Message from Dr. Karen Relucio, Health Officer
Varicella Medical Exemption Documentation Requirements:
Transitional Kindergarten/K-12 admission and 7th grade advancement

Napa County Public Health reminds all pediatric providers that under new laws, schools can only accept either a record of a child receiving a varicella vaccine or a medical waiver stating the child is immune due to chickenpox due to natural immunity.  Sending the student’s varicella titer results on an immunization record will not meet requirements according to the vaccine law.

Medical exemption documentation must include:
  1. The specific nature of the physician condition or medical circumstance of the child for which the physician does not recommend immunization.
  2. The required vaccine(s) being exempted.
  3. Whether the exemption is permanent or temporary.
  4. If the exemption is temporary, an expiration date no more than 12 months from the date of signing.
Please see attached memo below.  For more questions on these requirements, please call Trina Ullius, Napa County Immunization Coordinator, at 707-259-8737.
Varicella Medical Exemption Memo
E-cigarette or Vaping Associated Lung Injury (EVALI) Update

Since June 2019, 178 cases of severe acute pulmonary injury needing respiratory support among previously healthy individuals have been reported across California, with over 40% of cases being admitted to intensive care and 28% requiring mechanical ventilation.  There has been one confirmed EVALI case in Napa County.  

Most patients report vaping the cannabis compounds tetrahydrocannabinol (THC) and/or cannabidiol (CBD), and some patients also report vaping nicotine products, although the exact cause of illness is not yet known.  Several samples of vape pens and cartridges showed presence of Vitamin E acetate. While it appears that vitamin E acetate is associated with EVALI, there are many different substances and product sources that are being investigated, and there may be more than one cause.

More information on clinical features and management are here.  Healthcare providers are reminded to report suspected EVALI cases to the Communicable Diseases Control Program at (707) 299-4199. 

It's Not Too Late to Vaccinate

CDC established National Influenza Vaccination Week (NIVW) in 2005 to highlight the importance of continuing flu vaccination through the holiday season and beyond.   National Influenza Vaccination Week was on December 1 through 7.  Flu vaccination coverage estimates from past seasons have shown that few people get vaccinated against influenza after the end of November.
  • CDC and its partners choose December for NIVW to remind healthcare providers that even though the holiday season has begun, it is not too late to vaccinate.
  • As long as flu viruses are spreading and causing illness, vaccination should continue throughout the flu season in order to protect as many people as possible against the flu.
Influenza Report

In week 49, influenza-like illness (ILI) is currently at 1.9% at Queen of the Valley Medical Center.  Statewide, influenza activity is now widespread. Public Health has no active outbreaks and has investigated two outbreaks during this flu season.

Patients with ILI symptoms who are hospitalized, severely ill, or at higher risk for complications should be treated as soon as possible with a neuraminidase inhibitor antiviral agent (e.g., oseltamivir, zanamivir) as per CDC and CDPH recommendations, regardless of flu test results.   Healthcare providers are also strongly encouraged to continue to vaccinate patients.

For outpatients at lower risk of flu complications, consider testing for influenza using PCR prior to prescribing antiviral treatment. Please note that there will be more false negative rapid influenza tests due to the higher prevalence of influenza in the community.

Healthcare providers should continue to report the following using the Confidential Morbidity Report to the Communicable Diseases Control Program at (707) 299-4199. 

  • any influenza or acute respiratory illness outbreaks
  • lab-confirmed influenza deaths in patients aged 0-64 years
  • lab-confirmed influenza ICU cases in patients aged 0-64 years
  • RSV deaths in children <5 years of age
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2751 Napa Valley Corporate Drive
Building B
Napa, CA 94559
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NCHO · 2751 Napa Valley Corporate Drive · Building B · Napa, Ca 94558 · USA

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