Measles Exposure Among International Travelers

Marin County Public Health recently investigated two cases involving travelers exposed to measles during a long-haul international flight. A key challenge in our response was the inability to access vaccination records quickly. Exposed individuals may be subject to quarantine, school or work exclusion, and public health monitoring without documented proof of immunity.
This serves as an important reminder:

• Encourage patients to review and carry copies of their vaccine records.
• Ensure travelers are up to date on MMR vaccination, particularly for international travel.
• Discuss the risks of exposure without immunity, including potential quarantine and post-exposure protocols.

Please support your patients in preparing for safe travel and help us strengthen community protection against measles and other vaccine-preventable diseases.

Time to Prepare for a Spring COVID Wave

Ask. Screen. Connect.: Supporting Mental Health

As the COVID-19 pandemic recedes, its impact on the mental health of teens and young adults continues to emerge. Social isolation during critical developmental periods has left many young people experiencing anxiety, depression, and loneliness. Healthcare professionals can help heal these invisible wounds and support the long-term well-being of youth and families. Create space for open conversations by asking nonjudgmental, open-ended questions about patients’ social lives and emotional well-being. Screen for anxiety and depression using validated tools and normalize discussions about mental health as part of routine care. Connect patients and families with trusted resources, such as CalHOPE. This platform offers free, confidential digital support through two mobile apps:

• BrightLife Kids – Behavioral health coaching for parents, caregivers, and children ages 0–12
• Soluna – Mental health support and tools for youth and young adults ages 13–25

Visit Marin BHRS at  https://www.marinbhrs.org/ to learn about local behavioral health resources, supports, and services, including the 988 Suicide & Crisis Lifeline.

Bird Flu Update

As flocks of wild birds return to the north, we are preparing for another surge in bird flu activity statewide.  Migratory birds play a key role in the global spread of avian flu by shedding the virus along seasonal flyways and infecting poultry flocks and dairy herds. We are also seeing more cases among cats from direct contact with infected birds or consumption of raw meat or milk from infected animals. Healthcare providers should consider avian flu in patients with conjunctivitis or respiratory symptoms and animal exposure. Suspected cases must be reported immediately to Marin County Public Health by calling 415-473-4163. Collect respiratory and eye swabs for testing; initiate antiviral treatment and offer prophylaxis to close contacts. Providers should stay updated with guidance to ensure early detection and response. Marin County Public Health provides local updates on our Bird Flu (H5N1) webpage.

Message from the Health Officer: Public Health is Essential

I still wear a t-shirt from the pandemic that says, “Apparently, I’m essential. #PublicHealth.” It was a quiet badge of honor from a time when thousands of Marin residents stood up to protect our community. History tells us public health is easy to forget—until the next crisis hits. Marin County Public Health along with health departments nationwide are now grappling with the CDC’s abrupt and short-sighted withdrawal of $11.4 billion in COVID-era funding. This critical investment in a chronically underfunded public health system enhanced disease surveillance, prevented outbreaks in nursing homes, and supported rapid responses to rising threats like avian flu, measles, and resurgent tuberculosis. Public health is our first line of defense. Vaccination, education, and infection control don’t just prevent illness—they save lives and reduce hospitalizations, long-term complications, and health care costs. For example, a single measles vaccine costs under $30; one outbreak can cost hundreds of thousands.
Now is the time to champion sustained public health funding. An ounce of prevention is worth many times more than a pound of cure.

Thank you for your continued support of public health and partnership.

Lisa Santora, MD MPH
Public Health Officer
 

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