In the last several weeks, OCHCA has continued see a rise in influenza cases in the county that is early and steep and suggests that our county will experience a severe influenza season.

On November 1, 2022, the County Health Officer announced an emergency declaration related to the severe burden that the surge in RSV hospitalizations are putting on pediatric inpatient bed availability. RSV case rates remained high this week.

The CDC anticipates that a surge in COVID-19 will also occur in the coming months. In the face of a looming “tripledemic”, Orange County providers need to encourage vaccination and other measures to protect patients and preserve healthcare resources.

• Strongly recommend influenza vaccination to all patients six months of age and older. 
• Strongly recommend COVID-19 bivalent booster vaccination for all eligible patients. COVID-19 and influenza vaccination can be given concurrently.
• For RSV, assure that high risk infants are given Palivizumab, in accordance with AAP recommendations and the recent California Department of Public Health CAHAN advisory Early Respiratory Syncytial Virus Activity and Use of Palivizumab.
• Providers should consider the use of antiviral medications for the treatment and chemoprophylaxis of influenza as detailed in CDC’s Influenza Antiviral Medications: Summary for Clinicians.

Providers should continue to test for SARS-CoV-2; ideally, laboratory testing should be multiplex for both SARS-CoV-2 and influenza. Recommendations on treatment of COVID-19 can be found on our COVID-19 Therapeutic Recommendations page.

Current COVID-19 vaccination recommendations can be found at CDC’s Interim Clinical Considerations, Use of COVID-19 Vaccines in the United States. This guidance includes recent recommendations on the use of bivalent mRNA COVID-19 vaccine boosters for those 12 years and older. Additional authorizations for the use of bivalent boosters in younger ages are anticipated soon.

The Advisory Committee on Immunization Practices (ACIP) Influenza Vaccine Recommendations provides current recommendations for influenza vaccination. These include the new preferential recommendation for those > 65 years to receive either quadrivalent high-dose inactivated influenza vaccine (HD-IIV4), quadrivalent recombinant influenza vaccine (RIV4), or quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) whenever available.

We will be posting current data on influenza epidemiology on a weekly basis on the OCHCA Influenza page.