The California Department of Public Health (CDPH), the Center for Disease Control and Prevent (CDC) and multiple other states continue to investigate a large, multi-state outbreak, of infant botulism linked to at least two lots of ByHeart Whole nutrition infant formula. The manufacturer has now expanded their voluntary recall to all ByHeart formula nationwide - this includes both cans and single-serve Anywhere Pack™ sticks. Consumers with this product should stop using it immediately. Physicians with a suspected case of infant botulism may reach California’s Infant Botulism Treatment and Prevention Program at (510) 231-7600 at any time. Parents with concerns or questions about suspected infant botulism should seek medical advice immediately.
The California Department of Public Health is working with other state health departments and the U.S. Centers for Disease Control and Prevention to investigate a multistate outbreak of infant botulism linked to ByHeart Whole Nutrition Infant Formula. To date, 15 cases have been reported in the United States, including two in California. No cases have been reported from Orange County currently. See web link below for more information. The company has recalled two lots of its product. Consumers with this product should stop using it immediately. Physicians with a suspected case of infant botulism may reach California’s Infant Botulism Treatment and Prevention Program at (510) 231-7600 at any time. Parents with concerns or questions about suspected infant botulism should seek medical advice immediately.
Picture-perfect decorations, families dressed in matching holiday outfits laughing together in front of a cozy fireplace, snow falling outside the window—this is what the holidays look like in commercials and social media. However, in real life the holidays are the most stressful time of the year for many people, and a time when underlying anxiety and depression can become worse. Common causes of increased stress include financial concerns, family conflicts, increased feelings of grief or loneliness, and unrealistic pressures to be perfect when it comes to hosting, decorating, and choosing gifts. I’ve recently learned that even a popular tradition of seeing where a magical elf ends up each night in the home can be a daily stressor for parents, especially when the elf “forgets” to move to a new location.
Here are my 7 favorite tips for surviving the holidays:
1. Simplify your holiday routine
Think about what stressed you out during the last holiday season and consider making a change this year. Are you always scrambling to get holiday cards mailed out in December? Consider skipping the cards this year, sending a digital card, or making a “Happy New Year” card instead. Stressed about trying to find the perfect gift for everyone in your family? Ask them to switch to a White Elephant gift exchange or try using a gifting app where everyone can input their wish lists and track which items are purchased.
2. Keep your self-care routine
You may be focused on doing things for others, but please remember to take care of yourself first. This means trying to stay on a regular sleep schedule, eating balanced meals (with the occasional delicious holiday treat!), getting regular physical activity, and avoiding excessive use of alcohol or other substances. I also recommend making a “fun to-do list” of activities that make you feel relaxed and happy, like watching your favorite movie or snuggling your pet on the couch. Refer to this list when you’re stressed and set aside time to do one of these activities after a stressful event.
3. Don’t be afraid to set boundaries with others
Holiday gatherings can be a source of frustration when people ask intrusive personal questions, start political debates, or bring up sensitive topics. Remember that it’s okay to tell someone that you’re uncomfortable with a certain topic and don’t want to talk about it. It’s okay to “agree to disagree.” If verbal attempts to change the subject don’t work, you can always excuse yourself and go to another room to calm down.
4. Go outside and exercise
In Southern California, we’re lucky to be able to enjoy sunshine, blue skies, and ocean views year-round. Research studies have found that being in nature for just 20 minutes can lower cortisol levels, the main stress hormone in our body. Physical activity increases the release of natural “feel good” chemicals in our brain called endorphins, which can increase feelings of happiness and reduce pain. If you’re not sure where to go in Orange County (OC), visit the OC Parks website for information on parks, beaches, zoos, and historic sites: https://www.ocparks.com/.
5. Allow yourself to grieve
The holidays are a time when people are reminded of the loved ones they lost. This is especially hard if it’s the first holiday season without them. You may feel fine one moment and then see something that makes you cry, and that’s okay. Do what you feel is best for you, even if it means skipping a holiday event to stay in and binge your favorite show. For some, it can be helpful to share fond memories with close family and friends or continue a holiday tradition that the person enjoyed. For others, it might be best to seek a support group or grief counselor to learn how to cope with the pain.
6. Connect with the community
For people who don’t have a close support network of friends and family in their area, connecting with the community can help provide that support. Options include joining a local walking club, sports league, cultural center, or faith community. Volunteering is also a great way to feel a sense of purpose while helping others in need. If you’re interested in OC volunteering opportunities, you can visit: County of Orange Volunteer Opportunities.
7. Ask for help when you need it
If your mental health struggles are becoming too overwhelming to handle on your own, don’t be afraid to ask for help! Here are some resources that are available:
National Alliance on Mental Illness (NAMI): Provides support and education for individuals with mental illness and their loved ones.
Angela Yu, MD, is a Board-Certified Psychiatrist and the Associate Medical Director for the Adult & Older Adult Behavioral Health Services at the OC Health Care Agency. She is a Midwest native who completed medical school at the University of Missouri, then moved to California for her residency training at UC-Irvine. During her training, she developed a passion for community mental health after rotating at clinics and homeless shelters which provided services to the underserved. She chose to work for the OC Health Care Agency in 2014 so she could continue to help individuals with severe mental illness. In relation to her article about holiday wellness, she is currently contemplating whether to introduce the magical elf tradition to her home and she welcomes all advice on how to make this tradition as stress-free as possible.
(Santa Ana, CA) — An Anaheim resident over the age of 80 has tested positive for West Nile virus (WNV), marking the first confirmed human WNV case in Orange County this year. The person experienced headache and neurologic symptoms and was hospitalized with encephalitis, a serious brain inflammation linked to the virus. Orange County reported just one human case of West Nile virus and no related deaths in 2024.
“West Nile virus is common in Orange County, recurring every year during the summer months and continuing into the fall,” said Dr. Regina Chinsio-Kwong, County Health Officer. "The best way to avoid West Nile virus infection is to take precautionary measures to avoid mosquito bites.”
Recommended WNV precautions include: • Emptying all standing water on your property to reduce areas in which mosquitoes may breed, including flowerpot saucers and pet bowls. • Making sure your window and door screens are in good condition. • Using insect repellent containing DEET, picaridin, oil of lemon eucalyptus, or products containing IR3535, always following label directions. • Limiting outdoor activity at dawn and dusk when mosquitoes are most active. • Wearing long-sleeved shirts and long pants when outdoors.
Most people who become infected with WNV do not experience symptoms. However one in five may develop fever and may have headache, body aches, nausea, tiredness and sometimes a skin rash. In rare cases, WNV can lead to serious complications such as encephalitis (inflammation of the brain). Symptoms of severe illness may include: severe headaches, neck stiffness, confusion, muscle weakness or paralysis. Anyone experiencing these symptoms should seek immediate medical care. People over 50 years of age and those with certain medical conditions are at higher risk of serious illness from WNV infection.
ABOUT THE OC HEALTH CARE AGENCY The OC Health Care Agency (HCA) is a regional interdisciplinary health jurisdiction and an accredited health department, charged with protecting and promoting individual, family and community health through partnership and coordination of public and private sector resources. Visit www.ochealthinfo.com to learn more about services and resources.
An individual in their 80s confirmed positive for West Nile Virus (WNV), becoming the first human WNV infection in Orange County this year. In 2024, Orange County had one WNV human infection. As of October 24th, the California Department of Public Health reported 74 infections of human West Nile Virus statewide this season. More info...
(Santa Ana, CA) — A bat found on the sidewalk of the west side of the 500 block of S. Main Street in Orange has tested positive for rabies. The bat was found on Thursday, October 16, 2025, at approximately 2:00 p.m. Anyone who may have had physical contact with this 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 to determine their risk for rabies. This phone line is staffed 24 hours a day, 7 days a week. 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 a 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 the 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. Find out more at OC Animal Care Wildlife Information. You can download a flyer that contains information on what to do if you come in contact with a bat and who to contact by clicking here. More information about rabies is available at the Centers for Disease Control and Prevention (CDC) website at CDC Rabies.
ABOUT THE OC HEALTH CARE AGENCY The OC Health Care Agency (HCA) is a regional interdisciplinary health jurisdiction and an accredited health department, charged with protecting and promoting individual, family and community health through partnership and coordination of public and private sector resources. Visit www.ochealthinfo.com to learn more about services and resources.
As a parent, you may have been asked, “Does your child live in, or spend a lot of time in, a place built before 1978 that has peeling or chipped paint or that has been recently remodeled?”
That is the standard question pediatricians across the country ask families to screen children for increased risk of lead poisoning.
We ask that question too here in Orange County since many of our houses were built before 1978 and do have lead in the paint, which can then get into the dust (and soil too) that our children play in and may get in their mouths. But many of the children in Orange County with elevated lead levels actually have been exposed to other objects such as imported pottery, utensils, food, drink, or spices, cosmetics or ceremonial items, or things brought home from a family member’s work.
It is important to know what these potential sources are in and around your home so you can prevent exposure to your children.
There is no safe level of lead.
Many children who are at risk have not been tested for lead. Exposure to lead can cause delayed growth and development, learning and behavior challenges, and hearing and speech problems; these effects can be lifelong. Children under six years of age are most vulnerable because their brain is still developing; prevention of lead exposure to pregnant and breastfeeding people is also important for this same reason.
The only way to know if your child has lead poisoning is by getting a blood test.
Most children who have lead poisoning do not look or act sick. If you have concerns about lead exposure, ask your doctor for a lead test.
Lead poisoning is preventable.
In addition to being aware of what items might have lead and keeping them away from children, you can help protect against lead poisoning through a healthy diet. Eating foods rich in vitamin C, calcium, and iron can help limit the body’s absorption of lead. In addition, young children should eat healthy meals and snacks every 3-4 hours while awake since a full belly absorbs less lead.
In honor of National Lead Poisoning Prevention Week (October 19 to 25), our theme this year is “Nutrition as Prevention.” Please join me in spreading the word about preventing lead exposure, especially in children, and helping our children be “Well Fed = Less Lead.”
For more information about lead poisoning prevention:
California Department of Public Health: Well Fed = Less Lead Card English/Spanish
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 and 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.
The California Department of Public Health (CDPH) would like to alert healthcare providers, local health jurisdictions and laboratories about three unrelated clade I mpox cases, which have been confirmed in Southern California with no history of recent international travel. Public health investigation indicates that community transmission of clade I mpox is occurring in California. Persons at increased risk of mpox should be encouraged to be vaccinated. Mpox testing should be considered for patients with compatible signs and symptoms (PDF), regardless of vaccination status or previous infection.
