There has been an increase in travel-related introductions of clade I mpox into California and the U.S. in 2026, and clade II mpox cases have increased in California. Increases in clade I community transmission in Western Europe suggest that additional travel-related clade I mpox cases should be expected in California. Clinicians should have a heightened index of suspicion for mpox and particularly for clade I mpox in individuals who report recent international travel or sexual or intimate contact with someone who recently traveled internationally, especially to an area where clade I is circulating. Providers and assistants including cleaning staff should wear full PPE (gloves, gown, goggles, and fit tested N-95 respirator). Mpox testing should be considered for patients with compatible signs and symptoms (PDF), regardless of vaccination status or previous infection. Providers should report suspect or confirmed clade I mpox cases immediately to their local health department and/or CDPH. Mpox vaccination with two doses is recommended for individuals whomay be at risk for mpoxincluding immune compromised individuals and is expected to protect against both clade I and clade II mpox or any subclades.
Below are quotes from my otherwise healthy 22-year-old son. He was hospitalized for 4 days last month, after experiencing heat stroke from overexertion while running a half-marathon on a relatively warm day (in the 80’s F).
“I don’t know what happened. I was running and then I woke up in an ice bath. It was so cold, but they wouldn’t let me out because they said my temperature was 106.”
“I was so scared; I couldn’t move my legs. I thought I would never walk again.”
“They gave me back my phone, but I was so confused I couldn’t figure out how to use it.”
Those are NOT the words any mom wants to hear, especially from your child 2,800 miles away that you can’t get to right away to help take care of. On the phone with the emergency room doctor, my mind raced backwards trying to remember how serious heat stroke was and how to treat it. With summer and hotter days coming, this is a good time to review the signs and symptoms of heat-related illness and what to do if you encounter them.
Heat-Related Illnesses
I remember many hot days when my kids were playing soccer, and we worried about heat exhaustion. We gave the kids more breaks, had plenty of water on hand; sometimes the games would get cancelled because it was too hot. I recall one game during which one of our players started feeling dizzy and nauseous. She looked pale and was sweating profusely. We (the moms) got her into the shade, put towels soaked in cold water around her neck and sponged her exposed skin, fanned her, and gave her sips of cool water. Eventually she felt better and was able to sit up and watch the rest of the game from her shaded seat. This was heat exhaustion. Heat exhaustion is not uncommon and is generally not life-threatening but can progress if untreated.
How is Heat Stroke Different from Heat Exhaustion?
A key thing to remember is that heat stroke is a medical emergency and can cause death or permanent disability.Heat exhaustion occurs when the body loses too much water and salt, usually through sweating. Heat stroke occurs when the body becomes unable to control its temperature. This extremely high body temperature can damage multiple organs, including the brain, heart, kidneys and muscles.
While heat stroke can happen to anyone—including young, healthy, and athletic individuals like my son—certain groups are at even higher risk, including:
• People with chronic health conditions (such as heart disease, lung disease, or diabetes) • Very young children • Older adults and seniors • Individuals taking medications that affect hydration or temperature regulation • Pregnant people • Those working or exercising outdoors for prolonged periods
Here is a summary* of some heat-related illnesses, the symptoms to look for and what to do.
Heat-Related Illnesses
Symptoms (may have some or all)
First Aid/What to Do Initially
Heat Stroke (Sunstroke)
High body temperature (103-106 F or higher)
Hot, red, dry or damp skin
Rapid and strong pulse
Headache
Dizziness
Loss of consciousness (passing out and not being able to wake up)
Seizures
Call 911 immediately. Heat stroke is a severe medical emergency.
Move the person to a cooler area.
Remove excess clothing.
Cool with cold bath or sponge, cold compresses (neck, armpits, groin).
Use fans and air conditioners if available.
Do NOT give fluids by mouth if person is unconscious or vomiting.
Stay with person until help arrives and repeat cooling measures if temperature still high.
Heat Exhaustion
Heavy sweating
Cold, pale and clammy skin
Thready/weak pulse
May have normal temperature
Weakness
Vomiting
Dizziness
Fainting (passing out)
Move the person to cool, shaded or air-conditioned area.
Lay them down and loosen clothing.
Apply cool, wet cloths or give a cool bath.
Offer sips of water; stop if nausea or vomiting occurs.
If vomiting continues or symptoms worsen or persist, seek immediate medical attention.
Heat Cramps
Painful spasms in muscles (legs, abdomen, arms)
Heavy sweating
Stop physical activity and move to a cool place.
Apply firm pressure or gently massage cramping muscles.
Encourage drinking sips of water so sports drinks (with electrolytes); stop if nausea or vomiting occurs.
HealthyChildren.org (American Academy of Pediatrics): Extreme Heat English | Spanish
CDC National Institute for Occupational Safety and Health (NIOSH): Fast Facts: Protecting Yourself from Heat Stress English | Spanish | Vietnamese
National Weather Service: Heat Safety – learn about Excessive Heat, the Heat Index and Heat Disorders - Heat -- A Major Killer
About Dr. Michele Cheung Dr. Michele Cheung is board certified in Pediatrics and Pediatric Infectious Diseases and also completed a Preventive Medicine Residency and a master’s degree in public health (MPH). She is the MCAH (Maternal, Child & Adolescent Health) Medical Director for the OC Health Care Agency where she collaborates closely with the community on initiatives to support perinatal, infant, and child health and wellbeing. She has been working in public health, both local and state, in different capacities for the past 25 years. She also cared for children with infectious diseases in the hospital setting until 2024 and regularly teaches pediatricians-in-training about public health and communicable diseases.
(Santa Ana, CA) – The planned removal of neutralized methyl methacrylate (MMA) from the storage tanks at GKN Aerospace did not begin on Thursday, June 4th, due to unavailable resources. Once a removal date is confirmed, advance notice will be provided to the community with important information, including the potential odors during the activity.
As part of routine activity to empty an onsite stormwater/condensation tank located in an area unrelated to the incident site, a spill occurred. As the stormwater was being transferred into a 275-gallon tote for storage and analysis before disposal, as is typical, an overflow occurred and approximately 50 gallons of water flowed into the storm drain. Appropriate state and local notifications were made, and a quantity of the spill was collected during the cleanup effort. The stormwater will be analyzed and the potential for any trace amounts of MMA to be found in the stormwater is low.
An interactive data dashboard is now available on the www.occupainfo.com web page enabling residents to view air monitoring data from the stationary and mobile air monitoring. Air monitoring continues at the facility perimeter and in the surrounding community to ensure public safety and guide response actions.
Cleanup activities related to the GKN Aerospace facility incident in Garden Grove are continuing under the oversight of Unified Command including the OC Health Care Agency, South Coast AQMD and GKN Aerospace.
The first “State of Health in Orange County” focused on health trends and priorities in Orange County; local challenges, initiatives and progress; opportunities to advance health in OC; and a vision for building healthier, more resilient communities.
The overall message is “Safeguarding Public Health is Everyone’s Responsibility.”
(Santa Ana, CA) – Cleanup activities related to the GKN Aerospace facility incident in Garden Grove are continuing under the oversight of Unified Command including the OC Health Care Agency, South Coast AQMD and GKN Aerospace. Between Thursday, June 4 and Friday, June 5, neutralized methyl methacrylate (MMA) from the storage tanks is scheduled to be pumped out and removed. As part of the planned removal process, the material will be transferred directly from the storage tanks and into sealed trucks for transport and disposal. Temporary, intermittent odors may occur during this activity. MMA has a distinctive fruity or plastic-like odor. The product has a very low odor threshold, meaning people may notice a scent even when concentrations are well below levels associated with health concerns. Air monitoring continues at the facility perimeter and in the surrounding community to ensure public safety and guide response actions. The first few days of cleanup included portions of the neutralized MMA being removed, wastewater sampling and testing for proper disposal as well as ongoing air monitoring and tank temperature readings to ensure stability and safety. Daily updates are being posted to www.occupainfo.com.
A large influx of domestic and international travelers is expected into Southern California from June through July 2026, with highest concentration anticipated between June 12 and July 10 in connection with the World Cup.
Healthcare providers should be on increased alert for travel-related emerging and seasonal infectious diseases, including, but not limited to, measles, influenza, mpox, hepatitis A, dengue, chikungunya, and malaria.
Providers should report all mandatory diseases to Orange County Health Care Agency's Communicable Disease Control Division at (714) 834-8180.
Be aware of diseases that are immediately reportable by phone on the List of Reportable Conditions (indicated in red on second page) including any unusual disease, and outbreaks of any disease.
Report cases that are identified in Orange County to Public Health, even if the patient is traveling from another jurisdiction.
Providers can direct patients to public health tips and resources for World Cup matches and large events at Safety for Soccer Fans.
(Santa Ana, CA) – The GKN Aerospace hazardous material incident in Garden Grove is transitioning out of the emergency response phase. Beginning Friday, May 29, the OC Health Care Agency (HCA) as the County’s Certified Unified Program Agency (CUPA) will take the lead as the oversight authority for site cleanup and waste removal. The HCA, in its regulatory role, will work closely with GKN Aerospace throughout this next phase. During the cleanup process, air monitoring will be conducted at the fence line and in the community under the oversight of South Coast Air Quality Management District (AQMD). The U.S. Environmental Protection Agency (EPA) will provide technical advisory support to South Coast AQMD and the HCA throughout this next phase. Updates regarding the site cleanup and waste removal will be posted on www.occupainfo.com. Information regarding the GKN Aerospace hazardous material incident can be found here: https://www.ocgov.com/gkn-aerospace-hazmat-incident.
Each May, we recognize two important observances that highlight how our community can stay safe, prepared, and supported: Trauma Injury Prevention Month and Emergency Medical Services (EMS) Week. When woven together, these observances remind us that preventing injuries and ensuring rapid, skilled emergency response are essential parts of a healthy community.
Trauma remains a leading cause of death and disability across all ages. Many injuries, whether from falls, motor vehicle collisions, pedestrian incidents, or everyday activities, are preventable. Trauma Injury Prevention Month encourages each of us to take simple, practical steps that reduce risk and promote safety in our homes, workplaces, and neighborhoods.
This year, one area drawing increasing attention is the rise in injuries related to bicycles, scooters, and e-mobility devices - including e-bikes. As more children, teens, and adults turn to e-bikes and e-scooters for recreation and transportation, emergency departments and EMS teams are seeing more crashes involving excessive speed, lack of appropriate helmet use, and limited rider experience. Practicing safe riding habits makes a meaningful difference. Riders should always wear a properly fitted helmet, follow traffic laws, stay alert to cars and pedestrians, and choose speeds appropriate for their environment. Parents and caregivers can help by ensuring young riders understand how to operate e-bikes safely and by choosing models appropriate for their age and skill level.
At the same time, EMS Week honors the dedicated professionals who respond when emergencies happen. Paramedics, Emergency Medical Technicians (EMTs), dispatchers, and first responders work around the clock to deliver life-saving care, often within minutes. Their readiness and expertise form a critical safety net when prevention is not enough. Together, prevention and emergency response strengthen the resilience of our entire community.
This month is a good time to reflect on what we can do individually and collectively to reduce preventable injuries and support the emergency responders who serve us. A few simple habits make a meaningful difference:
Stay attentive on the road. Avoid distractions, wear seat belts, and follow posted speeds.
Prevent falls at home. Remove tripping hazards, improve lighting, and install handrails if needed.
Practice safe storage. Keep medications, chemicals, and sharp objects securely out of reach of children.
Ride bikes, e-bikes, and scooters safely. Wear a helmet, obey traffic laws, and keep speeds appropriate for the setting.
Be prepared. Learn basic first aid and CPR, know how to call 9‑1‑1 effectively, and keep emergency contacts readily available.
Supporting EMS professionals also strengthens community health. You can: Learn about local EMS resources and share them with family, friends, and neighbors.
Participate in community CPR or Stop the Bleed trainings.
Make 9‑1‑1 calls efficiently by staying calm, answering questions clearly, and providing your exact location.
By combining prevention with readiness, we create safer environments and ensure that help is available when it is needed most. Prevention reduces the number of emergencies; EMS ensures rapid care when prevention falls short. Together, these efforts form a powerful partnership that protects health and saves lives.
As we honor Trauma Injury Prevention Month and EMS Week, let’s recognize the role we each play. Small actions - buckling a seatbelt, securing a ladder, riding bikes, scooters, and e-bikes responsibly, or learning a lifesaving skill can prevent injuries and support the dedicated professionals who respond when seconds matter.
Together, we can build a safer, stronger, and healthier Orange County.
About Dr. Almaas Shaikh Almaas Shaikh, MD, MPH, FACS is a distinguished trauma and critical care surgeon who serves as the Interim EMS Medical Director and Deputy Public Health Officer for the OC Health Care Agency. In her EMS leadership role, Dr. Shaikh oversees system-wide clinical operations, protocol development, and quality improvement initiatives that strengthen emergency medical services across Orange County. She brings frontline expertise to regional coordination efforts, ensuring that prehospital providers deliver timely, evidence‑based care in critical situations. Her broader public health leadership reflects a strong commitment to health equity, community resilience, and evidence‑based emergency preparedness. She is dedicated to bridging clinical excellence with population‑level strategies so that diverse and vulnerable communities receive effective, culturally responsive care throughout the continuum of emergency response.
(Orange, CA) – A bat found in Irvine Regional Park has tested positive for rabies. The bat was found on Sunday, May 24, 2026 at 9:30 a.m. Anyone who may have had physical contact with the bat or saw someone else having contact with the bat is asked to call the OC Health Care Agency (HCA) Communicable Disease Control Division at (714) 834-8180 during business hours or after hours to determine the risk for rabies. Owners of pets who may have had contact with this bat should contact their veterinarian.
The rabies virus is found in an animal’s saliva and is transmitted to people by a bite from a rabid animal. Although very rare, contamination of the eyes, mouth or an open wound by the saliva of a rabid animal can also transmit rabies. Most cases of human rabies in the United States in recent years have resulted from bat strains of rabies; bats have very small teeth, and their bites may go unnoticed.
Once a person begins showing signs and symptoms of rabies, the disease is nearly always fatal. For that reason, preventive treatment to stop the rabies virus from causing illness is given to anyone who may have been exposed to rabies. Medical assistance should be obtained promptly after an exposure so any wound can be cleaned and preventive treatment can be started. This treatment is safe and effective.
The HCA and OC Animal Care recommend the following actions to minimize the risk of rabies:
Avoid all contact with wild animals.
Vaccinate all cats and dogs against rabies.
Do not sleep with open unscreened windows or doors.
If bats are seen inside the house or other structure, close off the area and contact animal control. Once the bat(s) have been removed, close off any areas allowing entrance into the house.
Do not leave pet food outside where it will attract wild animals.
Immediately wash all animal bites with soap and water, being sure to flush the wound well, then contact your doctor.
Report all animal bites to OC Animal Care.
Potential exposure to a bat or other wild animal should be reported to HCA Communicable Disease Control Division at (714) 834-8180. To report a bat in your home or an animal bite, contact OC Animal Care at (714) 935-6848. More information about rabies is available at the Centers for Disease Control website at http://www.cdc.gov/rabies/.
Health Advisory: Information on Methyl Methacrylate (MMA)
A hazardous materials incident in Garden Grove has led to mandatory evacuation orders due to the potential release of Methyl Methacrylate (MMA) a highly flammable and potentially toxic chemical commonly used in plastics, coatings, and manufacturing.
Evacuation boundaries were established using modeling scenarios to ensure public safety that include modeling of a potential on-site explosion. Everyone within the designated evacuation zone is urged to comply with these orders until authorities confirm it is safe to return.
Emergency teams are focused on keeping the liquid MMA stored in the special enclosed tanks in a stable temperature range to prevent further reaction and vapor production. Cooling and containment operations are ongoing. Air quality officials have deployed multiple stationary and mobile air monitors and have not detected any contaminants in the air to date.
Exposure is not expected as long as evacuation orders are followed. If you are exposed to MMA, you may or may not develop health effects. Those with underlying medical conditions or experiencing symptoms such as shortness of breath, throat or eye irritation or vomiting may need to be seen by a medical professional. Call the California Poison Control System at 1-800-222-1222 if you are experiencing symptoms and need to speak with an expert about how to proceed.
