Tijuana River Valley & Beach Water Sewage Crisis - Public Health Response

Page originally published 5/21/2026.

Health care professionals who work with patients impacted by the Tijuana River Valley can refer to resources to address health concerns.

On this page:

• Recommendations
• Resources

Recommendations

Exposure Assessment & Monitoring

• Ask about exposure: Ask if your patients live, work, or spend time near the Tijuana River Valley or affected beaches especially during known sewage or odor events.
• Screen for symptoms: Look for signs and symptoms residents have linked to exposure such as cough, shortness of breath, headache, gastrointestinal symptoms, nausea, fatigue, and skin irritation. See Studies for more information.
• Assess mental health: Screen for signs of stress, anxiety, and depression, as surveys show a high prevalence of these conditions in exposed populations.

Exposure Reduction Strategies

• Indoor improvements:
  • Recommend keeping windows and doors closed during elevated hydrogen sulfide (H₂S) events.
  • Encourage use of CARB-certified portable HEPA air purifiers with activated carbon and potassium permanganate to trap gasses like H₂S. Eligible households may access them through the SDAPCD AIRE program.  
    • Note that patients with Medi-Cal who have severe or uncontrolled asthma can also access no-cost support through their insurance plans. 
      • Help with Asthma |  Spanish

• Outdoor precautions:
  • Advise patients to avoid direct contact with contaminated river or beach water.
  • Direct patients to consult the County’s Environmental Dashboard for real-time updates on H₂S levels, air quality complaints, and beach closures.

Additional Information for Healthcare Professionals

• Health care professionals can contact the Tijuana River Valley Medical Providers inbox at tjrv.medicalproviders.hhsa@sdcounty.ca.gov for TJRV related questions. Please do not report cases to this inbox. Visit Disease Reporting for HCPS to provided mandated reporting using the Confidential Morbidity Report Form.
  
• View the TJRV Healthcare Professional Training video for a Healthcare Professional training on TJRV health concerns.

Resources

California Health Alert Network San Diego (CAHAN) 

• Health Advisory: Update #1: Cross-border Pollution in the Tijuana River Valley and Potential Health Effects (September 22, 2025)
• Health Advisory: Cross-border pollution in the Tijuana River Valley and potential health effects (September 13, 2024)

Local

• Behavioral and Mental Health Resources Tip Card (English and Spanish)
  • Connecting San Diego County residents with free, confidential, and trauma-informed services.
• Help with Asthma |  Spanish
  • No-cost support for eligible Medi-Cal members. 
• San Diego Access Crisis Line
  • Mental health resources are available for anyone feeling emotionally affected by the Tijuana River Valley sewage crisis by calling 1-888-724-7240 or 988.
• San Diego County Air Pollution Control District (SDPACD) Air Improvement Relief Effort (AIRE) Program
• Tijuana River Valley & Beach Water Crisis Environmental Dashboard
• Tijuana River Valley & Beach Water Crisis Studies

Top of Page

Send an e-mail to the Epidemiology Unit for more information.