HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
Health Officer Monthly Newsletter for Orange County Clinicians December 2025 December 19, 2025 Regina Chinsio-Kwong, DO County Health Officer
Season’s Greetings Dear Colleagues, As we enter December and close out another demanding year in Orange County, we want to extend our deep appreciation for your steadfast commitment to the health of our community. This season often brings both increased clinical pressures and meaningful moments of connection, and your work continues to reflect excellence, compassion, and resilience. Across our health care and public health systems, we have made measurable progress—from strengthening respiratory illness surveillance and expanding work on injury prevention, to deepening our partnerships on behavioral health, injury prevention, and health equity. These advances are possible because of your clinical leadership and your willingness to collaborate on shared priorities that protect and uplift the residents we serve. In this month’s newsletter, you’ll find timely updates on winter respiratory trends, vaccination reminders, information about our community health improvement plan, and resources to support clinical practice during the holidays. As always, our goal is to equip you with actionable information and to reinforce the vital bridge between the exam room and population-level health. Thank you for all you do, especially in these final busy weeks of the year. We look forward to continuing our collective work in 2026 to strengthen the health and well-being of Orange County. Warm regards, Dr. Regina Chinsio-Kwong and Deputy Health Officers Dr. Almaas Shaikh and Dr. Anissa Davis
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
PRESS RELEASES/NEWS HIGHLIGHTS 1. Federal Actions A. The Food and Drug Administration (FDA) released this letter December 15th reminding industry of their responsibility to remove recalled products such as ByHeart Infant formula when recall notices go out. To date, a total of 51 cases of infant botulism have been identified across the nation related to ByHeart. Parents are urged to stop using any ByHeart Whole Nutrition infant formula. Information about Infant botulism was highlighted in the November County Health Officer newsletter. If infant botulism is suspected, providers can consult experts 24/7 at the CDPH Infant Botulism Treatment and Prevention Program immediately at (510) 2317600. B. Hepatitis B Vaccination Centers for Disease Control (CDC) Director approves Advisory Committee on Immunization Practices (ACIP) recommendations On December 16, the CDC Director adopted ACIP’s recommendation of individual-based decision-making for hepatitis B immunizations for parents deciding on hepatitis B vaccination for newborns and infants born to women who test negative for the virus. CDC intends to update vaccination schedules to align with this change and created a Fact Sheet on Hepatitis B immunization. California and Coalition Response • California Department of Public Health (CDPH) and West Coast Health Alliance have reaffirmed support for the universal hepatitis B birth dose for all newborns ≥2,000g. • Concerns were raised about the lack of scientific rigor, potential delays in immunization, and increased risk of transmission. • California’s AB 144 ensures CDPH retains authority to issue independent vaccine guidance, which providers should continue to follow. • All doses of hepatitis B vaccine given in California, including doses given at birth, will continue to be covered by insurance and the Vaccines for Children (VFC) program. 2
HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
Clinical Guidance for Providers •
Continue to administer the hepatitis B birth dose per CDPH guidelines.
•
Educate families on the importance of early protection against hepatitis B.
•
Monitor updates from CDPH and CDC for any changes in official recommendations.
Recent Coverage of this Topic •
• • • • •
KFF Article - ACIP Vote Drives Online Engagement About Hepatitis B Vaccine, And Posts Claim a VAERS “Cover-Up” of COVID-19 Vaccine Deaths 12/18/2025 California Medical Association (CMA) - Update on topic 12/17/2025 American Academy of Pediatrics (AAP) - News Release - Court Hearing 12/17/2025 American Academy of Pediatrics - Statement 12/16/2025 American Medical Association (AMA) - Statement 12/16/2025 Public Health Communications Collaborative released recommendations and communication resources to help clinicians 12/8/2025
C. US Department of Agriculture (USDA) launched screwworm.gov late November and provides updates on Unified Government Response to protect the United States. 12/16/2025
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
2. State Actions a. California is bringing on former CDC officials to launch the Public Health Network Innovation Exchange (PHNIX) in an effort to strengthen public health innovation, collaboration, and communication at the state, national, and global level. The CDPH has set up a PHNIX website here, more on the announcement can be found here.
3. Local Press Releases, Alerts, Reports
a. Orange County Communicable Disease (CD) Control Division (CDCD) Health Alert - December 18, 2025 - Ciprofloxacin-Resistant Neisseria Meningitidis and Recommended Post Exposure Prophylaxis (PEP) A CD Alert was issued locally as cases of Neisseria meningitidis have been reported locally. The alert reminds providers that with the detection of ciprofloxacin-resistant strains of Neisseria meningitidis nationally and in Southern California, clinicians are recommended to discontinue the use of ciprofloxacin for invasive meningococcal disease (IMD) post exposure prophylaxis (PEP). Rifampin, ceftriaxone, or azithromycin are recommended options for IMD PEP in California.
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
b. OC Social Services Agency (SSA) Releases 31st Annual Conditions of Children Report 12/16/2025 The report, which is sponsored by SSA and the Children and Families Commission, highlights key trends in child well-being across four areas: Good Health, Educational Achievement, Economic WellBeing, and Safe Homes and Communities. The report aims to inform data-driven solutions for children’s needs. Notably, health care during pregnancy and improvements in kindergarten readiness were highlighted. Highlights Good Health • •
Improvements: More early prenatal care, vaccinations, and youth mental health support. Needs improvement: Delays in medical access, rising premature births, and a slight increase in teen births.
Educational Achievement • •
Improvements: Better reading and math scores, increased college readiness, and reduced absenteeism. Needs improvement: Decline in emotional maturity and rising dropout rates.
Economic Well-Being • •
Improvements: More licensed childcare spaces and strong local support. Needs improvement: High infant care costs, growing financial need, and increased reliance on assistance programs.
Safe Homes and Communities • •
Improvements: More foster youth reunified with families, low juvenile arrest rates. Needs improvement: Rising housing insecurity, increased accidental deaths, and persistent child abuse rates above the state average.
Prior published reports as well as the most updated reports are accessible at OC SSA Conditions of Children Reports.
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
c. Orange County - Communicable Disease Health Alert: 2025-2026 Respiratory Virus Season – Increasing Influenza and Respiratory Syncytial Virus (RSV) Flu and RSV have been on the rise locally resulting in increases in emergency department visits and hospitalizations. Clinicians are encouraged to remain informed of local trends, encourage prevention in the community, and treat as appropriate. d. CDPH/Health Advisory - Severe, Potentially Fatal Liver Damage in Children
and Adults Associated with Consumption of Forged Wild Mushrooms 12/5/2025 Late November and early December, multiple cases of amatoxin poisoning were reported from Monterey and San Francisco. Cases were linked to ingestion of Death Cap Mushrooms which have similar appearance to white button mushrooms. Clinicians need to be aware that gastrointestinal symptoms following ingestion of foraged wild mushrooms should be evaluated and cared for carefully. Clinicians can call the California Poison Control System at 1-800-222-1222 for guidance on diagnosing and treating. It is important to educate patients and the community to not consume foraged wild mushrooms as there are many poisonous types that grow naturally in California.
Images from CDPH Poisonous Wild Mushrooms.
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
PUBLIC HEALTH COMMUNICABLE DISEASE UPDATES 1. Winter Respiratory Virus Season is Here Seasonal influenza and RSV activity continue to increase but remain low nationally, in California and locally, based on test positivity, emergency department visits and hospitalization data. Influenza A viruses are the most common influenza viruses identified with the majority of those which are subtyped being Influenza A(H3N2). In a recent press release, the World Health Organization (WHO) noted that more than half of WHO European region is experiencing an intense, early influenza season which is driven by the new strain and encourages vaccination
COVID-19 Activity Remains Low It remains important to offer COVID-19, Influenza, and RSV vaccines to eligible individuals even now with increases in influenza and RSV activity.
Local trends can be found on the HCA Respiratory Viruses Dashboard while state trends can be found at CDPH’s Respiratory Virus Hub. For more information: CDC Respiratory Illness Data Channel CDC Respiratory Viruses Data and FluView CDC FluView.
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
2. Norovirus More recently, highly contagious norovirus has also been on the rise and has been highlighted in local news including this LA Times article. While cases and outbreaks of norovirus can occur at any time of year, the winter months tend to see an increase in disease activity. As a reminder, use of hand sanitizer DOES NOT kill norovirus! Remind the community and patients of the importance of hand washing!
More information about norovirus is available from the CDPH here. 3. Measles As of December 17, the CDC reports a total of 1,958 confirmed cases, across 44 jurisdictions, among 49 measles outbreaks. Currently, the largest outbreaks of measles involve communities in southwestern Utah and northern Arizona and an ongoing outbreak in South Carolina. CDC continues to monitor cases occurring in unvaccinated international travelers to the US. CDPH has reported 23 cases as of December 8, in 13 jurisdictions. For 2025, Orange County has had two confirmed measles cases in February and September.
The CDC continues to emphasize that providers should include measles in their differential in the appropriate clinical and epidemiologic settings: Healthcare Providers: Stay Alert for Measles Cases. Providers should continue to encourage measles vaccination in those who are not up to date. In addition, providers should review measles vaccination recommendations for those traveling outside of the US (Plan for Travel – Measles), including giving an early dose of measles vaccine to infants 6 through 11 months of age. Information and resources are available at CDPH Measles and HCA Measles.
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
4. Avian Influenza The risk to the public remains low and no person-to-person spread has been detected in California. The last human case reported in California was January 14, 2025. Updates from the CDPH are available here. Updates from the USDA are available here. As a reminder, health care providers should consider the possibility of avian influenza A(H5N1) virus infection in a patient with: • Signs or symptoms consistent with acute respiratory tract infection and/or conjunctivitis; AND • A history of exposure in the past 10 days to animals or humans suspected or confirmed to have avian influenza A(H5N1) or who have had exposure to raw milk. Clinicians are encouraged to educate patients who work with infected animals to use Personal Protection Equipment (PPE) and receive seasonal influenza vaccine during the influenza season. Clinicians who suspect influenza A(H5N1) virus infection should immediately reach out to HCA CDCD at (714) 834-8180 to help determine if testing is warranted and for further directions for appropriate specimen collection. In addition, if testing for influenza A is positive and sub-typing is attempted, and the results are not “nonsubtypable,” HCA CDCD should be contacted to facilitate transmission to the OC Public Health Laboratory for additional testing including influenza A(H5N1) testing. More information about bird flu can be found at: CDC Bird Flu Situation CDPH Bird Flu USDA Defend the Flock
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
5. Mpox
Clade II mpox continues to circulate at low levels. CDC noted a recent uptick of US cases of Clade II across several different states linked to an outbreak of Clade II mpox in Sierra Leone, Liberia, and other West African countries. No new Clade I mpox cases have been reported locally. A recent Public Health Alerts investigation in Southern California identified locally acquired Clade Ib mpox infections in unvaccinated individuals without travel history, indicating undetected transmission. The World Health Organization has issued a global alert due to increasing Clade Ib mpox spread. Cases of Clade II mpox continue to occur in Orange County with 2 cases in October and 3 cases in November. In 2025, so far, we have confirmed 12 cases, all Clade II, compared to 30 cases in all of 2024. With identified local transmission, providers should remain vigilant for people presenting with signs of mpox, test appropriately and notify the HCA CDCD at (714) 834-8180 with any suspect cases. Testing can be conducted through most commercial laboratories. All providers and particularly those serving the men who have sex with men (MSM) community should educate patients to prevent infection and spread of the virus, including: • Get vaccinated - Those at risk are advised to get the two-dose vaccine Jynneos if they haven’t already done so. Vaccination with both doses remains safe and effective and offers the best protection. Those who get exposed to mpox should get they mpox vaccine ASAP and before symptoms develop. Jynneos vaccine can be found through https://myturn.ca.gov/ or by Learn about vaccines and schedule contacting your local pharmacy about appointments at myturn.ca.gov. availability. • People with suspect mpox should avoid close contact and if confirmed, avoid contact with others until all lesions have healed. Get tested - Those who are exposed if symptoms develop (rash, fever or swollen lymph nodes). Additional information about mpox can be found at HCA Mpox and CDPH Mpox. 10
HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
6. Invasive Meningococcal Disease (IMD) Recently, two cases of IMD were identified in Orange County residents. No epidemiologic link has been identified between them. It is important for providers to remember that in California Ciprofloxacin is no longer recommended for post-exposure prophylaxis (PEP) due to increased resistance to Ciprofloxacin. In October 2024 CDPH released a Health Advisory with updated PEP recommendations for IMD. COMMUNITY COLLABORATIVE UPDATES 1. Orange County Community Health Improvement Plan The Orange County Community Health Improvement Plan (OC CHIP) is making strong progress, thanks to the efforts of six dedicated workgroups focused on key health priorities: Mental Health, Substance Use, Diabetes/Obesity, Housing & Homelessness, Care Navigation, and Economic Disparities. Examples of recent activities • Expanding the number of certified mental health professionals from underrepresented communities • Launching a multi-pronged campaign to combat the opioid crisis • Promoting family-based physical activity interventions • Evaluating programs that support financial empowerment, job training, and skill development Get Involved To join a workgroup or learn more, email occhip@ochca.com. View the full plan here: OC Health Improvement Plan | Orange County California - Health Care Agency. 2. Maternal, Child, and Adolescent Health (MCAH) • 31st Annual Report on the Conditions of Children in Orange County 2025 OC SSA Conditions of Children Reports. • Orange County Perinatal Council Meeting, January 13, 2026, 1 p.m. (virtual). Join county and community partners in supporting optimal perinatal health and wellness. Hear updates on maternal and infant health, mental health, and substance use. January’s meeting will focus on the 4th trimester and postpartum care. • Email PublicHealthNursing@ochca.com for meeting information. 11
HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
3. INJURY PREVENTION a. E-Bike Injury Prevention Collaborative In response to the growing concern over e-bike-related injuries, a multidisciplinary E-Bike Injury Prevention Collaborative has been formed in Orange County initiated by the OC Health Care Agency (HCA) and the OC Department of Education (OCDE). This initiative brings together a wide range of partners, including: • Local Trauma Centers • Public health officials from the HCA • Law enforcement and first responders • School districts and education leaders • Transportation agencies such as Orange County Transportation Authority (OCTA) • Community-based organizations and advocacy groups • UCI’s School of Transportation The collaborative was convened by Dareen Khatib, MPH, RDN, MCHES, Senior Administrator of Health Services at OCDE and Almaas Shaikh, MD, MPH, FACS, HCA Deputy Health Officer, with support from Regina Chinsio-Kwong, DO, HCA, County Health Officer, and is focused on a holistic, prevention-first approach. Goals of the collaborative include: • Reviewing injury data and trends across systems • Sharing best practices for prevention and education • Coordinating public messaging and safety campaigns • Exploring policy recommendations and legislative engagement The effort is part of a broader set of local initiatives highlighted in the 2025 Health Officer’s State of Public Health in Orange County, which emphasizes cross-sector collaboration to address emerging public health challenges like e-bike injuries. The OCTA has many resources on their webpage, including fun e-bike safety videos!
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
4. Trauma Systems of Care Meeting We had an excellent turnout at the inaugural OC Emergency Medical Services (EMS) Trauma Systems of Care meeting. Aimed at strengthening collaboration and advancing trauma care across the Orange County region, the meeting provided the opportunity to review the current and historical landscape of Orange County’s trauma system, highlight the work of our designated trauma centers and partners, and explore opportunities to enhance coordination and care for all in Orange County. The shared insights, collaboration, and commitment to trauma system excellence will continue to strengthen our countywide response. Together, we continue to build a coordinated, cross-sector Almaas Shaikh, MD, Deputy County Health Officer approach that supports patients throughout the entire continuum of trauma injury care. Thank you to all the partners and community for the voices and expertise.
Veronica Kelley, DSW, LCSW, OC Health Care Agency Director
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
SAFETY ALERTS/RECALLS/OUTBREAKS/FOODBORNE ILLNESSES Product Alerts/Recalls Related to Excess Lead Levels Town Food Service Equipment Co., Inc. is recalling 4 sizes of aluminum saucepans (1 quart to 3 quarts) because they have the potential to be contaminated with lead which may leach into food. The saucepans being recalled were distributed in many states, including California, between January 1, 2023, and November 30, 2025.
The recalled items have the following item or SKU numbers. Item no.
Description
SKU
35400
Town brand 1 Quart Aluminum Saucepan
843784003559
35401
Town brand 1-1/2 Quart Aluminum Saucepan
843784003566
35402
Town brand 2 Quart Aluminum Saucepan
843784003573
35403
Town brand 3 Quart Aluminum Saucepan
843784003580
The Food and Drug Administration has more at Town Food Service Equipment Co., Inc. Recalls Aluminum Saucepans Because of Possible Health Risk | FDA. 14
HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
FDA Recalls, Market Withdrawals, & Safety Alerts USDA Recalls and Public Health Alerts Date
Brand Names
Product Description
Product Type
Recall Reason
Company Name
12/18/2025
Charlevoix Cheese Company
Milk Cheddar Cheese
No Brand
Tamales
12/15/2025
So Delicious
Non-dairy frozen dessert
Food & Beverages
12/12/2025
Town Food Service Equipment Co
4 sizes of aluminum saucepans with capacities ranging from 1 to 3 quarts
Food & Beverages
Potential to be contaminated with Listeria monocytogenes. Potential presence of Listeria monocytogenes. Potential presence of foreign materials such as stones and other hard objects. Product has the potential to be contaminated with significant levels of lead (Pb) which may leach into food
Boss Dairy Farms
12/17/2025
Food & Beverages, Foodborne Illness, Cheese/Cheese Product Food & Beverages, Foodborne Illness
12/09/2025
Lucky Foods
Food & Beverages
Potential to be contaminated with elevated levels of lead
TBC Distribution Corporate
12/05/2025
Wegmans
Food & Beverages
Ambriola, Locatelli, Member’s Mark, Pinna, and Boar’s Head
11/26/2025
Prairie Farms
Fat Free Milk
Food & Beverages, Contaminants
Product may be contaminated with Salmonella Potential to be contaminated with Listeria monocytogenes May contain foodgrade cleaning agents
Mellace Family Brands California, Inc.
11/26/2025
Lucky Foods brand Cinnamon Powder 40g, best before date 15.09.2027, packaged in a vacuum or modified atmosphere 40g pouch with a brown label Deluxe Mixed Nuts Unsalted (34 oz tubs and 11.5 oz bags) Cheese
11/26/2025
Locatelli
Grated Pecorino Romano Cheese
Food & Beverages, Foodborne Illness
Wegmans Food Markets, Inc.
11/25/2025
Belevini
Dried Whole Salted Smelt, Mullet, Goby
Food & Beverages, Foodborne Illness
11/24/2025
Boar’s Head
Chicken Caesar Salad and Wrap
Food & Beverages
11/19/2025
Majestic Chef Pan
Milk Pan 24cm
Food & Beverages
Potential presence of Listeria monocytogenes. Potential to be contaminated with Clostridium botulinum. Due to the potential presence of Listeria monocytogenes Product has the potential to be contaminated with significant levels of lead (Pb) which may leach into food
Food & Beverages, Foodborne Illness
Primavera Nueva Inc. Danone U.S.
Town Food Service Equipment Co., Inc.
The Ambriola Company
Prairie Farms
Mamtakim, Inc.
Supreme Service Solutions, LLC. Shata Traders Inc
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
US Outbreaks CDC Current Outbreak List | Outbreaks | CDC o November 2025 Infant Formula- Infant Botulism Moringa Leaf PowderSalmonella Bearded Dragons- Salmonella Prepared Pasta Meals- Listeria International Outbreaks November 2025 - Marburg September 2025 - Ebola International Travel Health Notices o December 2025 Level 1- Rift Valley Fever in Mauritania and Senegal Level 2 - Chikungunya in Sri Lanka Level 2 - Chikungunya in Bangladesh Level 1 - Marburg in Ethiopia o November 2025 Level 1 - Rabies in Haiti Level 1 - Rabies in India
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
TRAINING & WEBINAR OPPORTUNITIES California Medical Association - CMA Continued Evolution of Public Health – Register for January 13, 2026 Vaccines • CIDRAP (Center for Infectious Disease Research and Policy) - Osterholm Update Episode 196: Flu Shifts: Why Vaccines Still Matter – Recorded November 20, 2025 • CIDRAP - Vaccine Integrity Project - Response to Health and Human Services (HHS) claims about vaccines – Recorded October 2025 • National Academies of Sciences, Engineering, and Medicine Vaccine Risk Monitoring and Evaluation at the CDC Report Release Webinar – Recorded October 7, 2025 • California Medical Association - The Evolving State of Public HealthVaccines, Advisory Groups and other Emerging Issues – Recorded October 29, 2025 HR 1 • CalHHS webinar - How Federal Policy Changes are Impacting a Healthy California for ALL – Recorded October 27, 2025 ο Recording link: HR 1 Efforts in California and the Rural Health Transformation Opportunity Slides link: 10-27-Webinar.pdf Webinar Links • National Emerging Special Pathogens Training and Education (NETEC) Podcast: EMS on the Frontlines: Drills, Exercises, and Unique ScenariosEpisode 46 – Recorded December 3, 2025 NETEC Podcast - December 3, 2025 • California Medical Association (CMA) On-Demand Webinars CMA Webinars • CIDRP Homepage • Osterholm Update Podcast - Dr. Michael Osterholm discusses the latest infectious disease developments. Link: CIDRAP Osterholm Update Episode 198 - Gaps in the Safety Net – Recorded December 18, 2025 National Association Webinar Webpages • American Public Health Association (APHA) APHA Webinars • CMA Recorded Webinars Virtual Grand Rounds (cmadocs.org) • National Foundation for Infectious Disease Webinars • Infectious Disease Society of America Public Health Page 17
HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
MONTHLY OBSERVATIONS/AWARENESS CAMPAIGNS Impaired Driving Prevention Month Dr. Jonathan Watson, Medical Director, Correctional Health Services takes a moment from his work inside the OC jail to focus on safe driving during this National Impaired Driving Prevention Month. Watch the video message by clicking here.
Information from OC Health Care Agency (HCA) doctors is posted on the HCA’s social media platforms and this webpage www.ochealthinfo.com/healthcorner. Safe Toys and Gifts Month Did you know imported and older toys, those made before 2009, are more likely to contain lead, a toxic metal which can affect your child's growth and development? Check your gift list twice to ensure toys are age-appropriate and safe! Avoid recalled toys: www.cpsc.gov/recalls. Wishing everyone a safe and healthy holiday season. For more info https://everyparentoc.org/blog/toys-andlead. #nationalsafetoysandgiftsmonth #thisispublichealth
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HCA Health Officer Monthly Newsletter for Orange County Clinicians December 2025
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