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As of August 19, the World Health Organization has reported a cumulative total of suspect and confirmed cases and 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. Early identification of such cases and prompt infection control implementation will be key components to containment and prevention of spread.

As of August 13, , 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.

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, 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. This is a higher number of cases than expected early in the year; from , 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. Statewide flu activity has been upgraded to "widespread. Since its emergence in 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.

Vaccination and good hygiene and infection control practices remain the best prevention strategies. 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.

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 or 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 mg capsules to make a liquid form of the drug.

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

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. 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. 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 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.

Dates of illness onset range from February 19 to April 27, Very limited person-to-person transmission or epidemiologic link between a few of the cases has been identified. 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. Meningococcal Disease is a severe infection caused by the bateria Neisseria meningitidis.

It can cause either meningococcal meningitis or meningococcemia septic infection. Neisseria meningitidis is spread through contact with the saliva, phlegm, or other fluids from the nose or mouth of an infected person. 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 , 4 cases in , and 11 cases in 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. Categories Alameda Health System. 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. UPDATE provides updated information regarding an incident or situation; unlikely to require immediate action.

Persons currently experiencing homelessness Persons using illicit drugs Men who have sex with men Persons with chronic liver disease Persons traveling to or working in countries where hepatitis A is common If inventory permits, also consider vaccinating persons with close contact to individuals in high risk groups listed above as well as anyone seeking protection from hepatitis A disease. Prevention Bay Area residents impacted by wildfire smoke are advised to: Stay aware of health warnings related to smoke.

Close windows and doors. Set air conditioning units and car vent systems on re-circulate to avoid drawing in outside air. Bay Area Air Quality District: Actions Requested of Clinicans: This includes those who provide personal care, food service, janitorial, maintenance, or sanitation services to these populations. Serologic testing for HAV immunity is not recommended prior to vaccination. Hepatitis A Prevention by Immunization Hepatitis A Vaccine While two doses of Hepatitis A vaccine separated by 6 months are recommended for full disease protection, high levels of protection are reached from just one dose.

CRE are easily spread between infected or colonized patients by health care workers and equipment, unless rigorous infection prevention precautions are taken. This has been attributed to a new strain of Norovirus that has been circulating in Europe and Asia since last year and is now in the US and CA. Infection spreads quickly in settings where people are in close contact with each other, such as cruise ships, health care facilities, daycare centers, schools and summer camps.

The most important steps to prevent the spread of Norovirus in schools are to ensure that: Ill persons stay home while sick and for another 48 hours after symptoms go away.

Everyone regularly washes hands especially after using the bathroom and before eating. Contaminated and frequently-touched objects and surfaces are thoroughly and frequently cleaned with an approved disinfectant, as Norovirus can survive for many days on surfaces.

No cases of botulism from this outbreak have been reported in Alameda County residents, but Alameda County residents who consumed prepared food at the Valley Oak Food and Fuel gas station in Walnut Grove until May 6 may still develop symptoms.

Providers are asked to consider botulism in patients with compatible neurological symptoms and to report suspected cases immediately to the Alameda County Health Department. Areas with Active Mosquito-Borne Zika Transmission For information on areas of the world, including parts of the United States, with active Zika virus transmission, please refer to http: Six of the cases are known to be caused by serogroup C and one additional case is awaiting serogroup identification.

This represents a substantial increase above the typical number of reported cases. Persons with HIV infection are known to be at risk of Meningococcal disease and vaccines are urged for adult gay and bisexual men at risk, and for all people with HIV. This advisory provides background information and Meningococcal vaccine recommendations to help clinicians safely address the current Meningococcal disease outbreak.

Benzathine penicillin G is the recommended treatment for syphilis and the only recommended treatment for pregnant women infected with or exposed to syphilis. Other formulations of penicillin, including Bicillin C-R, are not acceptable alternatives to Bicillin L-A for syphilis treatment.

The manufacturer estimates the Bicillin L-A shortage will last until at least July, This advisory provides recommended actions and resources to help clinicians safely address the current Bicillin L-A drug shortage. Instead of acetaminophen and hydrocodone, these counterfeit drugs actually contained an undetermined amount of fentanyl, a powerful synthetic opiate analgesic. CDPH is requesting that all health care facilities report suspected and confirmed fentanyl overdoses to local health departments to assess the magnitude and outcomes of this situation in California.

This alert provides awareness and actions for all health care providers in Alameda County to take when presented with a suspected or confirmed opioid overdose case at their facility.

Clinical illness is now defined as having one or more of the following signs or symptoms: The CDC updated its interim guidance for prevention of sexual transmission and preconception counseling recommendations for Zika virus. Zika Virus symptoms within two weeks of exposure Asymptomatic pregnant women Infants born to a mother with a potential Zika virus exposure Patients with Guillain-Barre Syndrome Potential Zika virus exposure is defined as a travel to areas with active Zika Virus transmission in the 2 weeks before symptoms onset; or b condomless sexual contact with a male partner who traveled to an area of active Zika virus transmission and had symptoms of Zika disease during travel or within 2 weeks of return.

Zika Virus Infection Among U. CDPH guidance to clinicians for diagnosis and reporting of chikungunya and dengue infections CDC clinical comparison of chikungunya and dengue infections and testing guidance September 2, Advisory Measles in a UC Berkeley Student One laboratory-confirmed case of measles has been identified in a UC Berkeley student. Liberia was declared free from Ebola virus transmission by the World Health Organization on May 9, Effective June 17, , the CDC changed its monitoring procedure for Liberian travelers from public health active monitoring to traveler self monitoring.

Travelers from Liberia will continue to be screened in the 5 east coast airports they must pass through to enter the US. Alameda County is no longer actively monitoring travelers from Liberia. Should conduct thorough histories that include: Should assess travel history for any possible infectious disease exposures e. Should use clinical judgment to evaluate patients based on those histories and their symptoms. Should implement infection control measures as appropriate to travel history and clinical presentation.

Follow standard protocols for patient care e. Should continue to report suspect cases of any potential high risk infectious disease to Alameda County Public Health Department Acute Communicable Disease at Risk factors for CRE colonization or infection include open wounds, presence of indwelling devices including endotracheal tubes, multiple co-morbidities, and high antimicrobial use.

Long-term acute care LTAC hospitals have the greatest prevalence of patients with CRE-colonization or infection as a result of receiving and caring for patients who have many CRE risk factors and a history of lengthy hospitalizations.

Multiple clusters and outbreaks of CRE have been increasingly recognized in recent years in Northern California acute and long-term care facilities, including facilities in Alameda County.

CRE are highly transmissible in healthcare settings and both infected and colonized patients can serve as reservoirs for transmission. Early recognition and prompt implementation of infection control precautions are critical to control the spread of CRE in our region.

The State of California has confirmed 33 recent cases. An outbreak of measles from exposures associated with visits to Disney theme parks in December th, has resulted in 28 cases throughout California, including in Alameda County.

Five additional cases have no identified common exposures with the outbreak. Cases involve both children and adults, ages 7 months to 59 years old, including 15 unimmunized individuals.

A small number of cases were previously immunized. Outbreaks in California typically involve infected international visitors or unimmunized persons traveling overseas in areas where large measles outbreaks are occurring, followed by local spread.

All Alameda County residents should ensure they are immune or have been vaccinated against measles Think of measles in patients with a fever and rash, especially with a history of travel or exposure to returning travelers or measles patients. Early recognition and appropriate infection control precautions are critical for disease control. Some of the Colorado cases with neurologic illness had respiratory specimens test positive for EV-D Actions Requested of Clinicians February 4, Advisory Doxycycline and Tetracycline Shortage On February 4, 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.

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 STD Treatment Guidelines or visit this CDC site for updates.

The low inventory is attributed to a shortage of the active ingredient for making INH and shipping delays. New York City Advisory. Alameda County Public Health Department. High Levels of Pertussis in Alameda County Pertussis, also known as whooping cough, is a contagious disease affecting the lungs. Influenza Testing, Treatment and Vaccination The California Department of Public Health has issued a clinical advisory to direct clinicians about national influenza testing and treatment recommendations.

Unhealthy Air Quality Due to Wildfires Information is evolving rapidly; please check website resources listed for most current information. Increased Norovirus Activity in School Settings Alameda County and California are experiencing an unusually large proportion of reported gastrointestinal illness outbreaks among students and staff in school settings.

Foodborne Botulism Outbreak From mid-April through May 16, , 10 cases of foodborne botulism have been reported to Sacramento, San Joaquin, Colusa and Solano county public health departments. Meningococcal Outbreak in Southern California Since May , nine confirmed cases of Meningococcal disease, including one death, have been reported in men living in Southern California, most of who were men who have sex with men MSM.

Fentanyl-Contaminated Street Norco - April 8, CDPH guidance to clinicians for diagnosis and reporting of chikungunya and dengue infections CDC clinical comparison of chikungunya and dengue infections and testing guidance.

City of Berkeley Public Health Alert. Marin County Public Health Alert. Ebola Virus Disease The ongoing Ebola epidemic in West Africa that started last year is the largest in history, and continues to affect the countries of Guinea and Sierra Leone. Carbapenem-Resistant Enterobacteriaceae CRE Carbapenem-Resistant Enterobacteriaceae CRE are untreatable or difficult to treat multidrug-resistant organisms that have developed high levels of resistance to carbapenems, a class of antibiotics that includes doripenem, ertapenem, imipenem and meropenem.

Ebola Virus Disease West Africa continues to experience the largest known outbreak of Ebola Virus Disease, with high case fatality rates, in three countries: Influenza Activity in Alameda County Statewide flu activity has been upgraded to "widespread.

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.

Actions Requested of Clinicians. Ibas of Edessa d. The work is part of a series of drawings, preliminary sketches and completed works in pastels and oils by Degas from this period that depict women bathing. The drawing was made on several pieces of paper mounted on cardboard.

Degas may have started with a smaller composition which he extended as he worked, requiring more paper. The painting is now in the National Gallery in London. Wikipedia is hosted by the Wikimedia Foundation , a non-profit organization that also hosts a range of other projects:. This Wikipedia is written in English. Many other Wikipedias are available; some of the largest are listed below. From Wikipedia, the free encyclopedia. Welcome to Wikipedia ,. Mascarene parrot Taapaca Yugoslav torpedo boat T5.

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Today's featured picture After the Bath, Woman Drying Herself is a pastel drawing by Edgar Degas , made at some point between and Black-headed lapwing The Hunting of the Snark A road. Archive More featured pictures. Other areas of Wikipedia Community portal — Bulletin board, projects, resources and activities covering a wide range of Wikipedia areas. Help desk — Ask questions about using Wikipedia. Local embassy — For Wikipedia-related communication in languages other than English.

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