COCA Email Updates: May 9 – May 23

If you have any questions on these or other clinical issues, please write to us at coca@cdc.gov

Sign up for Email Updates and Reminders

Available for download: May 23. 2016, COCA Email UpdateCdc-pdf


COCA News and Announcements

Upcoming COCA Calls:
NEW: Little Bite, Big Disease: Recognizing and Managing Tickborne Illnesses
Date: Tuesday, May 24, 2016
Time: 2:00 – 3:00 pm (Eastern Time)
Dial in Number: 800-857-9697 (U.S. Callers); 312-470-7286 (International Callers)
Passcode: 1921389
Webinar: https://www.mymeetings.com/nc/join.php?i=PW6927525&p=1921389&t=cExternal
Ticks transmit over a dozen infectious pathogens in the United States, including Lyme disease and Rocky Mountain spotted fever. Recent discoveries of emerging pathogens such as Borrelia mayonii and Ehrlichia muris add to the complexity of properly diagnosing and treating tickborne diseases. As we approach summer and people become more active in the outdoors, reports of tick bites and tickborne diseases are expected to increase. Clinicians can help prevent complications associated with tickborne diseases with early recognition and prompt treatment. During this COCA Call, clinicians will learn about the treatment, management, and prevention of tickborne diseases in the U.S., with an emphasis on Lyme disease, Rocky Mountain spotted fever and newly emerging tickborne diseases. http://emergency.cdc.gov/coca/calls/2016/callinfo_052416.asp

Recent COCA Calls:
Drivers of Infectious Diseases: Connections Matter
Date: Tuesday, May 12, 2016

Animal health represents an important factor in public health as zoonoses account for nearly two-thirds of human infectious diseases—the majority are from wild species. A multi-sectoral or One Health approach that considers the human-animal-environment links can promote synergies among public health, veterinary, and medical professions with other disciplines.

Archived COCA Conference Calls

Free continuing education credits (CME, CNE, ACPE, CEU, CECH, and AAVSB/RACE) are available for most calls. More information about free CE.


CDC Emergency Response

2016 Zika Virus

Fact Sheets and Posters in Different Languages
CDC fact sheets and posters for distribution to patients are available in languages, including Spanish, Arabic, Tagalog, Vietnamese, Mandarin, Creole, and Korean. These resources cover a variety of topics, including travel information, insect repellent, sexual transmission, and mosquito control.

Clinicians Caring for Pregnant Women and Women of Reproductive Age 

MMWR: Patterns in Zika Virus Testing and Infection, by Report of Symptoms and Pregnancy Status — United States, January 3–March 5, 2016
A low proportion of persons who had testing for Zika virus in the United States had confirmed Zika virus infection. Approximately 99% of asymptomatic pregnant women who were tested had no laboratory evidence of Zika virus infection. Given the potential for adverse pregnancy and infant outcomes associated with Zika virus, healthcare providers can continue to offer Zika virus testing to asymptomatic pregnant women with potential exposure. However, these data suggest that in the current U.S. setting, the likelihood of Zika virus infection among asymptomatic persons is low.

Tools for Health-Care Providers
View printable and easy to use CDC fact sheets, guidance documents, and testing algorithms for Zika virus infection.

Clinical Consultation Service for Health-Care Providers Caring for Pregnant Women with Possible Zika Virus Infection. 
CDC maintains a 24/7 consultation service for health-care providers caring for pregnant women with possible Zika virus infection. This consultation service is NOT for patients or the general public. To contact the service, email ZikaPregnancy@cdc.gov or call 770-488-7100.

Doctor’s Visit Checklist: For Pregnant Women Who Traveled to an Area with ZikaCdc-pdf

Doctor’s Visit Checklist: For Pregnant Women Living in an Area with ZikaCdc-pdf

MMWR: Interim Guidance for Health-Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016
CDC has updated its interim guidance for U.S. health-care providers caring for women of reproductive age with possible Zika virus exposure to include recommendations for counseling women and men with possible Zika virus exposure who are interested in conceiving. The updated guidelines also include recommendations for Zika virus testing and guidance for women residing along the US-Mexico Border.

MMWR: Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016
CDC recommends Standard Precautions in all health-care settings to protect both health-care personnel and patients from infection with Zika virus as well as from blood-borne pathogens (e.g., human immunodeficiency virus [HIV] and hepatitis C virus [HCV]).

Questions and Answers For Health-Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure

Clinicians Caring for Infants and Children

Congenital Microcephaly Case Definitions

Questions and Answers For Health-Care Providers Caring for Infants and Children with Possible Zika Virus Infection

Interim Guidelines for Health-Care Providers Caring for Infants and Children with Possible Zika Virus Infection — United
CDC has updated its interim guidelines for U.S. health-care providers caring for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy and expanded guidelines to include infants and children with possible acute Zika virus disease.

Sexual Transmission

MMWR: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, 2016
The following recommendations apply to men who have traveled to or reside in areas with active Zika virus transmission and their female or male sex partners. These recommendations replace the previously issued recommendations and are updated to include time intervals after travel to areas with active Zika virus transmission or after Zika virus infection for taking precautions to reduce the risk for sexual transmission.

Zika and Sexual Transmission

Zika Travel Information

MMWR: Ongoing Zika Virus Transmission — Puerto Rico, November 1, 2015–April 14, 2016
During November 1, 2015–April 14, 2016, a total of 6,157 specimens from suspected Zika virus–infected patients from Puerto Rico were evaluated and 683 (11%) had laboratory evidence of current or recent Zika virus infection.

CDC Issues Advice for Travel to the 2016 Summer Olympic Games

Zika Travel Notices

Clinical Evaluation and Testing

NEW: MMWR: Interim Guidance for Zika Virus Testing of Urine — United States, 2016

NEW: MMWR: Comparison of Test Results for Zika Virus RNA in Urine, Serum, and Saliva Specimens from Persons with Travel-Associated Zika Virus Disease — Florida, 2016

updated: Diagnostic Testing
Contact your state or local health department to facilitate testing.

updated: Collection and Submission of Body Fluids for Zika Virus Testing

CDC and OSHA Issue Interim Guidance for Protecting Workers from Occupational Exposure to Zika VirusCdc-pdf
CDC and the Occupational Safety and Health Administration (OSHA) issued new guidance and information for protecting workers from occupational exposure to Zika virus.

Biosafety Guidance for Transportation of Specimens and for Work with Zika Virus in the Laboratory

Clinical Evaluation & Disease
Zika virus is transmitted to humans primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis. Most people infected with Zika virus are asymptomatic. Characteristic clinical findings are acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis. Other commonly reported symptoms include myalgia and headache.

State and Local Health Department Resources

NEW: MMWR: Possible Zika Virus Infection Among Pregnant Women — United States and Territories, May 2016
In February 2016, CDC, in collaboration with state, local, tribal, and territorial health departments, launched two comprehensive surveillance systems to report and monitor pregnancies and congenital outcomes among symptomatic and asymptomatic women with laboratory evidence of Zika virus infection in the United States and territories. As of May 12, 2016, there were 157 and 122 pregnant women with laboratory evidence of possible Zika virus infection residing in participating U.S. states and U.S. territories, respectively.

NEW: Zika Active Pregnancy Surveillance System (ZAPSS)/Sistema de Vigilancia Activa de Zika en Embarazos (SVAZE)
The Puerto Rico Department of Health and Centers for Disease Control and Prevention have developed a surveillance system called Zika Active Pregnancy Surveillance System (ZAPSS)/Sistema de Vigilancia Activa de Zika en Embarazos (SVAZE). The surveillance system will be used to evaluate the association between Zika virus infection during pregnancy and adverse outcomes during pregnancy, birth, and early childhood up to 3 years old.

NEW: Pregnant women with any laboratory evidence of possible Zika virus infection in the United States and territories, 2016
These data reflect pregnant women in the US Zika Pregnancy Registry and the Zika Active Pregnancy Surveillance System in Puerto Rico.

NEW: Zika Crisis and Emergency Risk Communication Discussions
To address the communication concerns and needs of state, local, and territorial health communicators, as well as partner organizations, CDC is hosting a series of Crisis and Emergency Risk Communication (CERC) teleconferences related to Zika issues. These teleconferences will be held on a weekly basis beginning Tuesday, May 17, from 1-2 pm (Eastern Time). Each week, a new topic will be presented on a different aspect of CERC.

US Zika Pregnancy Registry
CDC has established the US Zika Pregnancy Registry to learn more about pregnant women in the United States with confirmed Zika virus infection and their infants and is collaborating with state, tribal, local, and territorial health departments to collect information about pregnancy and infant outcomes following Zika virus infection during pregnancy.

Survey of Blood Collection Centers and Implementation of Guidance for Prevention of Transfusion-Transmitted Zika Virus Infection — Puerto Rico, 2016
Importation of blood products from nonaffected areas might serve a role in prevention of transfusion-transmitted Zika virus. An approved laboratory test for blood donor screening and implementation of PRT are critical for compliance with FDA guidance and to ensure a safe and sustainable blood supply. Blood collection organizations and public health organizations need to collaborate to prepare for blood safety and adequacy challenges that might arise if Zika virus transmission spreads in the United States.

Top 10 Zika Response Planning Tips: Brief Information for State, Tribal, Local, and Territorial Health Officials

Zika Virus Microsite
CDC has developed an easily embeddable collection of Zika virus information for partner and stakeholder websites. This collection, called a microsite, can supplement partner web sites with CDC’s up-to-date, evidence-based content. . The content is automatically updated when CDC’s website is updated.

CDC News and Announcements

new: MicrobeNet: A Tool to Detect Rare Germs Digital Press Kit
MicrobeNet, an innovative online library of nearly 2,400 rare and emerging bacteria and fungi, provides real-time access to help health departments and labs identify rare infections and save lives.

CDC Science Clips: Volume 8, Issue: 20

Each week select science clips are shared with the public health community to enhance awareness of emerging scientific knowledge. The focus is applied public health research and prevention science that has the capacity to improve health now.

Public Health Preparedness

Emergency Preparedness and Response – (CDC)

Find preparedness resources for all hazards.

Emergency Preparedness and Response Training Resources for Clinicians – (CDC)

Find online and in-person training resources.

Natural Disasters and Severe Weather

CDC Feature: Prepare for Spring Weather – (CDC)

Food and Water Needs: Preparing for a Disaster or Emergency – (CDC)

Health and Safety Concerns for All Disasters – (CDC)

Morbidity and Mortality Weekly Report (MMWR)

The MMWR series is CDC’s primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. To subscribe electronically, go to. Electronically Subscribe.

April 22, 2016 / Vol. 65/Nos. 19 Download .pdf document of this issueCdc-pdf

Infectious, Vector-Borne and Zoonotic Diseases

Seasonal Influenza

What You Should Know for the 2015-2016 Influenza Season  – (CDC)

Information for Health Professionals  – (CDC)

Weekly Flu View – May 14 (CDC)

Flu View is a weekly influenza surveillance report prepared by CDC Influenza Division. All data are preliminary and may change as CDC receives more reports.

Planning and Preparedness: Health Professionals and Seasonal FluExternal  – (HHS)

Travel Safety

Current Travel WarningsExternal – May 16 (US Department of State)

The U.S. Department of State issues Travel Warnings when long-term, protracted conditions make a country dangerous or unstable. Travel Warnings recommend that Americans avoid or carefully consider the risk of travel to that country. The State Department also issues Travel Warnings when the U.S. Government’s ability to assist American citizens is constrained due to the closure of an embassy or consulate, or because of a drawdown of State Department staff.

Food, Drug and Device Safety

NEW: Recent Outbreak: Elizabethkingia– (CDC)
Since January, CDC has been assisting with the investigation of two outbreaks of infections caused by Elizabethkingia anophelis in the Midwest. Although Elizabethkingia is a common organism in the environment, it rarely causes infections. CDC is assisting with testing samples from patients and a variety of potential sources, including healthcare products, water sources and the environment; to date, none of these have been found to be a source of the bacteria.

NEW: Well Care Compounding Pharmacy Sterile Compounded Products: Recall – Lack Of Sterility AssuranceExternal– (FDA)
Well Care Compounding Pharmacy is performing a voluntary statewide recall in Nevada on all unexpired sterile compounded products due to FDA concern over lack of sterility assurance. The recall impacts all sterile compounded products distributed between 01/01/2016-04/29/2016.

MedWatch: The FDA Safety Information and Adverse Event Reporting ProgramExternal – (FDA)

MedWatch is your Food and Drug Administration (FDA) gateway for clinically important safety information and reporting serious problems with human medical products.

FoodSafety.gov Reports FDA and USDA Food Recalls, Alerts, Reporting & ResourcesExternal – (HHS/USDA/FDA/CDC/NIH)

Foodsafety.gov lists notices of recalls and alerts from both FDA and USDA. Visitors to the site can report a problem or make inquiries.

The CDC and HHS logos are the exclusive property of the Department of Health and Human Services and may not be used for any purpose without prior express written permission. Use of trade names and commercial sources is for identification only and does not imply endorsement by the US Department of Health and Human Services.

Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organizations.

Page last reviewed: May 23, 2016 (archived document)