Advisory

March 03, 2025

Advisory

Influenza-Associated Encephalopathy and Encephalitis in Children

Influenza-Associated Encephalopathy and Encephalitis in Children 

This purpose of this Health Advisory is to inform clinicians about reports of pediatric influenza-associated encephalopathy and encephalitis (IAE), including four deaths nationally from acute necrotizing encephalopathy (ANE), a severe form of IAE. Centers for Disease Control and Prevention (CDC) has requested that local public health be notified about these conditions.  

ACTIONS REQUESTED OF CLINICIANS   

• At every opportunity, strongly recommend and administer influenza vaccine to all patients at least 6 months of age. 
  
  
• Initiate early antiviral treatment for patients of any age who are at increased risk for influenza-associated complications. 
  
  
• Consider IAE or ANE in pediatric patients who present with persistent fever and altered mental status. CSF may show normal WBCs with elevated protein. Providers should:
     
  
  • Test for influenza. Retain and submit positive specimens to Alameda County Public Health Laboratory for subtyping and sequencing. 
    
    
  • Hold serum and CSF for possible further testing. 
     
  • Voluntarily report all suspected or confirmed IAE or ANE cases that have occurred since October 1, 2024 and meet the following criteria to Alameda County Public Health at (510) 267-3250:
     
    • Age <18 years 
      
      
    • Admitted to an acute care hospital or pronounced dead in an emergency department between October 1, 2024, and May 30, 2025 
      
      
    • Laboratory-confirmed influenza virus infection within 14 days preceding hospital presentation, during hospitalization, or in respiratory specimens collected post-mortem 
      
      
    • Documented neurologic abnormalities (meets one or more of the following):
      
      
      • Diagnosis of encephalopathy or encephalitis 
        
        
      • Neurologic signs or symptoms including but not limited to seizures, altered mental status, delirium, decreased level of consciousness, lethargy, hallucinations, or personality changes lasting >24 hours 
        
        
      • Neuroimaging abnormalities such as brain edema, brain inflammation, or brain lesions 
        
        
      • Electroencephalogram abnormalities 
        
        
      • Abnormal brain autopsy findings, if available, for children who died 
        
        
• Report laboratory-confirmed influenza-associated fatal pediatric cases (<18 years) to Alameda County Public Health at acutecd@acgov.org as soon as possible. 

For more information, please review the complete advisory. 

January 08, 2022

Advisory

Outpatient Therapies for the Treatment and Prevention of COVID-19 in High-Risk Patients

The purpose of this Health Advisory is to inform clinicians in Alameda County about the availability of outpatient therapies for high-risk patients with 1) mild to moderate COVID-19 illness who are not yet hospitalized; or 2) ongoing risk of exposure to COVID-19. When resources are limited, therapy should be prioritized for patients who are at the highest risk of progressing to severe COVID-19, as described in the NIH Panel’s interim statement. 

Please see the full health advisory full details and visit our website at https://covid-19.acgov.org/antibody-treatment

For questions regarding the distribution of COVID-19 outpatient therapeutic products within ALCO, please contact Cynthia Frankel, RN, Alameda County Therapeutics Distribution Lead at cynthia.frankel@acgov.org

For clinical questions about COVID-19 therapeutics, please contact Arnie Spanjers, MD, Alameda County Public Health Department at arnie.spanjers@acgov.org

April 28, 2021

Advisory

Revised Reporting Requirements for Suspect Variant SARS-CoV-2 Infections

The purpose of this Health Advisory is to inform clinicians in Alameda County about the changes in reporting for Variants of Concern, including:

(1) Definition of Vaccine Breakthrough Cases of Interest (VBCIs) and (2) Deletion of specific quarantine requirements for close contacts of persons with VOC infections.

• ACPHD Health Advisory