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In the last week several commercial laboratories (Labcorp, Mayo Clinic Laboratories, Quest) have announced availability of monkeypox testing. Additional commercial laboratories are anticipated to offer monkeypox testing in coming weeks. Providers should check with the commercial labs they work with about availability and specific specimen collection requirements. OCHCA approval is not required to order testing via commercial labs, although it is still required to request testing through public health. More info...

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Body On June 22, 2022, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) reviewed its recommendations for influenza vaccines for the 2022-2023 influenza season. The ACIP endorsed a preference for use of higher-dose or adjuvanted influenza vaccines for those 65 years and older whenever available. Last week the CDC endorsed the ACIP's recommendation. More info... Links in this section relate to Body

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(Santa Ana, CA) – The OC Health Care Agency (HCA), Communicable Disease Control Division (CDCD) has confirmed the first presumptive case of monkeypox infection in Orange County (OC) and is awaiting final confirmation from the Centers for Disease Control and Prevention (CDC). While awaiting CDC confirmation of a probable case, the HCA is proceeding with the assumption it is a monkeypox case and is conducting contact tracing and post-exposure prevention for close contacts.

“The Public Health Services (PHS) CDCD team is working with all relevant agencies and partners to track, control, and curtail the spread of monkeypox within the county,” said Dr. Christopher Zimmerman, CDCD Physician. “The affected individual is already in isolation and exposed contacts are in the process to receive post exposure prophylaxis vaccination.”
 
The outbreak of monkeypox in 50 nations throughout the world has resulted in 4,769 cases as of 06/28/2022. In the United States, there are 306 cases from 28 states.
 
Today, the U.S. Department of Health and Human Services (HHS) announced an enhanced nationwide vaccination strategy to mitigate the spread of monkeypox. The strategy will expedite vaccinations and protect those at-risk of monkeypox, prioritize vaccines for areas with the highest numbers of cases, and provide guidance to state, territorial, tribal, and local health officials to aide their planning and response efforts. See full report.
 
As of this time, vaccination soon after exposure can prevent for monkeypox virus infections, the best guidance is to take precautions to prevent monkeypox. Most treatment is supportive, easing the symptoms of illness. However, antivirals developed for use in patients with other viral diseases may prove beneficial in certain cases but are currently available under research protocols. Additionally, some measures including vaccination may be given to prevent the monkeypox infection after a high-risk exposure to the virus.
 
What people should do:

To prevent the spread of monkeypox in Orange County, we ask individuals to be aware of the risks and how monkeypox spreads. It is also important to remember that monkeypox can spread through sexual networks, and until we learn more, the HCA urges you to be vigilant. People who have symptoms of monkeypox, particularly the characteristic rash or lesions, should take the following steps:

• Visit a medical provider for an evaluation
• Cover the area of the rash with clothing
• Wear a mask
• Avoid skin-to-skin, or close contact with others
• Isolate in a separate room or area from family members and pets

Local clinicians who have any suspected cases are advised to immediately contact the HCA’s Communicable Disease Control Division. For additional information see the attached Health Advisory from the California Department of Public Health.
 
The CDC does not currently recommend widespread vaccination against monkeypox. However, vaccination may be recommended for some people who are close personal contacts of people with monkeypox, may have been exposed to the virus, and/or may have increased risk of being exposed to the virus. The HCA has secured some vaccines for individuals who are exposed to the virus through contact with cases. If you are exposed or believe you are at risk, please call or visit your primary care provider.
 
For more information on monkeypox, including case counts, prevention strategies, vaccination and what the HCA is doing in Orange County, visit www.ochealthinfo.com/monkeypox or https://www.cdc.gov/poxvirus/monkeypox/index.html.

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Orange County Health Care Agency (OCHCA) has been notified of its first probable monkeypox virus case. Probable cases are those who test positive for orthopoxvirus DNA by polymerase chain reaction (PCR) assay. Probable cases will be sent to the Centers for Disease Control and Prevention (CDC) for monkeypox virus confirmation. Probable cases are managed as monkeypox virus cases while awaiting laboratory confirmation. More info...

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In our health alert on June 20, 2022, an error was identified in the stated minimum interval when using Moderna COVID-19 vaccine in children 6 months through 5 years of age who are moderately to severely immunocompromised. The minimum interval between the second and third (additional) dose should be at least 4 weeks. 

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Today, the California Department of Public Health (CDPH) released updated information and guidance on managing monkeypox virus infection through its California Health Alert Network (CAHAN). The Orange County Healthcare Agency (OCHCA) wants to make sure providers are aware of the potential for monkeypox virus infection in patients who meet epidemiologic criteria and/or a clinically consistent rash. As of this time no cases of Monkeypox virus infection have been identified in Orange County. More info...

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(Santa Ana, CA) – The Centers for Disease Control and Prevention (CDC) recommends that people between 13 and 64 years of age get tested for human immunodeficiency virus (HIV), the virus that causes AIDS at least once as part of routine health care. For those at high risk of HIV, men who have sex with men (MSM), transgender individuals, and persons who inject drugs, the CDC recommends testing at least once per year as part of routine health care. June 27 marks National HIV Testing Day (NHTD), which promotes testing and early diagnosis of HIV. This year’s NHTD theme is HIV Testing is Self-care. HIV testing is an act of self-care, and knowledge of status is the gateway to engaging in prevention or treatment services that enable individuals, regardless of their status, to live a long and healthy life.

At the end of 2021, there were 6,772 people living with HIV in Orange County. The CDC estimates that an additional 950 Orange County residents have HIV and don’t know it – some of whom will develop AIDS before knowing they have HIV. Over 20% (54) of the 274 Orange County residents newly diagnosed with AIDS in 2021, learned they had HIV at the same time, indicating they were living with HIV for many years before getting ill. Many of these people had been to a health care setting like an emergency room, a community health center, or their doctor, but were not tested for HIV. A simple HIV test and treatment can prevent HIV from progressing to AIDS.

If you have never been tested for HIV, ask your health care provider for an HIV test. For those who test negative and are at high risk for HIV, Pre-Exposure Prophylaxis (PrEP), a medication to prevent HIV is available. In addition to health care providers throughout Orange County, the following agencies offer free confidential HIV testing and free or low-cost PrEP services:

• APAIT Health Center: Testing is offered Monday - Friday, 10 a.m. to 4:30 p.m. Call (714) 636-1349 or visit www.apaitonline.org/ for more information. Testing hours will be extended from 9 a.m. to 8 p.m. and walk-ins are encouraged on Monday, June 27 in celebration of NHTD. In addition, APAIT will be participating in The Greater Than AIDS campaign (www.greaterthan.org) offering free HIV testing in partnership with Walgreens located at 12001 Euclid St., Garden Grove, CA 92840 from 10 a.m. to 7 p.m. on NHTD.
• OC Health Care Agency/17th Street Testing & Treatment Clinic: Walk-ins accepted based on availability. Clinic hours: Monday, Wednesday, Thursday and Friday, 8 a.m. to 4 p.m. and Tuesday, 10 a.m. to 4 p.m. Call (714) 834-8787 to make an appointment or visit http://www.ochealthinfo.com/std for more information.
• Radiant Health Centers: Walk-Ins accepted. Tuesday and Wednesday, 10 a.m. to 7 p.m., Thursday, 11 a.m. to 7 p.m., Friday 9 a.m. to 3 p.m., and Saturday 10 a.m. to 4 p.m. Call (949) 809-8764 or visit www.radianthealthcenters.org/ for more information.
• The LGBT Center Orange County: Testing is offered Tuesday, 10 a.m. to 8:30 p.m., Wednesday and Thursday, 6 p.m. to 9 p.m., and Friday, 10 a.m. to 6 p.m. To make an appointment or for more information call (714) 953-5428 or visit www.lgbtcenteroc.org/. A special gift will be offered to those who test on Friday, June 24 in celebration of NHTD.

For more testing sites and information about HIV services in Orange County, please call (714) 834-8335 or visit www.ochealthinfo.com/phs/about/dcepi/hiv/sites   

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(Santa Ana, CA) – In response to Sunday’s approval from the Western States Safety Review Workgroup and the California Department of Public Health (CDPH), the OC Health Care Agency (HCA) is finalizing preparations to offer the Moderna and Pfizer BioNTech vaccines for young children ages 6 months and older.
 
“Starting this week, limited shipments of COVID-19 vaccines for young children will begin shipping to providers who have ordered the vaccine through the CDPH, including the HCA,” says Dr. Clayton Chau, HCA Director. “The HCA’s Public Health Services Division will partner with Children’s Hospital of Orange County (CHOC) to make the vaccines for young children available at select locations as soon as shipments arrive, and sites are operationalized.”
 
Some vaccine locations which are currently in receipt of the initial vaccine shipments and offering appointments, can be found by visiting www.vaccines.gov and searching locations by ZIP Code. Parents and legal guardians seeking a vaccine for their eligible child(ren) can also check with their primary care providers and/or pharmacy for expedited availability. Vaccination appointments for the HCA/CHOC sites will be made available on www.Othena.com over the next week as plans are finalized

According to the Food and Drug Administration, clinical trials involving thousands of infants and toddlers 6 months and older firmly show that COVID-19 vaccines are safe and provide protection against infection. Children get a smaller dose of COVID-19 vaccine than teens and adults that is the right amount for their age group. The Centers for Disease Control and Prevention (CDC) recommends everyone ages 6 months and older get vaccinated against COVID-19.

 COVID-19 primary series vaccination for children and teens (CDC), as of 6/19/22.

Child's Age	Pfizer-BioNTech	Moderna
6 months-4 years old	3 dose primary series	2 dose primary series
5 years old	2 dose primary series	2 dose primary series
6-17 years old	2 dose primary series	Not authorized

For more information on COVID-19 information and resources, including case counts, vaccination and testing in Orange County, visit ochealthinfo.com/covid.
 
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On June 18th  the Advisory Committee on Immunization Practices (ACIP) recommended the use of Pfizer-BioNTech COVID-19 vaccine for children 6 months through 4 years of age and Moderna COVID-19 vaccine for children 6 months through 5 years of age. This recommendation was subsequently endorsed by the Western States Scientific Safety Review Workgroup and California Department of Public Health. More info...

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(Santa Ana, CA) –In response to several recent tragedies occurring in our county and throughout the U.S., the OC Health Care Agency’s (HCA) Mental Health and Recovery Services (MHRS) office encourages OC residents to seek support for yourself and your children with mental health and emotional challenges.
 
“There have been several distressing and heartbreaking events recently. I’m concerned for the children in our community and want to encourage families in Orange County to take advantage of tools and resources available to support our young people,” stated Board Chairman Doug Chaffee, Fourth District. “Coming together as neighbors to support one another is important when we are processing tragic events.”
 
Emotional support is important for everyone and being able to share healthy expressions of feelings with others is critical. Children often need help identifying feeling and how to express themselves. Focusing on positive activities for children and families can help address emotions like fear or sadness.
 
In 2021, the U.S. Surgeon General issued an advisory on Protecting Youth Mental Health. In it, he states that today’s young people face unprecedented and uniquely hard to navigate challenges, causing an alarming increase in the prevalence of certain mental health conditions. The advisory contains recommendations on how families and caregivers can engage with children and youth on mental health topics, help them become more resilient, and address emerging mental health challenges. Read more: HHSAdvisory
 
“Traumatic events are cumulative, leaving their impact one on top of the other,” said Dr. Veronica Kelley, HCA’s Chief of Mental Health and Recovery Services. “Our brains can only take so much exposure to trauma, including disturbing images and upsetting news.” She recommends the following steps for care:
 

• Reduce exposure to media, including social media. 
• Protect your peace (physical, mental, emotional and spiritual self).
• Stay active. Physical activity resets your brain.
• Spend time with people that you love.
• At work, when on a break or lunch, step away from your desk and get some fresh air or go for a walk.

 
If you or someone you know needs to speak with some, the OC Nami/WarmLine is a free and confidential telephone service providing emotional support and resources to Orange County residents by calling or texting (714) 991-6412. Or contact OC Links to speak/chat/text 24/7 with a supportive Navigator trained to connect you with appropriate mental health services. Call or text (855) 625-4657, available in English, Arabic, Farsi, Korean, Spanish and Vietnamese.
 
Additional resources can be found by visiting www.OCNavigator.org.

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