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Urgency Level Categories

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

02-20-2015 Advisory

Health Advisory: Ocular SyphilisNew!

02-11-2015 Advisory

SFDPH Measles Health Advisory New!

01-22-2015 Advisory

 SFDPH Measles Health Advisory

01-13-2015 Update

CDC Health Update: Treatment of Patients with Influenza with Antiviral Medications

01-13-2015 Advisory

CDPH Measles Outbreak Health Advisory 

Please contact SFDPH CDCU (415-554-2830) for any suspected measles cases.

12-22-2014 Advisory

Increased Shigella Cases; Ciprofloxacin-Resistance Common

12-04-2014 Update

Influenza 2014-15 Health Update

12-04-2014 Advisory

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

12-04-2014 Advisory

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

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 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 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  

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 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 =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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