MEDICAL CARE SERVICES

Resources for Health Professionals

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Medical Care Services' Health Professionals Outreach & Education shares information on clinical guidelines, community resources and other services to support you and your practice. Please contact us at MCS@sdcounty.ca.gov.

Join the Health Professionals telebriefing on the 1st Thursday of the month at 3:30 pm. CME and Dental CE will be provided! 

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  • Avian Influenza (H5N1 Bird Flu)

    Background:

    The H5 Avian Influenza virus, commonly known as bird flu, is widespread in the wild bird population and has caused infections in poultry, wild, and domestic mammals, (e.g., cattle and cats). Most human infections with bird flu have occurred after unprotected exposure to sick or dead infected poultry or dairy cattle.

    The majority of human illnesses have been mild (e.g., upper respiratory symptoms, conjunctivitis), with rare significant cases (e.g., pneumonia, multi-organ failure), and one death.

    Risk to Public:

    At this time, the CDC considers the health risk to the U.S. public to be low; however, people with close or prolonged, unprotected exposures to infected individuals, birds, or other animals, or to environments contaminated by infected birds or other animals, are at greater risk of infection.

    Recommendations:

    CDC considers bird flu viruses to have the potential to cause severe disease in infected humans and recommends:

    • Clinicians should consider the possibility of bird flu in persons showing signs or symptoms of acute respiratory illness or conjunctivitis who have relevant exposure history or recent consumption of raw dairy products
    • Expedited subtyping of influenza A-positive specimens from hospitalized patients, particularly those in an intensive care unit (ICU).

    Treatment:

    Antiviral treatment is recommended as soon as possible for patients suspected or confirmed to have avian influenza A infection. Antiviral prophylaxis is recommended for close (e.g., household) contacts of infected persons. Treatment should not be delayed while waiting for laboratory test results.

    Exposure:

    If you suspect exposure to bird flu, contact the San Diego County Epidemiology line at (619) 692-8499 (Monday - Friday 8 AM -5 PM or (858) 565-5255 (after hours and holidays) to determine next steps.

    Please see the County of San Diego Bird Flu (Avian Influenza) Information for Health Care Professionals website for additional details on Specimen Collection, Treatment, and Infection Prevention and Control.

    Report Dead Birds: 

    If you find a dead bird, (Crow, Raven, Jay, Hawk, Owl, or Falcon) contact Vector Control at (858) 694-2888, Mon-Fri 8:00 am - 5:00 pm; (858) 505-6657, weekends, holidays, or outside business hours or email vector@sdcounty.ca.gov during business hours (8am-5pm, M-F only).

    Additional Resources:

    County of San Diego Avian Influenza webpage

    CDC Bird Flu webpage

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  • Mpox Resources

    Have a heightened suspicion for clade I MPXV for patients with mpox-like symptoms or probable/confirmed MPXV infection who have been in affected Central or Eastern African countries in the previous 21 days and/or have had close or intimate contact with symptomatic people who have been in those countries.

    Follow infection prevention and control recommendations for all patients with mpox symptoms. 

    Immediately report probable, suspected, and confirmed clade I MPXV cases to the County of San Diego Health and Human Services Agency as soon as possible and no later than 24 hours after diagnosis by submitting a Confidential Morbidity Report by fax to (619) 692-8541 or by secure e-mail to phs-hshb-stdreportingfax.hhsa@sdcounty.ca.gov.

    Test for clade I MPXV by submitting clinical specimens for clade-specific MPXV testing if clade I MPXV is suspected. General (i.e., clade-nonspecific) MPXV testing is available through commercial laboratories and the San Diego County Public Health Laboratory (SDCPHL). If clade I MPXV is suspected, refer to SDCPHL Guidelines to obtain approval for clade-specific MPXV testing and for detailed instructions on sample collection, storage, and transport. 

    Encourage vaccination for people who are vulnerable to mpox or who request the vaccine, particularly for people with weakened immune systems due to human immunodeficiency virus (HIV) infection or other conditions, as they are at risk for severe disease.

    The Advisory Committee on Immunization Practices (ACIP) recommends vaccination for people aged 18 years or older who may be at risk for mpox, which now includes people who are traveling to countries with ongoing person-to-person transmission of clade I MPXV who anticipate sexual activities, with two doses of the JYNNEOS vaccine (at least 28 days apart). 

    JYNNEOS may also be given as post-exposure prophylaxis to asymptomatic persons ideally within four days but up to 14 days after exposure if they have not already received two doses of the vaccine or been previously infected with MPXV. 

    Further information regarding vaccine eligibility is available through the CDC. 

    Clinical Treatment of Mpox:

    Currently there is no treatment approved for MPXV infections. For most patients with mpox who do not have severe disease or risk factors for severe disease (e.g., severe immunocompromise), supportive care and pain control will help them recover.

    Interim clinical guidance developed by CDC may assist clinicians in managing patients with protracted or life-threatening manifestations of mpox. Treatment for these patients involves Food and Drug Administration (FDA)–regulated drugs and biologics that are primarily stockpiled by the U.S. government.

    For any questions or to report a suspected case please contact the Epidemiology Unit by phone at (619) 692-8499. For urgent matters on evenings, weekends or holidays, dial (858) 565-5255 and ask for the Epidemiology Unit duty officer.

    Additional Resources

    Mpox Webpage | County of San Diego

    CDC Clinical Overview of Mpox | CDC December 11, 2024

    Mpox in the United States and Around the World: Current Situation | CDC January 8, 2025

    Recommendations for Relief of Pain | CDC        

Page last updated 3/3/2025

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