The influenza season is upon us once again. In the US, the flu season occurs during the fall and winter months with peak activity usually occurring from December through February. However, there are some years in which flu activity may last until May. During last year’s flu season, seventy-seven deaths occurred in LA County. The first deaths from influenza in Los Angeles County this year were reported on November 16th, 2017. So, influenza is present in our County and is causing serious illness, even death, among our population. Therefore, I highly encourage you and your family to get vaccinated as early in the season as possible.

Influenza, often referred to as “the flu,” is a disease caused by a virus that can illness that can be mild in some persons, but serious in others. It is spread from person to person by a cough or sneeze. You can also get the flu by touching your eyes, nose, or mouth after touching a surface that has the virus on it. Illness often start 2-5 days after being exposed, and usually begins suddenly. Symptoms commonly include fever, cough, sore throat, headaches, body aches, chills, runny or stuffy nose, extreme tiredness, and weakness. Some people may also have diarrhea and vomiting, but this tends to be less common in adults. Most people get better within two weeks, but some may develop serious complications like pneumonia, bronchitis, or sinus and ear infections. Many Los Angeles County residents are hospitalized each year due to complications from the flu, and some may die. That is why it is important for you and your loved ones to get the vaccine.

Get Vaccinated

The best way to prevent the flu is to get the flu vaccine. The vaccine not only protects you from becoming ill with the flu but also prevents the possibility that you may pass it on to your family, friends, or people you work with. Everyone 6 months of age and older should get the vaccine, especially those who are at high risk for complications. Individuals at high risk include people who are 65 years of age or older, people who have certain chronic medical conditions, pregnant women, and young children. For the second year in a row, the Centers for Disease Control and Prevention (CDC) only recommends the vaccine in shot form. The nasal spray form is not recommended this season due to concerns about its effectiveness.

Here are some key facts about the flu vaccine:

• The vaccine is effective. It helps protect you against several common flu strains that are in circulation during the current flu season. In most persons, the vaccine prevents you from getting the flu. In those who do get sick with the flu, the vaccine may lessen the severity of your illness.
• The vaccine is safe. The most common side effects are soreness, redness, tenderness, or swelling at the site on your body where you received the shot. Theses side effects are usually mild and are much less serious than actually having the flu. Severe allergic reactions are very rare.
• The vaccine does not cause the flu. The shot form of the vaccine contains dead flu viruses that do not cause flu illness. People sometimes mistake the side effects for having the flu, but this is not the case as the vaccine cannot cause influenza.

Most insurance plans fully cover flu vaccines. There is usually no out-of-pocket cost for patients who get the vaccine at their doctor’s office or at some pharmacies. If you have health insurance, contact your regular healthcare provider or insurance carrier to confirm your flu vaccine benefits.

Public Health Centers Offer Free Vaccines

If you do not have health insurance or your provider does not offer the flu vaccine, you can get a free vaccine without an appointment during clinic hours at our public health centers, at flu vaccination outreach events throughout the County, and at 17 Los Angeles County libraries. For more information on where to get the flu vaccine locally, please click here or call the LA County Information Line at 2-1-1. Due to on-going efforts to control the hepatitis A outbreak, some flu shot clinics will also make the hepatitis A vaccine available to persons who are at risk for hep A, including homeless individuals, active drug users, and people who provide services to these at-risk groups.

Tips to Protect Yourself from the Flu and Other Respiratory Illnesses

• Wash your hands regularly with soap and warm water for at least 20 seconds (about the time it takes to hum “Happy Birthday” twice)or use an alcohol-based hand sanitizer.
• Avoid touching your eyes, mouth, and face.
• Cough into your sleeve or tissue. Make sure your tissue is properly disposed.
• Stay home when you are sick.
• Avoid contact with people who are sick. People who are sick with the flu can spread it to others for up to 5 to 7 days after getting sick.

Visit the Department of Public Health’s Vaccine Preventable Disease Control webpage for more helpful information on the flu.

On September 19, 2017, the Los Angeles County Department of Public Health declared a local outbreak of hepatitis A occurring among persons who are homeless or actively use drugs. The declaration was based on the discovery of cases among individuals who appear to have acquired the infection within Los Angeles County. As of late September, Public Health has identified a total of 12 cases in Los Angeles County associated with this outbreak. Many of these cases had direct links with outbreaks in other counties. The most recent cases had no known links with other cases, suggesting that transmission may be occurring within our County.

The outbreak in Los Angeles County follows on the heels of much larger outbreaks that have been on-going in San Diego and Santa Cruz counties and are largely restricted to persons who are homeless or use drugs. Prior to the declaration of the outbreak in Los Angeles County, the Department of Public Health had been preparing for this possibility, given our proximity to San Diego and Santa Cruz counties. As cases have been identified, Public Health has worked with a variety of health care providers and community partners to conduct rapid investigations and ensure that all contacts receive appropriate treatment and follow-up. Now that a local outbreak has been declared, efforts to protect all persons who might be at-risk have become an even greater priority. Public Health is conducting active outreach to shelters, feeding centers, and other locations and working with a wide range of service providers to vaccinate persons who are homeless or use drugs, as well as other persons who might be at risk.

What is Hepatitis A and How is it Spread?

Hepatitis A is a highly contagious liver infection that is caused by a virus. Symptoms may include fever, fatigue, nausea, loss of appetite, stomach pain, vomiting, dark urine, pale stools, diarrhea, and yellowing of the skin or eyes (jaundice). Some people may not have any of these symptoms even though they are infected with hepatitis A. In some persons the illness can last for weeks or even months. Among individuals with pre-existing liver disease or other serious health problems, the illness can be severe, possibly leading to death.

Hepatitis A is spread from person-to-person through what is called the “fecal-oral” route. Persons who are infected excrete the virus in their stool. Other persons become infected by ingesting food or other material that has been contaminated with fecal material from an infected person. This is why hand-washing after using the bathroom or before eating food is so important. The ways in which hepatitis A is spread from one person to another include:

• Not washing your hands after using the bathroom or changing diapers
• Consuming food or drinks contaminated with the virus
• Having sexual or other close contact with infected persons
• Sharing needles, pipes or other items related to the use of drugs

Hepatitis A-infected individuals can spread the infection for two weeks before they exhibit symptoms. Once they have symptoms, they may spread the virus for another week. Some people will not have symptoms but can still pass the virus to someone else. Once someone fully recovers, they are immune and protected against ever getting the infection again.

Who is Most at Risk for Acquiring Hepatitis A?

Anyone can get infected with hepatitis A. However, in the current situation, those who are at-risk are limited to specific groups. These include persons who:

• Are homeless
• Use recreational drugs
• Have close contact with someone who has hepatitis A
• Have sexual contact with someone who has hepatitis A
• Are men who have sex with men
• Travel to or live in countries where hepatitis A is common
• Have chronic hepatitis or blood-clotting disorders
• Provide services that involve direct contact with persons who are homeless or use drugs
• Are involved in the environmental clean-up of areas that may be contaminated with feces
• Are food service workers who serve persons who are homeless

Hepatitis A Treatment

There is no specific treatment for hepatitis A infection. Most people will recover completely and, while they are ill, should rest, stay hydrated, eat nutritious foods, and be under the care of a doctor. However, those who become very ill may need to be hospitalized. Patients who are over 50 years of age, have underlying medical conditions or weakened immune systems are at greatest risk for severe illness. This is why it is very important to seek medical care if you experience the symptoms of hepatitis A.

Hepatitis A Prevention

The hepatitis A vaccine is the best way to prevent hepatitis A infection. This vaccine has been licensed for use in the United States since 1995. Most persons in Los Angeles County who were born in 1998 or later received the vaccine as children and are protected against this infection. The vaccine series consists of two shots, given six months apart. A single dose is highly effective in providing protection in adults, and there is no harm in getting the vaccine if you may have received it before.

Persons who are at-risk for infection as a result of the work they do can often receive the vaccine from their employer. Vaccine can also be obtained from a person’s primary care provider. Some pharmacies may also offer the vaccine. Persons who are at-risk for hepatitis A infection and who are not able to receive the vaccine from other sources, may get the vaccine at the Department of Public Health’s clinics. Extended hours are offered at some of these clinics. For more information on where to get the vaccine, call Los Angeles County’s 2-1-1 phone line.

Additional important steps to prevent hepatitis A infection include the following:

• Wash hands with soap and water after using the bathroom, changing diapers, and before preparing, serving or eating food and drinks
• Use your own towels, toothbrush and utensils
• Avoid sharing food and drinks with others
• Avoid sharing needles or pipes with others
• Clean any areas that may be contaminated with feces. Specific infection prevention and control measures can be found here.

Additional Hepatitis A Resources

The Department of Public Health’s hepatitis A web page has extensive information for the public including health education materials in multiple languages. Information specific to clinicians, such as how to report suspect cases of hepatitis A, is available on the Department’s Acute Communicable Disease Control hepatitis A web page.

You have probably been hearing about invasive meningococcal disease, IMD, or what is often called “meningitis,” in the news lately. There have been eight confirmed cases of IMD in Los Angeles County since the beginning of 2017, including one person who died from the infection. The ages of these cases range from 12 to 72 years, with the most recent cases occurring in teens. Although IMD is a very serious infectious disease, there is a vaccine available for persons who are at risk for the infection. It is highly recommended that children and high-risk groups get vaccinated.

What is IMD?

IMD is caused by a bacteria called Neisseria meningitidis. It is spread via direct contact with the secretions of someone who has the bacteria in their nose or throat. Kissing, coughing, or sharing items that put you in direct contact with an infected person’s saliva or spit are some of the most common ways IMD is spread. When a person becomes sick with IMD, they may initially feel like they are coming down with the flu. Usually, there is a sudden onset of fever, headache, and stiff neck. The illness can then progress to include confusion and a rash. If not treated, it can lead to swelling of the brain and spinal cord, loss of a limb, brain damage, or even death. This is why it is important to know what it is and how to prevent it.

The IMD Vaccine Can Protect You

The vaccine prevents IMD infection and is recommended for the following groups:

• All children ages 11-12 with a second dose at 16 years of age.
  • The Centers for Disease Control and Prevention recommends that all pre-teens and teens be vaccinated against meningococcus A, C, W and Y (Menactra or Menveo). A second type of vaccine (Bexsero and Trumenba) is available which adds protection against serogroup B.
• All HIV positive persons
• College students
• Workers in medical labs
• All gay or bisexual men (men who have sex with men) in Los Angeles County, regardless of risk or HIV status
• All persons older than 2 months of age who have certain medical conditions that make them less able to fight off disease

Seek Medical Care Immediately if You Think You Have IMD, or if You Have Had Recent Close Contact with Someone Who Has IMD

It is important to contact your health care provider if you experience symptoms that suggest you may have IMD. You should also talk to your health care provider if you have had recent close contact with someone who has IMD. IMD is treatable with antibiotics, but being vaccinated is the easiest and most effective way to prevent illness.

Our Public Health Centers offer vaccines for all people at higher risk for IMD, regardless of health insurance status. Please call ahead to confirm availability. Click here for additional clinics that offer the vaccine.

Ways to Prevent IMD

In addition to staying current with the vaccination recommendations, it is important to limit activities that spread saliva:

• Don’t share drinks, utensils, food, lip balm, or toothbrushes
• Don’t have multiple kissing partners
• Don’t share things you smoke, like cigarettes, e-cigarettes, cigars, pipes, and hookahs
• Practice good hygiene, including frequent handwashing and covering coughs and sneezes
• Limit close contact with people who are sick

Further information on IMD can be found on the Department of Public Health Acute Communicable Disease Control web page and the Immunization Program web page. More information specific to men who have sex with men can be found here.

Every year, World TB Day is celebrated on March 24th to commemorate the day in 1882 that Dr. Robert Koch discovered the bacteria Mycobacterium tuberculosis and identified it as the cause of the disease tuberculosis (TB). Well over 100 years later, TB persists as a global health threat, causing almost 1.8 million deaths worldwide in 2015 even though it is a preventable and curable disease.

TB most often affects the lungs but can attack any part of the body such as the brain, kidneys, or spine. It is spread when a person with TB disease in their lungs coughs or sneezes and releases droplets into the air, and people around them breathe in these droplets. Not everyone exposed to TB is infected. In a person who is infected, the body’s immune system is able to stop the bacteria from multiplying and thus prevents the person from becoming sick. However, in about 10% of persons, their immune system is unable to fight off the infection and the person becomes sick with the life-threatening form of the disease. During the period when the infection is dormant or “inactive,” a person has no symptoms and is not contagious to others. However, if their immune system is weakened by an illness, medications, or old age, the bacteria can become active, multiply, and cause the person the person to become sick.

Approximately 2.4 million Californians currently have the inactive form of TB infection. In Los Angeles County, 553 people suffered from TB disease in 2016. The best way for us to eliminate TB here and across the globe is to provide preventive treatment to those who have the inactive form of TB infection. This prevents them from becoming ill and from spreading it to others. In Los Angeles County, we seek to eliminate TB within the County, which would be fewer than 10 cases of TB per year. This would be a remarkable achievement!

Please join me in celebrating World TB day on March 24th and commit to taking action that will help us achieve our goal of elimination. In order to get there, we need you to:

Know the symptoms of TB disease.

This is the form of TB in which the person is sick. Most people with the contagious form of TB have symptoms which include fever, cough, weight loss, night sweats, and fatigue lasting greater than three weeks. If you have two or more of these symptoms, see a medical provider immediately. If you do not have health insurance, you may be evaluated at a Public Health Center.

Know your risk for TB infection.

The people most at risk for TB infection are those who were born or have lived in countries with high rates of TB, have medical conditions that suppress or will suppress their immune system, or know that they have had contact with a person who has the contagious form of TB in their lungs.

If you are at risk for TB infection, get tested for TB.

Your provider should have TB testing available with either the tuberculin skin test (TST) or interferon gamma release assay (IGRA) TB blood test. If your provider does not offer these tests or you do not have health insurance, Public Health Centers and low cost clinics offer TB testing for people at risk for TB infection.

If you have TB infection, get treated.

There are new drugs to treat TB infection. In addition, people with TB infection are now able to be treated with drugs that are safer and require less time to treat. We now have effective regimens that can treat the inactive form of TB infection in 3-4 months rather than 6-9 months. Talk to your provider about the treatment for TB infection.

Local Community Efforts to End TB

It will take a community-wide effort to eliminate TB in Los Angeles County. The Coalition to End TB consists of agencies and providers who serve populations at risk for TB and have committed to work together to find and treat TB infection and accelerate progress toward TB elimination. If you are a provider or agency and would like to get more information about the Coalition, click here.

If you have any questions about TB, please contact the Los Angeles County TB Control Program at 213-745-0800 or visit their web page.

We are now in the middle of the 2016-2017 flu season. A sharp increase in the number of cases has been seen throughout California, and more recently in Southern California. Even though the flu season is underway, it is still not too late to get the vaccine. I highly encourage you and your family to get vaccinated as soon as possible.

The flu, or influenza, is a virus that causes mild to serious illness. It is spread from person to person by a cough or sneeze. You can also get the flu by touching your eyes, nose, or mouth after touching a surface that has the virus on it. Symptoms usually start suddenly and can include fever, cough, sore throat, headaches, body aches, chills, runny or stuffy nose, extreme tiredness, and weakness. Some people may also have diarrhea and vomiting, but this tends to be less common in adults. Most people get better within two weeks, but some may develop serious complications like pneumonia, bronchitis, or sinus and ear infections. Many Los Angeles County residents are hospitalized each year due to complications from the flu, and some may die. That is why it is important for you and your loved ones to get the vaccine.

Get Vaccinated

The best way to prevent the flu is to get the flu vaccine. The vaccine not only protects you from getting the flu but also prevents the possibility that you may pass it to your family, friends, and the people you work with. Everyone 6 months of age and older should get the vaccine, especially those who are at high risk for complications. Individuals at high risk include people who are 65 years of age and older, people who have certain chronic medical conditions, pregnant women, and young children. Because recent studies have shown that the nasal spray form of the vaccine is ineffective, everyone should make sure to receive the shot form this year. Click here for more details.

Here are some key facts about the flu vaccine:

• The vaccine is effective. It helps protect you against several common flu strains that are in circulation during the current flu season. In most persons, the vaccine prevents you from getting the flu. In those who do get sick with the flu, the vaccine may lessen the severity of your illness.
• The vaccine is safe. The most common side effects are soreness, redness, tenderness, or swelling where you received the shot. The side effects are usually mild and are less serious than actually having the flu. Severe allergic reactions are very rare.
• The vaccine does not cause the flu. The vaccine contains dead or weakened flu viruses that do not cause flu illness. People sometimes mistake the side effects for having the flu, but this is not the case as the vaccine cannot cause influenza.

Most insurance plans fully cover flu vaccines. There is usually no out-of-pocket cost for patients who get the vaccine at their doctor’s office or at some pharmacies. If you have health insurance, contact your regular healthcare provider or insurance carrier to confirm your flu vaccine benefits.

Public Health Centers Offer Free Vaccines

If you do not have health insurance or your provider does not offer the flu vaccine, you can get a free vaccine without an appointment during clinic hours at our public health centers throughout Los Angeles County. For more information on where to get the flu vaccine locally, please click here.

Other Tips to Protect Yourself from the Flu

• Wash your hands regularly with soap and warm water for at least 20 seconds (about the time it takes to hum “Happy Birthday” twice).
• Avoid touching your eyes, mouth, and face.
• Avoid contact with people who are sick. People who are sick with the flu can spread it to others for up to 5 to 7 days after getting sick.

Click here for more helpful information on the flu.

Families often travel during the holidays to visit relatives or go on a vacation out of town. These trips are great opportunities to unplug from daily life, spend quality time together with family, and share new experiences. Whether camping in a nearby state park or traveling overseas, visiting places away from home exposes us to the great world around us.

From a health perspective, traveling for pleasure is good for our bodies and minds. Many vacation destinations offer recreational activities--from winter sports to water sports--and we’re more likely to explore our new surroundings while walking, biking, hiking or kayaking. Active transportation gets us physically moving and cuts down on pollution caused by motor vehicles.

New environments also stimulate our brains with novel sights, sounds, and situations. We have the chance to practice new skills--like building a campfire or speaking a different language--and we learn more about different cultures in museums, on tours, or when talking with residents. All of these mental activities exercise our brains and may promote health in a variety of ways, including the possibility of reducing the risk of Alzheimer's disease.

Ultimately, travel can be a time to have fun, rest, relax, and get away from the routine stresses of daily life. To make the most of your time away, it is important to take steps that ensure your vacation time doesn’t turn into sick time. When traveling near or far, keep these health tips in mind to stay healthy, happy and safe over the holidays or while on vacation in the new year!

• Ensure your family is up-to-date on all recommended vaccinations before traveling abroad. Many vaccine-preventable diseases that are now rare in the United States due to widespread immunization are still common in other parts of the world, such as measles and polio.
• Wear sunscreen. Just because it’s cold, it doesn’t mean you are safe from the harmful effects of UV rays. Even limited sun exposure can increase the risk of damage to our skin, and snow reflects even more UV radiation than water. Experts recommend covering the body in an ounce of sunscreen (an amount equal to about two tablespoons). Choose a product that protects against UVA and UVB rays, has an SPF rating of 15 or higher, and is water-resistant (if going in the water). Reapply every two hours or more if sweating or swimming. If using repellent, apply sunscreen before putting on the repellent.
• Apply EPA-approved bug repellent in areas with insect-transmitted diseases, such as Zika virus, malaria, and Lyme disease. The most effective repellents contain DEET or picaridin. When wearing sunscreen, apply repellent after putting on sunscreen.
• Walk in the center of trails, and stay away from heavily wooded and brushy areas when hiking or camping to avoid tickborne diseases. Wear long pants tucked into socks or boots to reduce exposure to fleas.
• Stay away from wild animals. They can transmit disease, like rabies and the plague, or really hurt you with their bite.
  • Park rangers advise staying at least 100 yards (the length of a football field) away from bears and wolves, and at least 25 yards away from other large mammals like bison, elk, bighorn sheep, deer, moose and coyotes.
  • Avoid feeding any animals in picnic or campground areas, and store food and trash in rodent- and bear-proof containers.
  • Never touch sick or dead animals.
• Avoid contaminated food and drinks that can cause diarrhea and other stomach upset. People traveling to developing countries are at particular risk.
  • Stick to hot foods that are thoroughly cooked, or dry and packaged foods. Opt for factory-sealed bottled or canned drinks, coffee and tea made with boiled water, and pasteurized milk from a sealed bottle.
  • Be wary of tap water in any form, including fountain drinks, juice from concentrate, and ice. Forego raw food, street food and bush meat.
  • Click here to download the CDC’s "Can I Eat This?" app for advice on making safe food and drink choices when you travel.
• Get up and walk around when traveling long distances by car, bus, train, or plane. Sitting still for long periods of time can increase the risk of forming a blood clot in the body, usually the legs. Choose an aisle seat to make moving easier and occasionally exercise your legs while sitting. Below are some suggested stretches:
  • Raise and lower your heels while keeping your toes on the floor.
  • Raise and lower your toes while keeping your heels on the floor.
  • Tighten and release your leg muscles.
• Practice motor vehicle safety on road trips, especially when it comes to kids. Make sure they’re properly strapped in age- and size-appropriate car seats, booster seats, and seat belts. Click here for a child passenger safety infographic with info about state laws and correct child passenger restraints by age.
• Avoid driving in really bad weather when possible. If you have to drive, be careful. In snow, drive slowly, accelerate and decelerate slowly, and increase your following distance to 8 to 10 seconds. Pack a charged cell phone, blankets, gloves, hats, food, water and any needed medication in your vehicle in case your family gets temporarily stranded.

Check out the CDC's website for travelers for more travel health and safety tips based on the destination.

Wherever you go or whatever you do this holiday season, have a very happy and safe holiday and wonderful New Year!

• Increased use of long acting contraception (hormonal birth control) versus condoms to prevent pregnancy. Unlike condoms, these methods do not protect against STDs;
• Condom fatigue among gay, bisexual, and other men who have sex with men, leading to more episodes of unprotected sex; and
• New technology that has changed the way people find sexual partners. Social media, internet sites, and dating/hook-up apps make it easier to have casual sexual encounters which are at increased risk for STDs.

What are STDs?

STDs are diseases spread from person to person through unprotected oral, vaginal, or anal sex. Women can also transmit STDs to their babies during pregnancy and delivery, or while breastfeeding in the case of HIV. More than 20 different STDs exist, although the most common include:

• Chlamydia
• Gonorrhea
• Hepatitis B
• Herpes
• Human Immunodeficiency Virus (HIV), which can lead to Acquired Immune Deficiency Syndrome (AIDS);
• Human Papilloma Virus (HPV), which can cause genital warts; and
• Syphilis

If left untreated, many of these STDs can cause serious health concerns ranging from infertility to increased risk for certain types of cancers. HIV and syphilis can be fatal without treatment. Therefore, it is important that you take steps to prevent STDs to protect your health, the health of your sexual partners, and your children.

Protect Yourself and Others
To reduce your risk of getting an STD:

• Get vaccinated for Hepatitis B and HPV, if eligible, and encourage others to do the same. The Hepatitis B vaccine is now required for all children entering daycare or elementary school, and is recommended for certain populations of unvaccinated adults. The HPV vaccine is recommended for children ages 11 and 12. Adults may receive the HPV vaccine through ages 26 for women and 21 for men. The HPV vaccine is also recommended for men who have sex with men as well as men with compromised immune systems through age 26 if not vaccinated when they were younger.
• Before having sex, talk to your partners about their STD testing history and whether they may have been exposed to an STD since their last test results. You cannot tell if someone has an STD just by looking at them.
• Use condoms and other barrier methods if you are unaware of a partner’s STD status. This may include new partners or those who have sex with other people. As mentioned, while birth control prevents pregnancy, it does not protect you from STDs. If you live in Los Angeles County, check out www.lacondom.com to have male condoms mailed to you free of charge or to locate places where you can pick up free male or female condoms.
• Talk to a healthcare provider about whether HIV pre-exposure prophylaxis (PrEP) is right for you. PrEP is a pill that you can take once a day, every day, to help reduce your chances of getting HIV. However, it does not protect you against other STDs. To learn more about PrEP, visit www.getprepla.com.
• Get tested if you think you may have been exposed to an STD, even if you don’t feel sick, or show any signs or symptoms. It is possible to have an STD and not know it. STDs are most often asymptomatic.
• Get recommended cervical cancer screenings if you are a woman or transgender man. This can help detect any cervical tissue anomalies early, including cervical cancer, and allow for prompt intervention. Remember, cervical cancer can be a result of HPV infection. General guidelines recommend a pap test for individuals ages 21 through 65 every three years. Talk to your healthcare provider to find out what’s right for you.

If diagnosed with an STD:

• Take the prescribed medication as instructed. Antibiotics are available to cure bacterial STDs, such as chlamydia, gonorrhea, and syphilis. To ensure that the antibiotics cure your infection, it is very important to finish all of the medicine as prescribed. This also reduces the chance of developing antibiotic-resistant bacteria, which makes treating STDs more difficult. At this time, a cure does not exist for herpes, HIV, or HPV, but medicine can help lessen the frequency and severity of related symptoms for herpes, and slow down the progression of HIV.
• Notify your sex partners. Encourage them to get tested for STDs and treated, if infected.
• If pregnant, seek prenatal care as soon as possible to seek treatment to protect your health and your baby. Treatment can prevent STD transmission to the baby and reduce the risk of pregnancy complications, including stillbirth, birth defects, or severe health consequences in infants and children.

Your sexual health is an important part of your overall well-being. If you live in Los Angeles County and are at least 12 years old, call the STD/HIV Hotline at (800) 758-0880 to find out where you can get tested and treated for free. The hotline can also help you with telling your partner(s) if you’ve been diagnosed with an STD. To learn more about STD prevention, visit our Division of HIV and STD Programs website at http://publichealth.lacounty.gov/dhsp.

Mosquito-Borne Diseases

Climate change is a source of concern for many, especially as warmer, drier weather is observed throughout the county. This affects us in many ways. While the mild El Niño season helped fill many of California’s reservoirs, water is still a major concern. We continue to experience record-breaking temperatures. In addition, in the past few weeks, a number of fires have caused many square miles of brush and property to burn.

Yet another result of our changing climate may be a rise in diseases, especially those that are related to insects. Warmer temperatures may allow mosquitoes to thrive, including two species of mosquitos recently introduced into Southern California that are known to spread diseases: Aedes aegypti (the yellow fever mosquito) and Aedes albopictus (the Asian tiger mosquito). Two mosquito-borne diseases I would like to cover this month include Zika and West Nile Virus.

Zika Virus

On August 1st, the Centers for Disease Control and Prevention (CDC) released travel guidance advising pregnant women, or women who may become pregnant, to avoid Wynwood, a neighborhood in Miami, Florida. This warning followed reports of mosquito-transmitted Zika virus in the area. More than 20 people in Florida have become infected locally by mosquito bites. To date, no local transmission of Zika has been reported in LA County. However, the Aedes mosquitoes that can transmit Zika are present in the San Gabriel Valley and in the eastern part of the County.

Recently, the California Department of Public Health (CDPH) reported that two infants with Zika-related microcephaly have been born in California to women who had Zika virus infections during pregnancy after spending time in a country where the virus is present. At the same time, state officials confirmed that a total of 21 infections have occurred in pregnant women. These events highlight the known, serious risks of Zika virus infection to the children of pregnant women. These include not only microcephaly, but also eye defects, hearing loss, impaired growth, and other brain defects. To learn more about microcephaly, click here. I urge all pregnant women and their partners to take steps to protect themselves against Zika virus.

The CDC outlines four simple recommendations to prevent Zika infection for women who are pregnant:

• Avoid travel to areas where Zika is spreading. Click here to learn more about places with local transmission of Zika.
• If you are in an area where Zika is present, take steps to prevent mosquito bites. These include:
  • Wear clothes that cover the whole body;
  • Apply mosquito repellent approved by the Environmental Protection Agency (EPA). EPA-approved repellents are safe for use by pregnant women when used as directed; and
  • Stay indoors when possible with screened windows and doors.
  
  Mosquito bite prevention here at home also helps everyone avoid all types of mosquito-borne diseases currently spread in LA County, such as West Nile Virus.



• Use condoms or other barrier methods with sexual partners who live or have traveled in Zika-affected areas. Zika can be sexually transmitted.
• Talk with your provider during prenatal visits. Tell them if you may have been exposed to Zika while traveling or through a sexual partner.

For couples who want to get pregnant, tell your doctor if you plan to travel to or if you or your partner recently returned from an area with known mosquito-borne Zika transmission.

West Nile Virus

West Nile Virus (WNV) is another disease spread by mosquitoes that are present throughout the county. Local transmission of the virus occurs every year in Los Angeles County and typically occurs during warm weather months when mosquitoes are the most active. In 2015, there were 300 cases leading to 24 deaths in LA County. This year, seven cases have been reported so far. More cases will occur as the summer progresses.*

WNV can cause very serious illnesses such as meningitis, encephalitis, paralysis and even death, while others who are infected may experience only mild flu like symptoms. Although everyone is at risk of WNV infection, the elderly and those with weak immune systems are more likely to experience severe effects. Practice mosquito bite prevention to protect yourself from the disease. Click here for more information on WNV.

Protect Your Community

To protect the people most at risk for serious harm due to mosquito-borne disease and to help keep LA County free of Zika transmission, help reduce the spread of mosquitoes by getting rid of places where they lay their eggs. Follow these tips:

• Dump and drain standing water from potted plants, pet water bowls, bird baths, and other places. Aedes mosquitos can breed in tiny amounts of water, for example, in as little as held by a bottle cap.
• Discard containers around homes where water collects. Check around and inside homes for eggs, and eliminate any location where eggs can be laid. Mosquitoes can lay eggs which remain alive until the next time water collects there, perhaps a year or more later.
• Ensure that swimming pools are well maintained. And for ponds or pools that are not maintained, “mosquito fish” which eat mosquito larvae can be obtained from your local vector control agency.
• Contact your local Vector Control to report a potential mosquito breeding situation. Click here to look up your vector control district by zip code.

Those you love are counting on you!

*Please note, these numbers exclude cases reported to Long Beach’s and Pasadena’s public health departments.

Mosquito-Borne Diseases

Climate change is a source of concern for many, especially as warmer, drier weather is observed throughout the county. This affects us in many ways. While the mild El Niño season helped fill many of California’s reservoirs, water is still a major concern. We continue to experience record-breaking temperatures. In addition, in the past few weeks, a number of fires have caused many square miles of brush and property to burn.

Yet another result of our changing climate may be a rise in diseases, especially those that are related to insects. Warmer temperatures may allow mosquitoes to thrive, including two species of mosquitos recently introduced into Southern California that are known to spread diseases: Aedes aegypti (the yellow fever mosquito) and Aedes albopictus (the Asian tiger mosquito). Two mosquito-borne diseases I would like to cover this month include Zika and West Nile Virus.

Zika Virus

On August 1st, the Centers for Disease Control and Prevention (CDC) released travel guidance advising pregnant women, or women who may become pregnant, to avoid Wynwood, a neighborhood in Miami, Florida. This warning followed reports of mosquito-transmitted Zika virus in the area. More than 20 people in Florida have become infected locally by mosquito bites. To date, no local transmission of Zika has been reported in LA County. However, the Aedes mosquitoes that can transmit Zika are present in the San Gabriel Valley and in the eastern part of the County.

Recently, the California Department of Public Health (CDPH) reported that two infants with Zika-related microcephaly have been born in California to women who had Zika virus infections during pregnancy after spending time in a country where the virus is present. At the same time, state officials confirmed that a total of 21 infections have occurred in pregnant women. These events highlight the known, serious risks of Zika virus infection to the children of pregnant women. These include not only microcephaly, but also eye defects, hearing loss, impaired growth, and other brain defects. To learn more about microcephaly, click here. I urge all pregnant women and their partners to take steps to protect themselves against Zika virus.

The CDC outlines four simple recommendations to prevent Zika infection for women who are pregnant:

• Avoid travel to areas where Zika is spreading. Click here to learn more about places with local transmission of Zika.
• If you are in an area where Zika is present, take steps to prevent mosquito bites. These include:
  • Wear clothes that cover the whole body;
  • Apply mosquito repellent approved by the Environmental Protection Agency (EPA). EPA-approved repellents are safe for use by pregnant women when used as directed; and
  • Stay indoors when possible with screened windows and doors.
  
  Mosquito bite prevention here at home also helps everyone avoid all types of mosquito-borne diseases currently spread in LA County, such as West Nile Virus.



• Use condoms or other barrier methods with sexual partners who live or have traveled in Zika-affected areas. Zika can be sexually transmitted.
• Talk with your provider during prenatal visits. Tell them if you may have been exposed to Zika while traveling or through a sexual partner.

For couples who want to get pregnant, tell your doctor if you plan to travel to or if you or your partner recently returned from an area with known mosquito-borne Zika transmission.

West Nile Virus

West Nile Virus (WNV) is another disease spread by mosquitoes that are present throughout the county. Local transmission of the virus occurs every year in Los Angeles County and typically occurs during warm weather months when mosquitoes are the most active. In 2015, there were 300 cases leading to 24 deaths in LA County. This year, seven cases have been reported so far. More cases will occur as the summer progresses.*

WNV can cause very serious illnesses such as meningitis, encephalitis, paralysis and even death, while others who are infected may experience only mild flu like symptoms. Although everyone is at risk of WNV infection, the elderly and those with weak immune systems are more likely to experience severe effects. Practice mosquito bite prevention to protect yourself from the disease. Click here for more information on WNV.

Protect Your Community

To protect the people most at risk for serious harm due to mosquito-borne disease and to help keep LA County free of Zika transmission, help reduce the spread of mosquitoes by getting rid of places where they lay their eggs. Follow these tips:

• Dump and drain standing water from potted plants, pet water bowls, bird baths, and other places. Aedes mosquitos can breed in tiny amounts of water, for example, in as little as held by a bottle cap.
• Discard containers around homes where water collects. Check around and inside homes for eggs, and eliminate any location where eggs can be laid. Mosquitoes can lay eggs which remain alive until the next time water collects there, perhaps a year or more later.
• Ensure that swimming pools are well maintained. And for ponds or pools that are not maintained, “mosquito fish” which eat mosquito larvae can be obtained from your local vector control agency.
• Contact your local Vector Control to report a potential mosquito breeding situation. Click here to look up your vector control district by zip code.

Those you love are counting on you!

*Please note, these numbers exclude cases reported to Long Beach’s and Pasadena’s public health departments.

Meningococcal Disease

In the last two months, 7 cases of invasive meningococcal disease have been reported within the Los Angeles County Public Health jurisdiction. Additional cases have been reported in surrounding jurisdictions. While a common social link among infected individuals has not been identified, the investigation is on-going and additional information may be available in the near future. Of note, most of the cases occurred among gay and other men who have sex with men (MSM).

In light of these recent cases among gay/MSM individuals, the Department of Public Health has reiterated its recommendation for meningococcal vaccinations among the following key risk groups:

• All HIV-positive people; and
• All gay/MSM individuals, regardless of HIV status, who regularly have close or intimate contact with multiple partners or who seek partners through digital applications (“apps”), particularly those who share cigarettes/marijuana or use illegal drugs.

The Department of Public Health offers meningococcal vaccines for people at higher risk. To ensure access for individuals without health insurance or whose healthcare provider does not offer the vaccines, there is no charge.

What is Meningococcal Disease?

Meningococcal disease is caused by a bacteria that can cause severe infections in the lining of the brain, spinal cord, and bloodstream. If not treated right away, it can lead to death. It is spread through saliva during close contact—like kissing and coughing—or living in close quarters (e.g. households). It is not spread through casual contact.

Vaccines to help protect against the types of meningococcal disease most common in the U.S. are the best way to prevent this disease. In addition to the recommendations above, meningococcal vaccinations are also recommended for:

• Children and adults 2 months of age and older who are HIV-positive;
• Preteens and teens. Click here for a graphic of recommended immunizations for this group;
• First-year college students living in a residence hall;
• Military recruits;
• Individuals with a damaged or removed spleen;
• Populations identified to be at increased risk because of disease outbreaks; and
• Individuals who are 56 years and older, and traveling to countries where the disease is common.

Ask your doctor about whether you and your loved ones are at risk for meningococcal disease and what vaccine might be right for you or your family.

The following are more ways to help reduce the spread of disease by limiting the spread of saliva, such as:

• Don’t share drinks, food, utensils, or toothbrushes;
• Don’t share things you smoke, like cigarettes, e-cigarettes, cigars, pipes, and hookahs; and
• Don’t have multiple kissing partners.

Meningococcal disease can start with flu-like symptoms, and progress to high fever, headache, stiff neck, confusion and rash. People who experience these symptoms should seek medical care immediately.

For more information and other resources on meningococcal disease, click here.

June 27th is National HIV Testing Day. The day is a great reminder to get tested for people who don’t know their HIV status or who may have been exposed to HIV since their last test. You can ask your primary care provider for an HIV test or you can get tested at one of many free HIV testing locations, available at this link: https://gettested.cdc.gov.

What is HIV?

Human Immunodeficiency Virus (HIV) is a virus that weakens a person’s immune system and can lead to AIDS if left untreated. HIV is spread through blood, semen, pre-ejaculate, and vaginal fluid when people share needles or have unprotected sex with someone who has HIV. Mothers with HIV can also give the virus to their babies during pregnancy, when giving birth, or while breast-feeding. HIV is not spread through casual or everyday physical contact.

Ways to prevent or lower the risk of getting HIV include:

• Not sharing needles for any reason;
• Using condoms during sex; and
• Taking Post-Exposure Prophylaxis (PEP) or Pre-Exposure Prophylaxis (PrEP), when needed.

What is PEP and PrEP?

PEP and PrEP are HIV prevention tools that protect against HIV in a way similar to how emergency contraception (aka the morning-after pill) and birth control pills are used to prevent pregnancy. PEP is medication a person takes within 72 hours (3 days) after exposure to HIV to reduce their chances of becoming infected. The sooner it’s taken after exposure, the more effective it will be. PrEP is a pill a person takes once a day to prevent HIV infection if exposed to the virus. Studies show that PrEP reduces the risk of HIV infection by up to 99% when taken as directed. PEP and PrEP do not protect against other sexually transmitted infections or pregnancy.

PrEP is a great tool to protect people who share needles or who do not use condoms every time they have sex with partners who may have HIV. People interested in getting PrEP should discuss it with their primary care provider or can seek care at a clinic with experience providing PrEP. PrEP medication is covered by health insurance plans, including Medi-Cal.

The Department of Public Health (DPH) now offers PrEP at Ruth Temple and North Hollywood Public Health Centers. The clinics help people who are at risk of HIV get started on PrEP. This fall, DPH will be funding several community health centers to provide PEP and PrEP for uninsured and underinsured persons. Last month, DPH launched its first-ever public education campaign, called “The Protectors,” to increase awareness about PrEP. To learn more about PrEP and see the campaign, visit Getprepla.com.

Alcohol is a huge continuing problem that affects many lives and can tear families apart. Alcohol is also the second leading cause of premature death and disability in Los Angeles County, contributing to more than 1000 deaths every year. In addition, the financial costs to society are staggering. In 2014, alcohol cost Los Angeles County more than $10 billion in related health care and criminal justice costs, lost productivity, vehicle and property damages, and death.

Earlier this month, the Los Angeles County Board of Supervisors recognized April as Alcohol Awareness Month to increase public awareness and understanding about alcohol abuse and alcohol-related issues. This local acknowledgment is part of a national effort, sponsored by the National Council on Alcoholism and Drug Dependence (NCADD), to highlight the importance of alcohol and drug abuse prevention and treatment.

This year’s theme "Talk Early, Talk Often: Parents Can Make a Difference in Teen Alcohol Use" draws attention to the problem of drinking, particularly binge drinking, among young people and children, and highlights the role parents can play in preventing teen alcohol use. Reducing underage drinking is critical to securing a healthy future for America’s youth. A key strategy is to provide education on the dangers of alcohol and/or drug abuse and its effects on children — and parents need to know the important part they can play.

In Los Angeles County, 23 percent of youth ages 12 to 20 reported drinking at least one alcoholic beverage in the past 30 days. Furthermore, 15 percent of youth under 21 reported binge drinking, that is, drinking 4-5 drinks or more during a single session. For teens, binge drinking can lead to dangerous and unfortunate consequences that can have lifelong impacts. Excessive alcohol use among young people is linked to motor vehicle accidents, violence and injury, suicide, problems at school, alcohol poisoning, unsafe sex and other risky behaviors, even for those who may never develop a dependence or addiction.

We encourage parents and children, friends and families, and community members and leaders to reach out to each other and talk about the impact of alcohol use within their homes and communities. Here are some tips to get the conversation started:

Talk to your Teen about Alcohol and Drugs

• Listen and Encourage Open Dialogue: Remember, this is a conversation, not a lecture. Showing kids that we are really listening to their thoughts and concerns is an important part of helping them.
• Set Expectations: Clearly state the “house rules” about drinking. The expectations should reflect your own beliefs and values, and the family should agree upon the limits.
• Provide Good Reasons Not to Drink: Focus on what your teen can gain by avoiding drinking: higher self-esteem, positive outlook, self-respect, or avoiding embarrassing and harmful situations. While it’s important to acknowledge the consequences of alcohol use, avoid scare tactics.
• Be Positive: Many parents have discovered that talking about alcohol and drugs with their children has built bridges rather than walls between them and have proudly watched those children learn to make healthy, mature decisions on their own.
• Know and Share the Facts: Educate yourself on the dangers of teen alcohol use and effective prevention strategies. If your family has a history of problems with alcohol, include this information as part of your honest and open dialogue with your children, just as you would with any other disease, such as heart disease, diabetes or cancer.

With everyone's help, we can prevent the deadly and costly harms caused by alcohol abuse, and help those who need treatment find support and overcome alcohol use disorders.

Public Health Is Working For You
At the Department of Public Health we work with health providers, community partners and the public to raise awareness and understanding about alcohol and drug abuse.

• The Substance Abuse Prevention and Control (SAPC) program leads and facilitates the delivery of a full spectrum of prevention, treatment, and recovery support services proven to reduce the impact of substance use, abuse, and addiction in Los Angeles County.
• Anyone looking for treatment, information and resources in Los Angeles County can call toll-free (888) 742-7900 or visit the Public Health website.
• About 15,000 individuals received treatment from publicly funded treatment centers in Los Angeles County each year (2005-2013), according to Los Angeles County Participant Reporting System data.

There has been a lot of information on Zika in the news lately. Below are some ways we can address this disease to keep our friends and family safe, and to prevent Zika transmission in our County.

What is Zika Virus?
Zika is a virus spread by mosquitos. There is no vaccine to prevent a Zika and there is no medicine to treat the infection. Shortly after being infected with the virus, about one in five people will experience mild symptoms, including fever, rash, joint and muscle pain, and pink eye. These symptoms last a few days, perhaps up to one week. Four in five people feel no symptoms at all.

The main issue that is causing considerable concern is a possible link between Zika virus and babies born with microcephaly. Microcephaly is an uncommon condition that causes unusually small heads in infants, leading to severe developmental issues and sometimes death. Mother-to-child transmission during pregnancy is possible during all three trimesters. To learn more about microcephaly, click here.

Recently, the Centers for Disease Control and Prevention (CDC) issued a travel warning that advises pregnant women to postpone travel to Zika-affected countries. It is recommended that pregnant women check the CDC travel advisories if they plan to travel for any reason and to delay travel if their plans include any countries where Zika outbreaks are occurring. There are approximately 30 countries with active Zika virus transmission. For a map and list of these countries, click here. If travel plans cannot be changed, pregnant women are advised to consult with their obstetrician or other medical provider before traveling.

A recent case of Zika in Texas in which the virus appears to have been transmitted sexually has also caused concern. In response, the CDC released guidelines to prevent possible Zika transmission through sexual activity. Sexual activity includes vaginal, anal, or oral sex. Men who live or have traveled in a Zika-affected areas are advised to abstain from sex or to consistently and correctly use condoms every time for vaginal, anal or oral sex with pregnant partners throughout their entire pregnancy.

How to Prevent Zika Virus Infection
At this time, no Zika transmission has been documented in LA County. To prevent Zika virus from becoming established here, as well as to prevent other mosquito-borne diseases, there are things that all of us can do. This is especially important as mosquitos also spread dengue, chikungunya, and West Nile Virus among humans, as well as heartworm among animals. Let’s protect the health of people and pets by doing our part to eliminate mosquito breeding sites around our homes.

• Get rid of places where mosquitos lay their eggs.
• Every two to three days, dump and drain water from potted plants, pet water bowls, bird baths, and other places where water collects.
• Also check inside homes and workplaces for eggs, and eliminate any location where eggs can be laid. Mosquitos that transmit Zika virus like to live and lay eggs indoors.
• Contact the Los Angeles County Vector Control at www.lawestvector.org or call (310) 915-7370 to report a potential mosquito breeding situation.

• Cover up. Wear clothes that cover the whole body, such as long-sleeves, pants, close-toed shoes, and other protective clothing when outside;
• Apply EPA-approved mosquito repellent. The most effective repellents contain DEET or picaridin. Click here for a table showing the efficacy of commercially available mosquito repellents based on a 2015 study. If wearing sunscreen, apply repellent after putting on sunscreen;
• Wear clothes treated with Permethrin. Permethrin is the only approved insect repellent used for factory-treated clothing. For more information about Permethrin, click here; and
• Stay indoors when possible. Make sure any open windows or doors have screens to keep mosquitos out.

Public Health Is Working For You
Due to the rising concern about Zika virus, Public Health has been quick to respond by:

• Investigating possible cases of Zika virus infection in our communities. There has been only one confirmed case of Zika virus infection in LA County. The person became infected while traveling abroad in El Salvador last November. The person has since recovered;
• Updating our website with information and education on Zika virus for LA County residents. You can find our Zika webpage with Zika resources here; and
• Developing outreach plans and education activities for medical providers and populations more likely to travel to Zika-affected areas.

What Is Cervical Cancer?
Cervical cancer is a disease caused by the uncontrolled growth of cells that line the cervix. The cervix is the lower part of the uterus that connects the uterus to the vaginal canal. Worldwide, cervical cancer is the 3rd most common cancer among women and the 2nd most frequent cause of cancer-related death. Fortunately, the availability of screening tests such as the Pap test have greatly reduced cases of cervical cancer in the U.S. In addition, several vaccines are available that can prevent the human papilloma virus (HPV) types that cause most cervical cancers.

Today, approximately 12,000 women in the U.S. get cervical cancer each year, and 4,000 women die from it. Compared to all women, Latina women are more likely to be diagnosed with cervical cancer, while African American/Black women are more likely to die from it. These health disparities are largely the result of unequal access to healthcare, which leads to lower cervical cancer screening rates and delayed treatment if abnormal cell growth or cancer is identified. Some real-life stories from women and their families impacted by cervical cancer and HPV are available at this link.

Cervical Cancer Screening: What You Need to Know
Ensuring women receive the recommended screening tests for cervical cancer is critical for detecting and treating early signs of cervical cancer. The Pap test (sometimes called Pap smear) looks for cell changes on the cervix that might develop into cancer if left untreated. The HPV test looks for the virus that can cause abnormal cells on your cervix that can lead to cancer. The U.S. Prevention Services Task Force recommends these standard guidelines:

• Women 21 to 65 years of age receive a Pap test every 3 years; Women 30 to 65 years of age may alternatively choose to receive a Pap test and HPV test every 5 years (co-testing).
• Women older than 65 years if they have not received adequate screening in the past.

The HPV Vaccine Helps Prevent Cervical Cancer
Most cases of cervical cancer are caused by HPV. HPV is a common virus that is passed from one person to another through skin-to-skin contact during sex. Nearly all sexually active men and women get HPV at some point in their lives. In many cases, the virus goes away on its own and does not cause health problems, but it can lead to cervical and other types of cancer in some people.

There is an HPV vaccine available to protect people from diseases caused by HPV, including cervical and other cancers. The vaccine is safe and effective. Currently, it is recommended for:

• All girls and boys ages 11 or 12 years. This helps protect them from getting HPV before they first have sex.
• Men through age 21 and women through age 26 if they did not get the vaccine when they were younger.
• Men who have sex with men through age 26, and for men with compromised immune systems (including HIV) through age 26 if they did not get HPV vaccine when they were younger.

HPV vaccines are covered under most health insurance plans. Those who do not have health insurance may visit our Immunization Program website or call our Office of Women’s Health hotline at 1 (800) 793-8090 for referrals to providers that may offer HPV vaccines at low to no cost. For more information about HPV and the HPV vaccine from our Immunization Program, click here.

DPH Is Working for You
At the Department of Public Health (DPH) we work with health providers, community partners and the public to raise awareness and promote cervical cancer screenings and the use of HPV vaccines. The following are a few activities focused on this important topic:

• The Office of Women’s Health hotline is multilingual and helps low-income, uninsured women get appointments for Pap tests at low or no cost. The hotline can also refer callers to locations that offer the HPV vaccine. Call the hotline at 1 (800) 793-8090 for more information.
• We provide education about cervical cancer screening and HPV vaccines through the Women’s Health hotline, during community events, on our website, and through social media. Follow us on Twitter at @lapublichealth.
• Our Immunization Program works with providers to promote the use of HPV vaccines and serves on an HPV Community Advisory Board led by the Norris Comprehensive Cancer Center at the University of Southern California.

For more information, check out our fact sheet in English or Spanish on cervical cancer screening, HPV vaccine recommendations, and resources for getting these services.

I would like to wish everyone a happy and healthy holiday season! I hope many of you are able to spend time with family and friends while enjoying and sharing your cultural traditions. To help you and your loved ones celebrate safely over the next few weeks, here are some tips and guidelines to keep in mind:

1. Prevent food-borne illnesses. Improperly prepared or stored food can make you and your guests sick.
   • Wash your hands with soap and warm water for at least 20 seconds before handling food and after using the restroom.
   • Wash fresh fruits and vegetables thoroughly before eating or cutting into them.
   • Separate raw meats and poultry from other foods such as fruits and vegetables. Avoid cross contamination by using separate cutting boards, knives, and platters for these foods.
   • Wash cutting boards, utensils, and platters after preparing each food item and before going on to the next item.
   • Bring sauces, soups, and gravies to a rolling boil when re-heating.
   • Keep hot foods hot (135°F or above). Use chafing dishes or pans with Sternos or other heating devices, or keep foods in the oven until they are served.
   • Keep cold foods cold (40°F or below). Refrigerate leftovers within 2 hours. Throw out foods that should have been kept cold, but have been left out for more than two hours.
   • Leftovers should be used within 3 to 4 days. Avoid “taste testing” food or drinks to see if they have spoiled.
   To test your own food safety habits, take our Environmental Health Division’s Home Kitchen Self-Inspection!
   
   
2. Ensure everyone gets to the party and back home safely. Don’t let people drive when they’re “tipsy,” “buzzed,” or drunk.
   • Encourage people to plan ahead if they intend to drink alcohol; make sure they have a non-drinking driver to take them home.
   • Arrange alternate transportation if someone is unable to drive home safely. This may include a sober friend or family member, a car-share or taxi service, or public transportation. The Metro will offer free service during the night of Christmas Eve and New Year’s Eve and some companies offer free rides or car tows for drivers who have consumed alcohol on New Year’s Eve night.
   • When hosting an event:
     • Offer a variety of non-alcoholic drinks;
     • Serve standard-sized drinks to help guests accurately estimate their alcohol intake and prevent overindulgence; and
     • Stop serving alcohol at least an hour or two before the party ends to reduce the likelihood of someone driving immediately after consuming a cocktail.
   Also keep in mind that blood alcohol content (BAC) is affected by the number of drinks, a person’s individual characteristics (e.g., weight, sex, food intake, individual metabolism), and passage of time. Refer to the BAC chart from the California DMV for more information. Here’s some more information about Drinking and Alcohol Abuse from our Substance Abuse Prevention and Control Division.
   
   
3. Give kids gifts that are age-appropriate, accessible, and safe. Avoid toys that can accidentally choke, burn, or injure a child.
   • Avoid giving young children toys with small parts (including magnets and “button” batteries). If a piece can fit inside a toilet paper roll, it’s not appropriate for kids under age three.
   • Include properly-fitted protective gear (e.g., helmets, knee pads, elbow pads) when giving sports equipment, bikes, scooters, skateboards, and skates. It’s also a good idea to orient the child on safety rules before they’re allowed to play with them.
   • Avoid toys (and clothes) that can hurt children, such as ropes and cords, heating elements, and flying objects (e.g., bb guns, sling shots, etc.).
   • Watch out for toys and other gifts with lead. Check out this fact sheet on tips for lead-safe toys.
   • When purchasing toys for children with access and functional needs:
     • Take into consideration the strength, fine motor skills, and cognitive ability needed to use the toy; and
     • Search for items that allow for adjustable heights, sound volume, and difficulty levels.
     Consult the AblePlay website for more information.
   • Check the Consumer Product Safety Commission's Recall by Product website before you buy or save your receipts. You can sort the latest product recalls by babies and kids, electronics, sports and recreation, and toys.
   
   
4. Protect you and your family from the flu. Get your annual influenza (flu) vaccine. The flu season usually peaks in winter between December and February. Find out more about the flu vaccine here.

As the year comes to a close, take a moment to reflect on important events that occurred throughout the year and get ready to ring in 2016! The Department of Public Health looks forward to our continued partnership with you in keeping your family healthy, active, and safe for many years to come.

Get Smart: Know When Antibiotics Work

November 16-22, 2015 is Get Smart Week. The goal of Get Smart Week is to raise awareness about antibiotic resistance. Antibiotic resistance occurs when bacteria change in a way that allows them to grow in the presence of drugs that would normally kill them or limit their growth. Every year, more than two million people in the U.S. get infections that are resistant to antibiotics, and at least 23,000 people die as a result. In Los Angeles County, we have seen several examples of ‘superbug’ outbreaks in hospitals as a result of this growing problem.

Unnecessary antibiotics can be harmful.

Antibiotics are powerful drugs. They can be lifesaving when used appropriately, but using antibiotics incorrectly or when it is unnecessary can lead to more antibiotic-resistant bacteria. Therefore, it is very important to only use antibiotics when needed to treat bacterial infections. They do not work and should not be used to treat infections caused by viruses. Use of antibiotics when someone has a viral infection can actually be harmful. Antibiotics won’t cure a viral infection and can kill protective bacteria in our bodies, increasing the chance to develop a serious infection or an infection caused by bacteria resistant to antibiotics. Antibiotics can also cause an allergic reaction or other unpleasant side effects.

Protect yourself and your loved ones. Use antibiotics appropriately.

Be a champion for proper antibiotic use at your doctor’s office, in your family, and in your community. Here are a few tips to help prevent more antibiotic resistance in our communities:

• Don’t demand antibiotics from your doctor. Antibiotics are used to fight bacteria and should only be used for bacterial infections. They will not help cure infections like the common cold or flu that are caused by viruses. Talk with your doctor about the type of infection you have and ask whether or not antibiotics would be useful in treating it.
• Take antibiotics exactly as directed when prescribed by your doctor. Even if you start to feel better, never skip doses or stop taking an antibiotic early unless your doctor tells you to do so.
• Only take antibiotics prescribed for you; do not share or use leftover antibiotics. Unused antibiotics may not be the right medicine for the problem and can lead to serious harm. Even if the drug seems to work and the pain or symptoms go away, it may not actually cure the infection. Without the right treatment, the health condition will remain and may even get worse over time. Discard old antibiotics (and other unused/expired prescriptions) at a County Household Hazardous Waste and Electronic Waste Permanent Collection site.
• Reduce your risk of getting sick. Take these steps to help keep you healthy during cold and flu season:
  • Get the flu shot. The flu shot will help protect you from getting the flu.
  • Regularly wash your hands with soap and warm water for at least 15 seconds (about the time it takes to sing “Happy Birthday” twice).
  • Avoid touching your eyes, nose, mouth, and face.
  • Avoid contact with people who are sick.

The Department of Public Health (DPH) works hard to ensure that antibiotics are used properly in hospitals, nursing homes, and in the community. We track antibiotic-resistant infections, as well as antibiotic use in healthcare facilities to prevent and measure our progress in limiting the spread of these life-threatening infections. We also collaborate with healthcare facilities to improve infection prevention practices throughout the County. In the community, DPH plans to provide educational resources for patients at community health clinics on proper antibiotic use.

Thank you for helping us to reduce the rise of antibiotic resistance in our communities!

COMMUNITY RESOURCES:

To learn more, please visit http://www.cdc.gov/getsmart/.

It's the Start of the Flu Season

The 2015-2016 influenza season has started. Make sure you and your family are protected! Get your influenza vaccine now.

Influenza, or the flu, is a virus that causes mild to serious illness. Flu symptoms usually start suddenly and may include fever, coughing, sore throat, headaches, body aches, chills, runny or stuffy nose, extreme tiredness, and weakness. Some people may also experience vomiting and diarrhea, though this is more common in children. Most people get better within two weeks, but some people can develop serious complications, such as pneumonia, bronchitis, sinus and ear infections. In Los Angeles County, residents are hospitalized each year due to flu complications and some will die.

Protect Your Loved Ones – Get the Flu Vaccine

The flu spreads from person-to-person through coughing and sneezing or by touching your eyes, nose, or mouth after touching a surface that had the virus on it. The best way to prevent the flu is by getting the flu vaccine. The vaccine helps protect you from getting the flu and then passing it on to your family, friends, and people at work. Everyone ages 6 months and older should be vaccinated, especially those at serious risk for flu-related complications. These include people 65 years of age and older, people with certain chronic medical conditions, pregnant women, and young children. The flu vaccine is available in the form of a shot or nasal spray. Ask your doctor which vaccine may be right for you and your family.

I encourage everyone to get the flu vaccine as soon as possible. Some key facts about the flu vaccine include:

• The vaccine is effective. It helps protect against several flu strains, including the H3N2 strain most likely to cause illness this flu season. If you do get sick with the flu, being vaccinated may also lessen the severity of illness.
• The vaccine is safe. The most common side effects are soreness, redness, tenderness or swelling where the flu shot was given and nasal congestion after the flu vaccine nasal spray. These side effects are usually mild and are less serious than having the flu. Serious allergic reactions are very rare.
• The vaccine does not cause the flu. The vaccine contains killed or weakened viruses that cannot cause flu illness. People sometimes mistake the vaccine's side effects for flu symptoms.
• You can get the flu vaccine at no charge. Most insurance plans fully cover flu vaccines as a preventive health service. There is typically no out-of-pocket costs for patients who get the vaccine at their doctor’s office or at some pharmacies. If you have health insurance, please contact your regular healthcare provider or insurance carrier to confirm your benefits.

The Department of Public Health (Public Health) kicks off a number of County-wide flu prevention activities this month.  Throughout the fall, we will offer flu vaccines at our public health centers and flu clinics organized across the County. Flu clinic sites may include senior and community centers, schools, public libraries, and churches. Click here for a listing of all flu clinics by date and city. Appointments are not necessary, and there is no charge for vaccines to ensure access to those who don't have health insurance or whose healthcare provider does not offer flu vaccines.

More Ways to Protect Yourself from the Flu

The following are some other tips to help protect you and your family from the flu:

• Regularly wash your hands with soap and warm water for at least 15 seconds (about the time it takes to sing “Happy Birthday” twice);
• Avoid touching your eyes, nose, mouth, and face;
• Avoid contact with people who are sick. People with the flu can spread it to others up to about 6 feet away; and
• If you are sick, stay home until 24 hours after the fever ends. People can spread the flu to others for up to 5 to 7 days after becoming sick.

For more information about the flu, check out our flu fact sheet.

Prescription drugs play a critical role in treating people when they are sick or feel pain. It is also very important to properly dispose of all unused or expired medications. Unused medication can pose a major health and safety risk if left in the home. Consider these facts:

• Prescription drugs are widely available in the home. According to the National Community Pharmacists Association, an estimated 200 million pounds of unused or expired prescription drugs are stored in medicine cabinets across the United States.
• Prescription drugs left in the home can be misused. Nearly 75% of LA County residents who used prescription drugs incorrectly got them from family members, other relatives, or friends.
• Young children may consume prescription drugs while unsupervised at home. In 2012, poison control centers across the country fielded 490,000 calls from caregivers regarding a possible medication overdose involving a small child and more than 64,000 kids nationwide were treated in an emergency room for medicine poisoning. If you believe a child in your care has accidentally overdosed on prescription or over-the-counter medication, call (800) 222-1222 as soon as possible.
• Older children and adults may abuse prescription drugs that are easily accessed at home to get high. In a 2013 survey, 3 in 4 teens said it was easy to get prescription drugs from their parents’ medicine cabinet and over one-third who have misused or abused a prescription drug got it from home. This can have serious consequences. The Centers for Disease Control and Prevention (CDC) estimates that 44 people die every day from an overdose of prescription painkillers and many more become addicted. In LA County, 8,265 drug-related deaths were reported between 2000 and 2009; 61% of those deaths involved a commonly abused prescription or over-the-counter drug.
• Giving unused prescription drugs to friends or family when they are sick is dangerous. Unused medications that are given to others can lead to serious problems. Medications can lead to a severe allergic reaction or other serious unintended side-effects. In rare cases, these can be fatal. Even when the drug seems to work and the person’s pain or symptoms go away, it may not actually cure the problem. Without proper medication or the correct dose, the individual’s health condition will persist and may even get worse over time.

For these reasons, finding ways to properly discard unused and expired medication is important to protect our communities.

Use the following methods to properly dispose of unused prescription medication:

• Take advantage of household hazard waste (HHW) collection sites. LA County has a few permanent locations, including Antelope Valley Environmental Collection Center, the EDCO Environmental Collection Center in Signal Hill.
• Find one-day, mobile HHW collection events throughout the County. Click here for a flyer with more detailed information. Sign up for E-Notify to receive automatic notifications of new events.
• Anonymously drop the medication off at designated Sheriff’s stations.
• If discarding prescription medication at home, place it in a sealed container and then out of reach from children and pets. Some experts recommend mixing it with coffee grounds or kitty litter before disposal to discourage people and animals from finding and consuming it.

Currently, the Department of Public Health is working on an initiative with other County Departments to expand safe and secure disposal options. This will help prevent more unused prescription medication from misuse and abuse.

Last Thursday the California Department of Public Health (CDPH) announced a case of human plague in California. The patient lives in LA County and was hospitalized for the illness after a family trip to Yosemite State National Park and Stanislaus National Forest. Officials are still investigating where the individual may have contracted the disease.

Human plague is caused by the bacterium Yersinia pestis and takes one of three forms depending on the area of infection within the body. Bubonic plague is an infection of the lymph nodes; pneumonic plague is an infection of the lungs; and septicemic plague is an infection in the blood stream. All three types of infections can be deadly in about 50% of infected individuals if not treated right away.

Today, human plague is rare but does occur in the western United States, including California. It is typically transmitted by flea bites from infected rodents or direct contact with sick animals. In very rare cases, it can spread person-to-person from a patient with pneumonic plague. The last reported previous case in California was in 2006, although two other cases of human plague have been reported this year in Colorado. Both patients in Colorado died from the disease.

Reduce your risk of exposure to human plague by doing the following when hiking or camping:

• Avoid feeding squirrels, chipmunks, or other rodents in picnic or campground areas. Store food and refuse in rodent-proof containers;
• Never touch sick or dead rodents;
• Avoid walking, hiking, or camping near rodent burrows;
• Wear long pants tucked into socks or boots to reduce exposure to fleas;
• Spray insect repellent containing DEET on socks and pant cuffs; and
• Leave pets at home when visiting rural areas. They can get plague from wild animals or fleas and increase potential exposure to their owners.

When at home:

• Prevent wild animals, such as rodents or stray cats, from seeking shelter in and around your place. Remove heavy brush and block access to crawl spaces, attics, and under decks or porches;
• Never trap or relocate a wild animal on your own. Call your local animal control office for help;
• Get rid of outside sources of food that may attract wild animals. Keep pet food indoors. Pick up fallen fruit from trees. Secure trash with a tight fitting lid; and
• Use flea control products on your pets.

Visit here for more information about human plague.

I am happy to report that new Ebola cases in West Africa have significantly declined due to the extraordinary efforts by healthcare professionals to care for infected individuals and reduce community transmission. The number of new weekly cases in West Africa has remained below 30 for several weeks and efforts remain strong to bring the epidemic to a closure as soon as possible. Here in LA County, we continue to maintain surveillance activities as necessary to ensure the health and safety of travelers returning from Ebola-affected countries and we anticipate a decrease in active monitoring as the situation continues to improve in West Africa. At this time, I wish to thank all of our County Departments and community partners for their very strong support and dedication in the deployment of our Ebola preparedness and response strategy. Their collaboration strengthened local efforts to protect LA County residents, and there remains no confirmed or suspected cases of Ebola in our jurisdiction.

Second, I want to share that Senate Bill 277 was recently passed by our state legislature and signed into law by Governor Jerry Brown. The new law no longer allows personal belief exemption (PBE) from school vaccination requirements. I recognize the importance of this measure as it is designed to protect the public’s health by ensuring that as many individuals as possible receive needed vaccinations against potentially fatal diseases. In California, 90% of kindergartners were up-to-date with required immunizations in 2014, and Los Angeles County was slightly below the state average with 86% up-to-date. PBEs may be a contributing factor to this recent decline in vaccination rates for school required immunizations.

Vaccines are the best defense we have to prevent serious illnesses from spreading in our communities, such as diphtheria, measles, pertussis (whooping cough), and polio. For example, it is likely that higher vaccination rates would have better contained the multi-state measles outbreak experienced last December. Many individuals who fell ill during the outbreak were not immunized.

Last month our Office of Health Assessment and Epidemiology released a new report, “What Do Parents Think? Knowledge and Attitudes about Immunization.” The report includes results from a survey of parental knowledge and attitudes toward vaccinations, immunization facts, and recommendations. The following are facts everyone should know about vaccines:

• Vaccines are safe: Many vaccines can have mild side effects, such as fever or soreness around the injection site. More serious side effects are extremely rare, and vaccine-preventable diseases that might occur in unvaccinated persons are likely to cause much more harm. There is no evidence that the Measles, Mumps, and Rubella (MMR) vaccine or Thimerosal, a preservative in some vaccines, cause autism. The original research paper by Dr. Andrew Wakefield in The Lancet that alleged a vaccine-autism link in 1998 was retracted in 2010 by the medical journal following no corroborating scientific evidence. Thimerosal has also been removed from all childhood vaccines in 2001, with the exception of inactivated flu vaccines due to an abundance of caution and a general efforts to reduce childhood mercury exposure.
• Vaccines are effective: Vaccine-preventable diseases have declined dramatically over the past century. Smallpox was successfully eradicated worldwide in 1977, the U.S. has been polio-free since 1979, and measles was eliminated in the U.S. in 2000. This means that measles is no longer endemic in the U.S. population. Recent outbreaks have been the result of unvaccinated travelers bringing the virus from other countries into the U.S. We know LA County is a popular tourist destination with a bustling Tom Bradley International Airport, so our communities are at some risk for diseases imported from abroad that are typically no longer seen in the U.S.
• Vaccines protect individuals and the people around them: High vaccination rates in a population protect those who are unable to receive immunizations for health reasons by preventing the spread of the disease. This concept is called herd immunity. Unfortunately, if the vaccine rate in a population dips below a certain level, it is more likely that herd immunity will decline and an outbreak will occur, disproportionately affecting the unvaccinated, including infants too young to vaccinate, immune-compromised individuals, and people with life threatening allergies to the vaccine.

To improve immunization rates and protect residents from vaccine-preventable diseases, our Immunization Program works to raise awareness and ensure access to immunizations. The program assists residents in making informed decisions about immunizations and conducts ongoing surveillance to detect and quickly respond to cases of vaccine-preventable diseases to prevent further transmission. Click here for a list of clinics that provide no- to low-cost immunizations to youth 18 years of age and younger in LA County.

For more information about immunizations or other health topics, please review the material available on our webpages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator.

Progress continues to be made as the world responds to the Ebola epidemic in West Africa. Although the situation has improved greatly and the weekly number of new cases has fallen well below 100, we must remain vigilant until the number of new cases in affected countries reaches zero. Here in Los Angeles County, we continue to closely monitor individuals who travel here from affected countries and who may be at risk of developing Ebola. We maintain our surveillance and actively monitor a small number of travelers each day who have returned from Ebola-affected countries. There are currently no suspected or confirmed cases of Ebola in LA County.

The Department of Public Health (DPH) maintains efforts to ensure we have the most effective strategy possible in place to respond to a potential case of Ebola in LA County. DPH and our County partners are strongly committed to protecting your health and safety. Ongoing departmental activities include:

• Tracking and monitoring travelers returning to LA County from affected West African countries;
• Ensuring hospitals remain prepared to medically support an individual with Ebola, including their staffs’ ability to access and properly use personal protective equipment (PPE). Some medical centers in LA County are included on the federal list of Ebola Treatment Centers designated by the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH); and
• Refining County-wide protocols to effectively handle a suspected or confirmed case of Ebola in LA County.

For more information about Ebola, please review the material available on our webpages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator. Operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting Ebola in LA County is low. The information can help you and your family stay informed.

The world response to the Ebola epidemic in West Africa has decreased the number of new cases occurring there and there is hope that the epidemic can be stopped sometime this year. Here in Los Angeles County, we continue to closely monitor individuals who travel here from affected countries and who may be at risk of developing Ebola. We maintain our surveillance and actively monitor a small number of travelers each day who have returned from Ebola-affected countries. There are currently no suspected or confirmed cases of Ebola in LA County.

The Department of Public Health (DPH) maintains efforts to ensure we have the most effective strategy possible in place to respond to a potential case of Ebola in LA County. DPH and our County partners are strongly committed to protecting your health and safety. Ongoing departmental activities include:

• Tracking and monitoring travelers returning from affected West African countries to LA County;
• Ensuring hospitals remain prepared to medically support an individual with Ebola, including their staffs’ ability to access and properly use personal protective equipment (PPE). Some medical centers in LA County have been added to the federal list of Ebola Treatment Centers designated by the Centers for Disease Control and Prevention (CDC) and the California Department of Public Health (CDPH); and
• Refining County-wide protocols to effectively handle a suspected or confirmed case of Ebola in LA County.

For more information about Ebola, please review the material available on our webpages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator. Operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting Ebola in LA County is low. The information can help you and your family stay informed.

There are no suspected or confirmed cases of Ebola in LA County. Our level of vigilance remains high as we continue to closely monitor individuals who have traveled here from affected countries and may be at risk of developing Ebola based on their activities abroad.

The Department of Public Health (DPH) maintains efforts to ensure we have the most effective strategy possible in place to respond to a potential case of Ebola in LA County. DPH and our County partners are strongly committed to protecting your health and safety. Ongoing departmental activities include:

• Tracking and monitoring travelers returning from affected West African countries to Los Angeles County;
• Ensuring hospitals remain prepared to medically support an individual with Ebola, including their staff’s ability to access and properly use personal protective equipment (PPE); and
• Refining County-wide protocols to effectively handle a suspected or confirmed case of Ebola in LA County.

For more information about Ebola, please review the material available on our webpages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator. Operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting Ebola in LA County is low. The information can help you and your family stay informed.

There are no suspected or confirmed cases of Ebola in LA County. Our level of vigilance remains high as we continue to closely monitor individuals who have traveled here from affected countries and may be at risk of developing Ebola based on their activities abroad.

The Department of Public Health (DPH) maintains efforts to ensure we have the most effective strategy possible in place to respond to a potential case of Ebola in LA County. DPH and our County partners are strongly committed to protecting your health and safety. Ongoing departmental activities include:

• Tracking and monitoring travelers returning from affected West African countries to Los Angeles County;
• Ensuring hospitals remain prepared to medically support an individual with Ebola, including their staff’s ability to access and properly use personal protective equipment (PPE); and
• Refining County-wide protocols to effectively handle a suspected or confirmed case of Ebola in LA County.

For more information about Ebola, please review the material available on our webpages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator. Operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting Ebola in LA County is low. The information can help you and your family stay informed.

Earlier this week the Centers for Disease Control and Prevention (CDC) added Mali to the list of Ebola-affected countries, which continues to include Guinea, Liberia, and Sierra Leone. To date, more than 15,000 individuals have contracted Ebola during this latest epidemic and there have been 5,420 related deaths worldwide. In the United States, a second Ebola-related death occurred last Monday after Dr. Martin Salia was transferred to Nebraska Medical Center from Sierra Leone for medical care following several days of illness. His tragic passing highlights the critical importance of early intervention and care in recovery.

There are no suspected or confirmed cases of Ebola in LA County. Our level of vigilance remains high in LA County as we continue to closely monitor individuals who have traveled here from affected countries and may be at risk of developing Ebola based on their activities abroad.

The Department of Public Health has spent the last several weeks strengthening local efforts to ensure we have the most effective strategy possible in place to respond to a potential case of Ebola in LA County. To test key elements of our Ebola preparedness and to practice our response, the Department successfully completed a tabletop exercise with our County partners. The exercise demonstrated our high level of preparation and strong commitments to protect LA County residents’ health and safety. Additional departmental activities that are ongoing include:

• Tracking and monitoring travelers returning from affected West African countries to Los Angeles County
• Ensuring hospitals remain prepared to medically support an individual with Ebola, including their staff’s ability to access and properly use personal protective equipment (PPE)
• Refining countywide protocols to effectively handle a suspected or confirmed case of Ebola in LA County.

For more information about Ebola, please review the material available on our web pages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator. Operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting Ebola in LA County is low. The information can help you and your family stay informed.

Ebola outbreaks continue to affect Guinea, Liberia, and Sierra Leone in West Africa with some new cases reported in Mali. While the rate of new cases in Liberia and Guinea has leveled off, the rate of rise in Sierra Leone continues to accelerate. To date, approximately 14, 000 individuals have contracted Ebola during this latest epidemic and there have been 5,160 related deaths worldwide. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) will continue to monitor the situation and coordinate relief efforts to control the spread of infection. It is important to note that only two cases of Ebola have been exported from West Africa to other parts of the world, which is a testament to the effectiveness of the strategies that are in place to prevent spread. Those two cases are, of course, the case that was diagnosed in Dallas on September 30, and the more recent case in a physician in New York City who has recovered and been released.

There are no suspected or confirmed cases of Ebola in LA County. Our level of vigilance remains high in LA County as we continue to closely monitor individuals who have traveled here from affected countries and may be at risk of developing Ebola based on their activities abroad.

The Department of Public Health (DPH) has spent the last several weeks strengthening local efforts to ensure we have the most effective strategy possible in place to respond to a potential case of Ebola in LA County. To test key elements of our Ebola preparedness and to practice our response, this week the Department will host a tabletop exercise with our County partners. Additional departmental activities that are ongoing include:

• Tracking and monitoring travelers returning from affected West African countries to Los Angeles County
• Ensuring hospitals remain prepared to medically support an individual with Ebola, including their staff’s ability to access and properly use personal protective equipment (PPE)
• Refining countywide protocols to effectively handle a suspected or confirmed case of Ebola in LA County.

For more information about Ebola, please review the material available on our webpages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator. Operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting Ebola in LA County is low. The information can help you and your family stay informed.

The Department of Public Health continues to coordinate efforts to ensure we have an effective strategy to respond to a potential case of Ebola in LA County. As part of these ongoing efforts, we met last week with the Hospital Association of Southern California and the California Association for Health Facilities. The meetings were held jointly with LA County Emergency Medical Services and provided hospitals and long-term health care facilities with an update on Ebola, our current activities, and response plans for LA County. Each meeting was an opportunity to strengthen partnerships and facilitate coordination with all health care providers who may play a role in identifying and treating an individual with Ebola.

To date, there are no suspected or confirmed cases of Ebola in LA County. We remain prepared to respond should a case occur here. Our strategy remains unchanged and includes three key elements: to rapidly identify and isolate any individual suspected of having Ebola, ensure the safe care of that individual, and monitor any individuals who may have been exposed. This includes closely monitoring individuals who have returned from Ebola-affected countries in West Africa and may be at risk of developing Ebola so that we can quickly isolate anyone who might develop symptoms and prevent the possible spread of this disease. As needed, I may issue quarantine or other orders to specific individuals. The Department is also in close communication with workplaces, schools, and other entities that may be directly impacted by any quarantine order.

The University of California announced that all five UC Medical Centers are willing and able to provide in-patient care for individuals who have confirmed cases of Ebola. This includes the UCLA Medical Center in Los Angeles. Public Health continues to work closely with UCLA and other hospitals throughout LA County to ensure that they remain prepared to medically support an individual with Ebola and safeguard the health of their workforce who may be involved in the patient’s care.

For more information about Ebola, please review the material available on our webpages or call 2-1-1 from any land or mobile phone in LA County to speak with an operator. Operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting Ebola in LA County is low. The information can help you and your family stay up-to-date.

The State Health Officer from the California Department of Public Health recently issued a risk-based quarantine order for any individuals coming into California who had contact with a person confirmed with Ebola in Liberia, Sierra Leone, or Guinea. The Los Angeles County Department of Public Health will comply with the State’s order.

To date, there are no suspected or confirmed cases of Ebola in Los Angeles County. We remain prepared to respond should a case happen here. Our strategy is threefold: to rapidly identify and isolate any individual suspected of having Ebola, to assure the safe care of that individual, and to monitor any individuals who may have been exposed.

The State’s directive builds upon a multi-layered strategy to strengthen local efforts that ensure that those who are at risk of developing Ebola are under close monitoring. This order creates a standard, statewide protocol for managing those individuals at highest risk of developing and possibly spreading this disease.

Public Health applauds the brave and extraordinary work of health care workers in West Africa, and we welcome these dedicated individuals upon their return. Our department is in constant communication with local agencies that send health care workers to West Africa, and we will work with these organizations to identify any returning individuals to whom this order may apply.

We will have an open process and clear communication with returning health care workers as to what the quarantine order entails. Our goal is to ensure the health and safety of all people in LA County, including the health care workers transitioning back home.

If you have questions about Ebola, I encourage you to review the material available to you on our webpages, or dial 2-1-1 from any land or mobile phone in LA County and speak with one of the operators. These operators have general information about Ebola, including how it is prevented, how it is spread, and why the risk of getting sick with Ebola in LA County is low. This information can help ease concerns that you and your family might have about Ebola.

Last week a doctor based in New York, who had treated patients with Ebola in Guinea, tested positive for Ebola. In Los Angeles County there are no confirmed or suspected cases of Ebola, and we remain prepared to respond should a case happen here.

I have confidence in the procedures we have in place to keep the public safe. It is important for everyone to note that of the four cases that have been diagnosed in the U.S., two had exposures in West Africa and two were health care workers who had provided care to an Ebola patient.

Our efforts to ensure the safety of the people of Los Angeles County are ongoing. The Department of Public Health continues to work with hospitals and health care providers to support their abilities to quickly identify and isolate any individual suspected to have Ebola. We are also actively engaging first responders, health care professionals, local elected officials, and community members with information on Ebola and supporting efforts to train health care workers on how to care for patients with Ebola symptoms and to capture patients’ travel histories.

For example, Public Health recently partnered with the UCLA Medical Center to test the hospital’s plan and processes for caring for people with Ebola. UCLA emergency room doctors and nurses prepared as if they were receiving a person who was suspected to have the disease. Emergency department nursing staff led the patient through an outside entrance into an isolation room in the emergency department. The medical team then admitted the patient directly to a specially designated and prepared room in the hospital. Doctors and nurses practiced putting on the personal protective equipment, taking blood tests, disposing of waste, and taking off the personal protective equipment.

Public Health doctors and nurses observed the drill and provided feedback to the UCLA physicians and nurses. Our role as the Los Angeles County Department of Public Health is to be the bridge that connects us as quickly as possible with the lessons learned in other communities and puts those lessons learned into practice here locally. Our goal is to keep all health care workers, especially those on the front lines of patient care, safe.

I recognize that ongoing coverage about Ebola has caused concern for adults and children alike. It’s normal to feel some stress and anxiety; however, it is very important to manage our feelings effectively. We’ve been collaborating with the LA County Department of Mental Health to identify things we can all do to stay healthy:

1. Manage Our Stress
   • Keep usual routines for eating, sleeping and exercising.
   • Talk openly about feelings of fear, anxiety and irritability.
   • Try relaxing stretches and breathing exercises.
   • Fight fear with facts. Refer to credible sources for periodic updates on the situation.
2. Connect with Our Community
   • Keep contact with friends, extended family, coworkers, and neighbors.
   • Participate in fun activities in your community, neighborhood, or faith group.
   • Be careful not to exclude others who are from or have traveled to affected regions since unwarranted discrimination and be emotionally harmful.

I would like to affirm once again that there are no suspected or confirmed cases of Ebola in Los Angeles County. We continue to monitor and learn from events that are occurring elsewhere in the U.S. and in the world so that each day we are more prepared than we were yesterday.

For general information about Ebola, dial 2-1-1 from any land or mobile phone in Los Angeles County. For more information about mental health assistance, please call the Access Center 24/7 Helpline at (800) 854-7771.

As the news continues to evolve around Ebola, I want to reassure all residents in Los Angeles County that, to date, there are no suspected or confirmed cases of Ebola in Los Angeles County. This past week, we have worked diligently to update and strengthen our plans to address Ebola. We are more prepared today than we were yesterday, and we will be more prepared tomorrow than we are today.

Our efforts to reach out and partner with all the organizations that may be involved in the response to a case of Ebola are continuing. A taskforce consisting of multiple County agencies and departments is working together so that we are all prepared in the event we need to take action. We are working with the Los Angeles County Metropolitan Transportation Authority (MTA) to address safety concerns regarding rail and bus lines, and to ensure people feel safe traveling by public transit.

We continue to work with health care facilities. Our role as the Department of Public Health is to be the bridge that connects us as quickly as possible with the lessons learned in other communities and puts those in practice here. Our goal is to keep all health care workers safe in addition to ensuring patients have the best care possible. We encourage all hospitals in the County to develop training exercises for their staff that can be adapted to their own facility’s unique needs to help ensure staff is comfortable and skilled in the use of those safety procedures.

I also want to reassure everyone in Los Angeles County that while health care facilities continue to train their staff to respond should a case of Ebola occur here, these same hospitals, clinics, and doctor’s offices remain open to treat any patient with any illness.

Finally, I encourage everyone to get the influenza vaccine as we enter flu season. This time of year, people start to travel more as we near the holiday season. Public transportation, including air travel, means that we are in close contact with each other, whether on a bus, a train, or airplane. The flu virus is much more common and more easily spread than Ebola. Influenza and Ebola may share some of the same symptoms, but there is very low risk of catching Ebola and very high risk for catching the flu. Free flu vaccines will be available at our public health centers and over 100 flu clinics organized throughout the county. Flu Clinics for a listing of our flu clinics. Services are available to everyone at no cost.