The California Department of Public Health (CDPH) is urging all Californians, in an effort to prevent Zika and West Nile Virus infections and eliminate mosquito populations, to remove standing water around their homes and businesses. There is also updated guidance from the Centers for Disease Control and Prevention (CDC) for Zika testing in pregnant women. Visit Marin HHS' Zika web page for more information.
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Elephant Tranquilizer New Threat 
End of Life Option
Summer time and pool parties are upon us. As the weather warms up, so does the risk of drowning. (Drowning is a leading cause of injury death for children ages 1 to 4.) As providers, we can encourage parents to prevent 
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Kindergarten immunization rates in Marin County are the highest they have been since 2000. This school year, 93.2 percent of Marin kindergarten students have received all of the immunizations required for school, increasing nearly 20% from the 2011/12 school year, when local immunization rates were at their lowest point, or 77.9 percent of kindergarten students. Providers and parents can visit the 
This week, I had the surreal experience of sitting near Newt Gingrich and Patrick Kennedy while they strongly agreed on something of national importance. The event was the Marin County’s track record of being one of the healthiest counties in California is intact, according to new statistics, but several significant issues remain for those who deliver health care and other wellness services.
Dr. Matthew Willis, the County's Public Health Officer, says known problems with substance use were one contributor to Marin receiving the No. 2 ranking rather than No. 1.
The Robert Wood Johnson Foundation released its annual rankings of California’s 58 counties, and Marin came in at No. 2 this year behind San Mateo County. Marin had been ranked No. 1 in statewide health for seven consecutive years. The County Health Rankings data give a glimpse of a community’s health and provide a starting point for investigating and prioritizing ways to improve health.
“As the safety net for our community, our goal is to create a safe and healthy community for all our residents,” said Board of Supervisors President Judy Arnold. “We have a lot to be proud of, but major challenges remain in the areas of income inequality, affordable housing, binge drinking, and prescription drug abuse.”
Marin retained the top spot statewide in overall health factors such as education, employment, family and social support, and community safety.
Dr. Matthew Willis, the County’s Public Health Officer, said one contributor to the change in ranking is known problems with substance use.
“Compared to other counties, we lose points for having higher rates of adult binge drinking, drunk driving deaths, and drug overdose rates,” Willis said. “This is another sign that these are issues we need to take seriously.”
Marin experienced a spike in accidental drug overdoses from 2012 to 2014, the time period reflected in the latest rankings for that category. In response, the County helped create a grassroots initiative called RxSafe Marin in 2014 to tackle prescription drug abuse. The Marin County Department of Health and Human Services and several other County departments are involved and shepherding positive change.
“We've made some progress since 2014, and we’re losing fewer people to overdoses, but we have long way to go,” Willis said.
Marin was worse than the state average in income inequality and still experiences a large division between the top and bottom ends of the income spectrum. Marin consistently shows a low rate of children in poverty (9 percent), but social inequity came to light as the foundation broke down the statistics by race for the first time. Thirty percent of African-American children and 24 percent of Hispanic children experience poverty compared with 4 percent of white children.
As a countermeasure, the County has made steady progress on many fronts with social equity, and the Board of Supervisors made equity a priority in its 2016 State of the County message. It is working to preserve existing affordable housing, helping underserved residents visit and enjoy parks and open spaces, and making its annual County Fair one of the healthiest of its kind in the country, and improving access for disabled visitors at County-maintained pathways, park trails and buildings.
“Our scores did not change dramatically from last year,” Willis said. “San Mateo has made substantial progress and that’s good news. No one is backsliding here: San Mateo is raising the bar and it’s up to us to meet the challenge.”
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In 2015, scientists reported the emergence of the plasmid-encoded mcr-1 gene, conferring bacterial resistance to the antibiotic colistin, signaling potential emergence of a pandrug-resistant bacterium. The mcr-1 gene makes bacteria resistant to the antibiotic, colistin. Colistin is one of the few "last resort" antibiotics available to treat bacteria that are resistant to many other antibiotics, such as carbapenem-resistant Enterobacteriaceae (CRE). The Centers for Disease Control and Prevention (CDC) Get Smart program offers 
This communication is for those who have been contacted by the Marin County Public Health Department by phone the week of August 19, 2019
For contacts of Bacterial Meningitis case:
The purpose of this letter is to inform you that you may have had contact with a person who had meningococcal meningitis. For that reason, we encourage you to contact your health care provider or go to Urgent Care to discuss possible preventive treatment with antibiotics (post-exposure prophylaxis).
Close contact includes:
- household members
- persons who frequently eat or sleep in the same house
- persons who spent 4-6 hours per day together
- persons who have come in close contact with the saliva or respiratory secretions of an infected person.
Preventive antibiotic treatment is recommended for individuals who are close contacts of someone who had meningococcal disease. Ciprofloxacin 500mg one tablet effectively prevents disease.
Symptoms of meningococcal disease include, but are not limited to:
- Fever
- Headache
- Stiff neck
- Confusion
- Rash
If you experience any of these signs or symptoms, contact your health care provider immediately for evaluation. If you or your provider have additional questions or concerns, please call Marin County Communicable Disease and Prevention Control (CDPC) at 415 473 4163 and ask to speak to a Public Health Nurse. Additional information about meningococcal disease can be found at https://www.cdc.gov/meningococcal/index.html.
Flu Is Here! On December 1st, the California Department of Public Health (CDPH) announced the first influenza-associated fatality in a person under the age of 65 for the 2016-2017 flu season. It is mandatory to report laboratory-confirmed influenza cases who require admission to an intensive care unit (ICU) and/or who die at any location (i.e. home, hospital, ER). Visit www.marinflu.org for the most up-to-date information about current influenza activity in Marin.
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Flu Is Here 
RxSafe Marin
Wash Your Hands!
Tuberculosis Outbreak In the summer, pediatric patients visit their doctors for health examinations for school entry and pre-participation physical examinations. These are opportunities to discuss both required and recommended vaccinations (e.g., HPV, meningitis). With the introduction of SB277, parents may be seeking temporary and/or permanent medical exemptions for required vaccinations. Visit our Immunization Program website for forms and guidance on medical exemptions or call (415 473 3078) or email (dhiser@marincounty.org) Danielle Hiser, RN, PHN, Immunization Coordinator, with any questions.
Many college campuses are experiencing mumps outbreaks. Summer is around the corner, and students from colleges and universities will intermingle, increasing risk for mumps transmission. Contact the Communicable Disease Prevention and Control unit at (415) 473-7805, if you have any questions.
For the seventh straight year, Marin holds the title of the healthiest County in California, according to the Robert Wood Johnson Foundation. Despite the best overall rating, persistent health and social inequities remain a challenge for Marin health officials.
The annual County Health Rankings were released today, and Marin shines in many measures of health. The rankings consider two main health outcomes: premature death and quality of life, and multiple factors that affect health including behavior, clinical care, the physical environment, and social and economic factors.
For example, Marin ranks highest in life expectancy and lowest rates of adults reporting fair or poor health and teen births. Marin is No. 2 among counties with a high number of adults with a healthy body weight and low rate of unemployment and violent crime.
“Community investments such as reserving land for open space and social norms around healthy eating and staying active have helped Marin maintain our ranking,” said Dr. Grant Colfax, Director of Marin County Department of Health and Human Services (HHS). “However, the rankings also reflect major disparities across Marin and help us know where we need to prioritize our work. For example, we need to focus on increasing equity in health care coverage, access to health food, early childhood education, and job training so everyone has an opportunity to optimize his or her health.”
Marin ranked poorly – No. 54 out of 57 counties reporting – in income inequality, a measure that focused on the ratio between those with the highest incomes (above 80 percent of the median) and the lowest incomes (below 20 percent of the median). The County also fared poorly in one of the foundation’s new additional measures: racial segregation between whites and non-whites. Marin came in No. 50 among the 56 counties reporting. Racial segregation can translate to disparities in income, educational opportunities and work opportunities – all three of which lead to poor health outcomes.
When it comes to opportunities to live a long and healthy life, a few miles can make an enormous difference in Marin. There is a 15-year gap between life expectancy in Ross (94) and Marin City (79), a disparity that correlates with the per capita income.
Marin HHS is working in communities to help improve life expectancy. The Nutrition Wellness Program works with schools that have high obesity rates, which is known to drive heart disease and other conditions that lead to premature death. In Marin City, for example, Marin HHS supports nutrition education, walk to school programs, school gardens, and marketing to attract health-conscious grocery stores.
“While there are signs of progress, we’re more vulnerable than these rankings suggest,” said Dr. Matt Willis, the County’s Public Health Officer. “There is much more to do to achieve health equity in Marin. We need to continue to bolster programs and policies that address poverty, jobs, housing, and education.”
The County has made steady progress on many fronts with social equity, and the Board of Supervisors has made equity a priority. For instance:
- It has made a commitment to preserve existing affordable housing, explore ways to acquire more affordable housing and encourage landlords to adhere to voluntary rent guidelines.
- Marin County Parks is in its third year of a program designed to help more Marin residents, especially the underserved, to visit and enjoy parks and open spaces.
- The Marin County Fair and Play Fair Marin have partnered for 14 years to build and maintain a healthy and successful fair as well as create a resource guide for ongoing and future success.
- The Department of Public Works is diligent in its efforts to improve disability access and safety at County-maintained facilities, such as widening a popular pathway in the lower Ross Valley.
- The County has even launched a TV series to promote education on mental health.
Other community efforts working to alleviate poverty and promote success of Marin residents are Rise Together, Marin Promise, and Marin Strong Start.
County fairs are not known for healthy food and drink. The Marin County Fair is an exception. We received the 2015 Merrill Award by the Western Fairs Association for its Play Fair health initiatives. The fair is a strong reflection of the community health values in Marin. The Play Fair team shared their model in this Growing Healthy Events Guide.
The number of reported outbreaks of acute gastroenteritis due to norovirus in Marin County has increased significantly since October, 2015. While this is consistent with the seasonal nature of norovirus, the California Department of Public Health has announced higher than usual activity state-wide. In Marin, affected facilities have included adult congregate living facilities and childcare centers. The duration of most of the outbreaks is a few days to two weeks, reflecting both the natural history of the illness and the control measures taken by the facilities. Information about norovirus can be found here.
This month there was an outbreak of influenza A at a local skilled nursing facility. During our investigation, the first influenza-associated fatalities were announced for California, which included an infant, an adult and an elder. These events remind us that influenza can cause serious illness or death across the lifespan. Visit marinflu.org for links to clinical information and surveillance reports. The first of our regular seasonal influenza surveillance reports for 2015-2016 will be released in early December.
Since 2009, Marin County has seen an increase in syphilis cases, as is being seen regionally. In 2014, there were 20 cases reported. 19 of these were men, and most were men who have sex with men (MSM). USPSTF recommends that providers screen those at increased risk for syphilis infection, including MSM. The CDC recently updated its Sexually Transmitted Diseases Treatment Guidelines, which are now available as a mobile app.
FREE flu shots! October 17th at Novato High School from 10 a.m. to 2 p.m. Available while supplies last, regardless of insurance, ages 3 years and up. Kaiser patients will have their information updated for them. The school is at 625 Arthur Street, and the clinic is open from 10 a.m. to 2 p.m
Dr. Matthew Willis, the County’s Public Health Officer, says a flu shot is the single best defense against influenza, which can lead to a lot of time missed at school or work. The flu virus can spread one day before symptoms develop and up to a week after someone becomes sick, so protect yourself, your family and friends by getting your flu shot.
Marin HHS staff and emergency medical personnel will be on hand to administer the vaccine. All County staff members are disaster service workers as well, and they are treating the Novato flu shot clinic as a “point of dispensing” to simulate an emergency need to dispense medicine to, or vaccinate, the whole community. The recent wildfires in Lake County and the 2014 earthquakes in Napa have reminded us all about the need for training and preparedness.
“Leadership plays a great role in responding to any disaster, and Health & Human Services is committed to preparing staff for emergency response,” said HHS Projects Coordinator Kristen Seatavakin. “We are looking forward to using this chance to improve the department’s ability to respond and to recognize where we may need to build larger capacity.”
The flu begins with an abrupt onset of fever, muscle aches, sore throat and cough that often make people sick enough to keep them in bed for several days. Flu can be especially dangerous for young children, seniors, pregnant women and people with chronic illnesses such as heart disease, diabetes and asthma.
The California Department of Public Health (CDPH) recommends basic steps to prevent and stop the spread of influenza and other respiratory illnesses in addition to getting the flu vaccination. These include:
- Stay home when you are sick to avoid spreading illness to those around you.
- Do not go to work when ill, particularly if you work with vulnerable populations.
- Wear a face mask when coming within six feet of a sick person.
- If you are sick, wear a facemask before going near other people.
- Restrict visitation with vulnerable populations while you are ill.
- Cough or sneeze into your elbow or a tissue and properly dispose of used tissues.
- Wash your hands thoroughly with soap and warm water or use an alcohol-based hand sanitizer to get rid of most germs.
- Avoid touching your eyes, nose and mouth.
- Stay healthy with a balanced diet, plenty of water and adequate rest and exercise.
Stay up to date with information regarding this season’s flu activity and additional options for flu vaccination by visiting www.marinflu.org.
Marin County is known for high average life expectancy and wide health disparities between communities. Differences in cardiovascular mortality rates drive the 17 year gap in life expectancy within our county. In order to focus our understanding of this complex problem and to prioritize programs toward early prevention, a new Health Equity initiative concentrates on 1) childhood healthy weight and 2) access to primary care for all. The initiative is summarized here.
Any providers in the state Vaccines for Children (VFC) program, and any healthcare workers who would like to learn more about childhood vaccines and vaccine preventable diseases are invited to an Immunization Update Conference. Co-sponsored by the health departments of Marin and Sonoma counties, this event features speakers from the California Department of Public Health Immunization Branch. Join us Friday, June 19, 8:00 -11:30 AM, at the Petaluma Health Center. For more information or to RSVP, please call Danielle, our Marin Immunization Coordinator, at 415-473-3078 or click here.
In 2014, 21 Marin County residents were diagnosed with HIV. In recent years, an increasing proportion of those newly diagnosed are Latinos or African-Americans and individuals under the age of 30. Over the past four years, approximately one in four people diagnosed with HIV in Marin had AIDS upon entry into care. Health care providers should remain aware of HIV trends and screening standards to ensure timely diagnosis and early intervention. Please see the Marin County HIV fact sheet here.
Marin County Public Health is monitoring the Ebola Virus Disease outbreak in the Democratic Republic of the Congo's Ituri Province.
There are no cases of Ebola Virus Disease in Marin County.
Marin County is prepared to respond to communicable disease outbreaks, including Ebola. Marin County Health and Human Services (HHS) works closely with local hospitals, emergency medical services, clinics, and healthcare providers to ensure clinicians and healthcare facilities are informed, trained, and prepared to respond safely and effectively.
The risk of Ebola in Marin County remains very low. However, should a suspected case arise, Public Health and healthcare partners are prepared to respond quickly, using established countywide response plans designed to protect the community's health and safety.
Healthcare providers should routinely ask patients with acute infectious symptoms about recent international travel, including travel to areas experiencing an Ebola outbreak. Providers should immediately isolate any patient with compatible symptoms and relevant exposure history, use appropriate infection prevention measures, and contact Marin County Public Health for consultation.
Ebola is reportable immediately. Marin County Public Health will coordinate with CDPH, CDC, healthcare facilities, laboratories, emergency medical services, and other partners to conduct risk assessment, testing, infection control, patient management, and contact monitoring, as needed.
Vaccines and FDA-approved therapeutics are available for Ebola disease caused by Zaire ebolavirus. The current outbreak in Ituri province appears to involve the Bundibugyo strain, for which no approved vaccines or strain-specific therapeutics are currently available. Laboratory sequencing is ongoing to confirm the strain. Marin County Public Health will continue to monitor developments and update guidance as new information becomes available.
Updated: May 15, 2026