can be safely administered to HIV-infected persons.

 

October 4, 2012

Advisory Meningitis and Stroke Associated with Potentially Contaminated Product
The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are coordinating a multi-state investigation of fungal meningitis among patients who received an epidural steroid injection. Several of these patients also suffered strokes that are believed to have resulted from their infection.

October 1, 2012

Advisory Mandatory Influenza Vaccination or Masking of Health Care Workers During Influenza Season
Alameda County Health Officer is issuing a joint order with Berkeley Health Officer mandating that all licensed health care facilities in Alameda County and the City of Berkeley require their health care workers (HCWs) to receive an annual influenza vaccination or, if they decline, to wear a mask during the influenza season while working in patient care areas. Facilities with a documented 90 percent or greater HCW influenza vaccination rate are exempt from the masking requirement.

September 5, 2012

Alert Hantavirus Guidance for Physicians with Patients Presenting with Concerns or Symptoms of Hantavirus Pulmonary Syndrome After Visit to Yosemite National Park
The California Department of Public Health is collaborating with the Centers for Disease Control (CDC) and the National Park Service to investigate the outbreak of hantavirus in recent visitors to Yosemite National Park. CDPH issued this more detailed health alert and guidance for physicians that supports and builds on the previous ACPHD health alert.

August 31, 2012

Update Hantavirus Cardiopulmonary Syndrome in California
The California Department of Public Health has reported six confirmed cases of Hantavirus Cardiopulmonary Syndrome (HCPS) in visitors who stayed in Yosemite National Park from early June to mid-July 2012. Clinicians are asked to educate patients that HCPS is a rare disease that is prevented by avoiding contact with rodents and excreta. Clinicians may consider testing for HCPS in patients with fever, severe pulmonary disease and a history of contact with rodents in rural areas. Suspected HCPS cases should be reported to Alameda County Public Health Department at 510-267-3250.

May 6, 2012

Advisory Hot Summer Weather Advisory
The summer season with its potential for fluctuating high temperatures is approaching. Health care facilities are reminded that the elderly and other health compromised individuals are more susceptible to extremes in temperature and dehydration.

January 25, 2012

Advisory NOVEL H3N2 INFLUENZA VIRUS: INCREASED SURVEILLANCE
California Department of Public Health (CDPH) is requesting increased surveillance and testing for influenza in children less than 18 years of age. Since July 2011, a novel swine-origin triple reassortant H3N2 influenza virus (S-OtrH3N2) has been reported in 5 states with a total of 12 cases. California has no cases but heightened surveillance is being requested.

October 5, 2011

Alert Healthcare Providers: Mumps Health Alert
Alameda County has 4 confirmed and 3 probable cases of Mumps that are epidemiologically linked. Individuals are at increased risk for mumps if they are unvaccinated. Mumps should be considered in the differential diagnosis even in fully immunized individuals.

August 18, 2011

Advisory Pediatric Health Providers: Fatal Vaccine-Preventable Pneumococcal Disease
Immunize all children younger than 5 years of age who have not yet received 13-valent pneumococcal conjugate vaccine.

May 20, 2011

Advisory FDA Warns Not to Feed SimplyThick to Premature Infants
Do not feed the thickening product called SimplyThick to infants born before 37 weeks because it may cause a life-threatening condition.

May 3, 2011

Advisory Measles
Since January 2011, 11 cases of measles have been reported in California. A nationwide increase in the numbers of reported measles cases has also been noted this year. As in recent years, nearly all of the cases are known to have involved recent travel to Europe or Asia, or contact with international travelers (including via transit through U.S. international airports). Some of the cases have been intentionally unvaccinated children.

May 19, 2010

Alert Mercury Poisoning Linked to Face Cream
The California Department of Public Health (CDPH) issued a Health Alert May 19, 2010 notifying persons who may be using unlabeled, nonprescription face creams from Mexico for the purpose of skin lightening, fading freckles and age spots, and preventing acne that these products contain very high levels of mercury, are harmful to your health, and should not be used.
February 23, 2010
Alert Measles Health Alert
Four cases of measles have been diagnosed in the San Francisco Bay Area in the past two weeks. Two cases occurred in two unvaccinated toddlers who traveled to Europe and Asia; one case in an older adult who traveled to Europe; and the fourth case was an unvaccinated adult with no travel history.
July 23, 2009
Alert Novel H1N1 Flu
July 20, 2009
Alert Novel H1N1 Flu
September 20, 2008
Update Rabies Vaccine Supply Shortage
August 29, 2008
Update Rabies Vaccine Supply Shortage
August 26, 2008
Alert Rabies Vaccine Supply Shortage
The Centers for Disease Control & Prevention has strongly recommended that health care providers, state and local health authorities, and animal control officials take immediate steps to ensure the appropriate use of human rabies vaccine due to a national rabies vaccine shortage.
July 10-11, 2008 Advisory Heat Advisory
The National Weather Service has issued a heat advisory for the San Francisco Bay Area that remains in effect until 8 p.m. Friday, July 11.
July 8-10, 2008 Advisory Health Advisory, Red Flag Warning, Spare the Air
The National Weather Service has issued a heat advisory for the San Francisco Bay Area and a red flag warning for the North and East Bay hills that remain in effect noon today, July 8, until 5 p.m. Thursday, July 10.

The Bay Area Air Quality Management District has a spare the air notice for the same period.

June 25-27, 2008 Advisory Air Quality Health Advisory
Bay Area Air Quality Management District Issues Health Advisory
May, June 2008
Update Salmonella Outbreak Update
New cases of Salmonella linked to certain types of tomatoes have been reported to CDPH.
May 16, 2008 Advisory Heat Advisory
The National Weather Service's heat advisory for the San Francisco Bay Area remains in effect noon to 8 p.m. today, May 16.

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