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Alert: Conveys the highest level of importance; warrants immediate action or attention.

Advisory: Provides important information for specific incident or situation; may not require immediate action.

Update: Provides updated information regarding an incident or situation; unlikely to require immediate action.

Health Alerts

The San Francisco Department of Public Health sends out Health Alerts, Advisories, and Updates regarding communicable disease outbreaks, immunization updates, and emerging infectious diseases to San Francisco clinicians.

 

Clinicians can sign-up or submit updated contact information to receive Health Alerts. All contact information is kept confidential.

 

Click for disease reporting numbers, lab forms, and legally reportable diseases.

 

 

Health Alerts, Advisories, and Updates

 

Date_of_Alert_

__Urgency__

Subject

12-04-2014 Update

Influenza 2014-15 Health Update New!

12-04-2014 Advisory

CDC Health Advisory Regarding the Potential for Circulation of Drifted Influenza A (H3N2) Viruses New!

12-04-2014 Advisory

CDC Health Advisory: Fatal Gastrointestinal Mucormycosis in an Infant Following Ingestion of Contaminated Dietary Supplement – Connecticut, 2014 New!

11-25-2014 Advisory

Updated: Recognizing and Handling Suspect Ebola Cases

10-27-2014 Advisory

Recognizing and Handling Suspect Ebola Cases in Outpatient Settings

10-21-2014 Update

CDC Guidance for Personal Protective Equipment for Hospitals

10-03-2014 Advisory

SFDPH and CDC Ebola Virus Disease Health Advisory Update

10-03-2014 Advisory

Enterovirus-D68 and Acute Flaccid Paralysis Health Advisory

09-25-2014 Advisory

CDC Health Advisory: Acute Neurologic Illness with Focal Weakness of Unknown Etiology in Children

09-24-2014 Advisory

Enterovirus D68 Interim Recommendations for Evaluation, Laboratory Submission, & Infection Control

09-18-2014  

CDPH Press Release: Confirmed 4 enterovirus D68 cases in patients in San Diego and Ventura counties  

09-10-2014 Update

CDC's information concerning Enterovirus D68

08-13-2014

Update

CDC's comprehensive information for healthcare providers concerning Ebola Virus Disease

08-06-2014 Advisory

Ebola Virus Disease Health Advisory

08-01-2014 Advisory

CDC Health Alert concerning Ebola virus. 

CDC Infection Prevention and Control Recommendations for Ebola Hemorrhagic Fever in U.S. Hospitals 

07-08-2014 Update

Pertussis Health Update 

05-07-2014 Advisory

Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Interim Recommendations for Evaluation, Infection Control, & Laboratory Submission  (updated on 5/20/14)

As of June 12, 2014, the CDC has updated its Interim Guidance for testing for MERS-CoV. Testing criteria have been liberalized for individuals who have been in a healthcare facility in or near the Arabian Peninsula in which healthcare-associated MERS cases have been identified. Click here to learn more about updated testing guidance.


Please contact the San Francisco Department of Public Health, Communicable Disease Control Unit at (415) 554-2830 to discuss MERS testing.

04-04-2014 Advisory

Los Angeles County Reports Invasive Meningococcal Disease Among Men Who Have Sex with Men; Recommendations for San Francisco

04-02-2014 Advisory

CDPH Measles Health Advisory

02-19-2014

Update 

Measles Health Update  

Measles Quick Guide for Physicians

02-14-2014

Update

Potential Measles Exposure on BART: Health Update and Quick Guide

01-08-2014

Update

FDA Announced a Brief Temporary Shortage of Liquid form of influenza drug oseltamivir (Tamiflu), other formulations still available 

This brief temporary shortage only affects the oral suspension formulation intended for small children and others who can't swallow capsules. It is expected to last from early to mid January according to the FDA.  The company expects to have more of the product in mid-January. Oseltamivir remains available in capsules at all three doses (30, 45, and 75 milligrams). 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. For more information go to the FDA shortages page covering oseltamivir. 

01-08-2014

Advisory 

Health Advisory: Influenza Update

12-24-2013

 

SFDPH Press Release: Hepatitis A in Food Handler in San Francisco

12-17-2013

Advisory

Health Advisory: Wound Botulism in SF Injection Drug Users 

11-27-2013

Advisory

Health Advisory: Serogroup B Meningococcal Disease Associated with Outbreaks at Princeton University and the University of California at Santa Barbara 

11-07-2013

Advisory

Influenza Health Advisory 

09-20-2013

Advisory

Meningococcal Disease Advisory

09-13-2013

Alert

Nationwide Tubersol Shortage

08-30-2013

 

SFDPH Press Release: Statement regarding E. coli cases in San Francisco

08-28-2013

Alert

E Coli 0157 Health Alert

08-23-2013

Advisory

Updated Influenza A H7N9 Testing

08-15-2013

Update

CDC Health Update on MERS-CoV

Updated guidance from CDC states that: 1) testing for MERS-CoV and other respiratory pathogens can be done simultaneously; 2) positive results for another respiratory pathogen should not preclude testing for MERS-CoV; and 3) clusters of patients with severe, unexplained respiratory illness should be considered for MERS-CoV testing.  Read the full text of the August 12, 2013 update.

06-11-2013

Update

CDC Health Update (HAN)

CDC has updated several MERS-CoV evaluation and lab specimen recommendations: 1) the incubation period has been extended to 14 days; 2) the clinical presentation may not initially include respiratory symptoms; 3) co-morbid conditions and immunosuppression may increase risk for infection and/or severe disease; and 4) lower respiratory tract specimens are the highest priority specimens to collect. Read the full text of the June 7, 2013 update.

06-05-2013

Advisory

Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Interim Recommendations for Evaluation, Infection Control, & Laboratory Submission

06-03-2013 

 

SFDPH Press Release: Multi-State Outbreak of Hepatitis A Associated with a Frozen Berry Food Product

05-31-2013 

 Alert

Multi-State Outbreak of Hepatitis A Associated with a Frozen Berry Food Product

05-24-2013 

Update

Product Recall: Methylprednisolone Acetate Compounded by Main Street Family Pharmacy, Tennessee

FDA recommended on May 24, 2013 that clinicians not administer any products labeled as sterile from the Main Street Family Pharmacy, LLC of Newbern, TN. FDA states that 7 adverse events were reported in 2 states (IL and NC) among patients who developed skin and soft tissue infections following IM administration of preservative-free methylprednisolone acetate (MPA) 80 mg/mL in 10 mL vials.  For more information, read the FDA News Release.

California Department of Public Health (CDPH) states that 2 clinics in CA are known to have received the recalled products (neither of which is located in San Francisco), and recommends that in evaluating infections possibly linked to contaminated injectable products, diagnostic specimens should be sent for bacterial, mycobacterial, and fungal cultures, and if possible, also for histopathology. Any positive culture or specimen should be retained and the local health department informed.

In light of this and other product recalls due to contamination of injectable products shipped by compounding pharmacies, SFDPH recommends that medical facilities use caution in ordering any injectable medication products from compounding pharmacies, which may not be inspected or regulated as thoroughly as are pharmaceutical manufacturers.

05-03-2013 

 

SFDPH Press Release: Typhoid Fever in Restaurant Worker 

05-01-2013

Advisory 

Avian Influenza A: H7N9 Advisory  

04-16-2013 Advisory 

Additional Cases of Invasive Meningococcal Disease in Men Who Have Sex with Men in New York City; Updated Recommendations for San Francisco

04-12-2013 Update 

Avian Influenza A: H7N9 Update

04-05-2013 Advisory 

CDC Health Advisory: Human Infections with Novel Influenza A (H7N9) Viruses

The purpose of this advisory is to inform and provide guidance to health care providers in the evaluation of patients for novel Influenza A (H7N9) infection. Read the full advisory or go to the CDC Health Alert Network Page for additional advisories or updates. As of April 4, 2013, 14 cases of human infection with a novel avian influenza A (H7N9) virus were reported from four different provinces in China. All patients were hospitalized with severe respiratory illness and six persons died. These are the first human infections identified with an avian influenza A (H7N9). All illness onsets were from February 19 - March 31, 2013. No person-to-person transmission or epidemiologic link between any of the cases has been identified. Sources of infections are under investigation. 

The CDC is not yet issuing any formal travel advisories.  No cases of human infection with avian influenza A (H7N9) viruses have been detected in the United States. However, clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even outside of the typical influenza season. Read the latest updates, case definitions, and guidance from the CDC on their website.  In hospitalized patients or others at high risk of severe disease (i.e, age <5 or >=65 or underlying medical conditions), treatment with oral oseltamivir or inhaled zanamivir should be started as soon as possible, without waiting for laboratory confirmation.  Preliminary information indicates the virus is susceptible to neuraminidase inhibitors.

Clinicians in San Francisco should implement appropriate infection control recommendations and contact the SFDPH/Communicable Disease Control Unit immediately at (415) 554-2830 to arrange testing for Novel Influenza A(H7N9) for suspected cases with a travel or exposure history. 

03-08-2013  Advisory 

CDC Health Advisory: Updated Guidelines for Evaluation of Severe Respiratory Illness Associated with a Novel Coronavirus

The purpose of this Advisory is to provide guidance to health care providers in the evaluation of patients for novel coronavirus infection. Read the full advisory here or go to the CDC Health Alert Network Page for additional advisories or updates.

CDC does not recommend that anyone change their travel plans because of these cases of the novel coronavirus. CDC recommends that US travelers to countries in or near the Arabian Peninsula monitor their health and see a doctor right away if they develop fever and symptoms such as cough or shortness of breath. They should tell the doctor about their recent travel.

UPDATE: As of March 27, 2013, 17 laboratory-confirmed cases of Novel Coronavirus have been reported to WHO - from Saudi Arabia, Qatar, Jordan, United Arab Emirates and the United Kingdom. Among the 17 cases, eleven were fatal. Two of the 17 cases experienced a mild respiratory illness and fully recovered. Read the latest updates, case definitions, and guidance from the CDC.  Doctors in San Francisco should contact the SFDPH/Communicable Disease Control Unit immediately at (415) 554-2830 to arrange testing for suspected cases. 

03-04-2013  Update

CDC Health Update (HAN): Notice to Clinicians: Continued Vigilance Urged for Fungal Infections among Patients Who Received Contaminated Steroid Injections

CDC is still receiving new reports of fungal infections among patients who were given injections of contaminated methylprednisolone acetate (MPA) from NECC. Most of these recent cases have been localized spinal or paraspinal infections in patients, although new cases of meningitis or arachnoiditis also have been reported. CDC is recommending that physicians seeing patients with mild or even baseline symptoms, consider evaluation with magnetic resonance imaging (MRI) if clinically warranted.

Read the full update here, or go to the CDC Health Alert Network Page for more updates.

NOTE: San Francisco Clinicians did not receive any of the contaminated medication. 

 01-11-2013 Advisory

 Influenza Health Advisory - contains new Situational Information and updated Anti-Viral Treatment Recommendations 

 12-06-2012....  

 

SFDPH Press Release: Consider Vaccination to Prevent Meningitis for Certain San Francisco Men Traveling to New York City

 12-03-2012

Advisory

New York City Health Department Expands Recommendations for Meningococcal Vaccine for Certain Men Who Have Sex with Men

 12-03-2012

 Update

CDC Health Update (HAN): New England Compounding Center - Additional Contamination Identified

CDC and FDA identified additional microbial contamination in unopened vials of betamethasone, cardioplegia, and triamcinolone solutions distributed and recalled from NECC. Contamination includes bacteria known as Bacillus, and fungal species including Aspergillus tubingensis, Aspergillus fumigatus, Cladosporiumspecies, and Penicilliumspecies. Healthcare providers should remain alert for the possibility of infections from these medications.

Read the full CDC Health Update, and for updated information go to the FDA website.

 11-07-2012

Advisory

 Influenza Health Advisory

   11-01-2012  

 Update

Ameridose Voluntary Recall

 

Health Care professionals should stop using Ameridose products at this time, and return them to the firm. 

The US Food and Drug Administration (FDA) recommended a recall of any unexpired Ameridose products remaining in circulation as of October 31, 2012 out of an abundance of caution. As of October 31, the recall is not based on reports of patients with infections associated with any of Ameridose's products.  Therefore, at this time, the FDA is also recommending that health care professionals to not need to follow up with patients who received Ameridose products.  

Please refer to the following websites for more information about the recall as information may be updated during the investigation:

 10-09-2012   Alert

NECC Recall and Meningitis

 09-24-2012  Update

West Nile Virus Health Update

 09-07-2012  Update

Hantavirus Pulmonary Syndrome Health Update

 06-12-2012  Update

Pertussis

 10-17-2011   Advisory   

 Influenza Health Advisory

 03-17-2011  Advisory   

Radiation Health Advisory

 10-06-2010  Advisory   

Influenza Health Advisory

 08-04-2010  Update

Pertussis

 06-24-2010

 Update

Pertussis

 05-06-2010  Alert

Rubella Health Alert

 02-22-2010  Alert

Measles Health Alert

 02-19-2010  Advisory

H1N1 Swine Influenza A Health Advisory

 02-05-2010  Advisory

H1N1 Swine Influenza A Health Advisory

 01-21-2010   Advisory

  H1N1 Swine Influenza A Health Advisory

 10-26-2009

 Advisory

H1N1 Swine Influenza A Health Advisory

(Updated 10/30: Infection Control Precautions for Health Care Settings)

 10-21-2009  Advisory

H1N1 Swine Influenza A Health Advisory

 07-06-2009    Advisory

Novel Influenza A H1N1 (Swine) Virus Health Advisory
(Testing and Infection Control sections updated October 13, 2009)

 06-24-2009  Alert

Health Alert: Novel Influenza A H1N1 (Swine) Virus Health Alert

 06-02-2009  Advisory

Novel Influenza A H1N1 (Swine) Virus Surveillance, Testing,
Reporting, Antiviral Treatment and Chemoprophylaxis, and Infection Control Precautions

 05-18-2009  Alert

Novel Influenza A H1N1 (Swine) Virus: Surveillance, Testing,
Reporting, Antiviral Treatment and Chemoprophylaxis, and Infection Control Precautions

 05-12-2009  Alert

Novel Influenza A H1N1 (Swine) Virus: Surveillance, Testing, Reporting,

Antiviral Treatment and Chemoprophylaxis, and Infection Control Precautions

 05-04-2009  Alert

H1N1 (Swine) Flu Surveillance, Testing, Reporting, Antiviral
Treatment and Chemoprophylaxis, and Infection Control Precautions

 05-01-2009  Alert

H1N1 (Swine) Flu Surveillance, Testing, Reporting, Antiviral
Treatment and Chemoprophylaxis, and Infection Control Precautions

 04-29-2009  Alert

Swine Influenza Health Alert - Surveillance, Testing, Reporting and Antiviral Treatment

 04-27-2009  Alert

Swine Influenza Health Alert - Instructions for Surveillance, Testing, and Reporting

 04-24-2009  Alert

Swine Influenza Health Alert

 01-30-2009  Alert

Measles Health Alert

 01-22-2009  Advisory

Interim Recommendations for the Use of Antiviral
Medications During the 2008-2009 Influenza Season

 10-30-2008  Advisory

Seasonal Influenza Health Advisory

 10-27-2008  Advisory

Syphilis in San Francisco

 10-14-2008  Update

MRSA and Skin and Soft Tissue Infections Treatment Guidelines

 10-03-2008  Update

Limited Supply of Rabies Vaccine -
Post-Exposure Prophylaxis Available with Public Health Approval

 07-17-2008  Advisory

Another Measles Case in San Francisco

 05-08-2008  Alert

Measles Case in San Francisco

 01-28-2008  Update

Botulism Health Update and Rabid Bats found in San Francisco

 01-18-2008  Advisory

Community Associated Methicilin-Resistant Staphylococcus aureus (CA-MRSA)
in San Francisco

 11-15-2007  Advisory

Seasonal and Avian Influenza Health Advisory and Directions to MRSA Resources

 08-27-2007  Update

Changes in California Disease Reporting Regulations

 08-14-2007  Alert

Wound Botulism Cases in Injection Drug Users

 11-30-2006  Advisory

Seasonal and Avian Influenza Health Advisory

 10-26-2006  Update

N. meningitidis Surveillance & Annual Report on Communicable Diseases in SF

 08-07-2006  Advisory

Contaminated Oysters Responsible for Cases of Vibrio parahaemolyticus

 06-02-2006  Alert

Wound Botulism Cases in Injection Drug Users

 05-09-2006  Update

West Nile Virus: Recognition, Testing, Reporting Procedures, Surveillance Activities

 12-12-2005  Update

Rabies Prophylaxis for Potential Bat Exposures

 11-17-2005  Alert

Cluster of Necrotizing Soft-Tissue Infections in Injection Drug Users

 11-08-2005  Advisory

Seasonal and Avian Influenza Health Advisory

 10-31-2005  Advisory

Environmental Detection of F. tularensis

 09-09-2005  Advisory

Communicable Disease Management for Hurricane Katrina Evacuees

 04-2005  Update

West Nile Virus, Reporting & Testing

 02-24-2005  Update  

Meningococcal Disease, Enhanced Surveillance & Testing & New Conjugate Vaccine

 12-22-2004  Alert

Lymphogranuloma Vernereum (LGV) Infection in San Francisco

 11-29-2004  Alert

Cases of Wound Botulism in Infection Drug Users

 11-09-2004  Alert

Cases of Wound Botulism in Injection Drug Users

 11-03-2004  Advisory

Influenza Health Advisory

 08-03-2004  Alert

Cluster of Necrotizing Soft-Tissue Infection in Injection Drug Users

 02-09-2004  Advisory

Updated Recommendations for Avian Influenza and SARS

 01-23-2004  Advisory

Enhanced Surveillance for SARS and Avian Influenza

 03-18-2003  Advisory

Severe Acute Respiratory Syndrome (SARS)

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