COCA Email Updates: November 7 - November 21

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: November 21, 2016, COCA Email UpdateCdc-pdf


COCA News and Announcements

Upcoming COCA Calls:

NEW: Assessment and Evidence-based Treatments for Opioid Use Disorder
Date: Tuesday, November 29, 2016
Time: 2:00 – 3:00 pm (Eastern Time)
Dial In: 800-779-0686 (U.S.Callers), 312-470-0194 (International Callers)
Passcode: 3377346
Webinar: https://www.mymeetings.com/nc/join.php?i=PW1897448&p=3377346&t=cExternal
One substantial risk associated with prescribing opioids for chronic pain is opioid use disorder (OUD). This disorder is associated with specific criteria, such as unsuccessful efforts to cut down or control opioid use, as well as use resulting in social problems and a failure to fulfill obligations at work, school, or home. During this COCA Call, clinicians will learn about OUD diagnosis criteria, evidence-based treatment options, and patient education techniques. Presenters will use actual case studies to illustrate how clinicians can use recommendations from the CDC Guideline for Prescribing Opioids for Chronic Pain to select OUD evidence-based treatment options such as medication-assisted treatment with buprenorphine or methadone in combination with behavioral therapies.

Recent COCA Calls:

Advancing the One Health Concept through Collaborations that Connect, Create, and Educate
Date: Thursday, November 17, 2016
During this COCA Call, clinicians learned about several arenas of One Health, discussed the critical need for and process of connecting the many passionate stakeholders around the world, and shared an update on efforts across the U.S. and beyond to make One Health ways of thinking the ‘default way of doing business.

Zika in the ED: How Emergency Care Staff can Take Action
Date: Tuesday, November 1, 2016
During this COCA Call, emergency providers learned critical information about Zika, such as how to identify people at risk for infection either through recent travel or through sex with someone infected with Zika, examine the importance of screening protocols, and understand likely symptoms, such as fever, rash, joint pain, and conjunctivitis. Additionally, emergency providers learned key nursing assessment, clinical interventions, and the general process for reporting Zika cases.

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

Zika Virus Information for Healthcare Providers

NEW: Healthcare Exposure to Zika and Infection Control
Standard Precautions should be used to protect healthcare personnel from all infectious disease transmission, including Zika virus.

UPDATED: Key Messages – Zika VirusCdc-pdf
A collection of the most up-to-date and cleared information on the ongoing Zika virus outbreak.

NEW: MMWR: Incidence of Zika Virus Disease by Age and Sex — Puerto Rico, November 1, 2015–October 20, 2016
Among 28,219 nonpregnant persons with laboratory evidence of Zika virus disease identified in Puerto Rico during November 1, 2015–October 20, 2016, incidence was highest among women aged 20–49 years. Women aged 40–79 years with suspected cases were more likely to test positive for Zika virus infection than those in males in the same age group.

Zika Training for Healthcare Providers
View recorded webinars and on-demand trainings.

Print Resources 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 

NEW: Pregnancy and Zika Testing Clinical Algorithm
The interactive clinical algorithm allows healthcare providers to receive recommendations tailored to their pregnant patients with possible Zika exposure. Healthcare providers can answer questions about pregnant patients and, based on the responses, receive information regarding the type of testing indicated as well as clinical management recommendations. It can be used on computers and mobile devices/tablets.

U.S. Zika Pregnancy Registry
CDC and state, tribal, local, and territorial health departments request that healthcare providers, especially obstetric and pediatric healthcare providers, participate in the US Zika Pregnancy Registry.

Clinical Guidance for Healthcare Providers Caring for Pregnant Women

Clinical Guidance for Healthcare Providers Caring for Women of Reproductive Age

Clinicians Caring for Infants and Children

Measuring Infant Head Circumference: An Instructional Video for Healthcare Providers in English and Spanish
CDC is working to ensure that infants with microcephaly and other brain abnormalities receive the services they need. Accurately identifying infants with microcephaly is crucial. The goal of this instructional video is to provide clinicians with the tools needed to accurately measure infant head circumference and length.
In English: https://www.youtube.com/watch?v=HWV1JdAhsSo
En Español: https://www.youtube.com/watch?v=tPBxXkIIjt0

Clinical Guidance for Healthcare Providers Caring for Infants & Children

Sexual Transmission

Zika and Sexual Transmission

Travel Information

Zika Travel Information

Advice for People Living in or Traveling to South Florida
As of September 19, CDC has updated guidance for the Wynwood-designated area after three mosquito incubation periods passed without any new locally transmitted cases of Zika.

Clinical Evaluation and Testing

UPDATED: Guidance for U.S. Laboratories Testing for Zika Virus Infection 
The guidance was updated to be inclusive of the currently available Emergency Use Authorization (EUA) assays; it takes into account the recent updates to the CDC Trioplex Real-time RT-PCR Assay EUA, which includes the addition of whole blood as an acceptable specimen type. The updated guidance also specifies that plaque reduction neutralization testing (PRNT) confirmation is currently not routinely recommended in Puerto Rico, where dengue is endemic.

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.

Testing for Zika Virus
Contact your state or local health department to facilitate testing.

State, Local, Tribal and Territorial Health Department Resources

State, Local, Tribal, and Territorial Health Department Resources

Interim CDC Zika Response PlanCdc-pdf
The purpose of this document is to describe the CDC response plan for the first locally acquired cases of Zika virus infection in the continental United States and Hawaii.

Zika Community Action Response Toolkit (Z-CART)
The Z-CART outlines an approach to risk communication and community engagement planning and is intended as a template for state, local, and tribal agencies to adapt to their needs and to use for reviewing plans for communicating about Zika during the event of a locally transmitted Zika virus.

CDC News and Announcements

NEW: Get Smart About Antibiotics Week 11/14-11/20
Antibiotic resistance is an urgent public health threat. Antibiotic use is the single most important factor contributing to antibiotic resistance, and up to 30% of antibiotic use is either unnecessary or inappropriate.

CDC Science Clips: Volume 8, Issue: 44

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

Hurricanes and Other Tropical Storms – (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.

November 18, 2016 / Vol. 65/Nos. 45 Download .pdf document of this issueCdc-pdf

Infectious, Vector-Borne, and Zoonotic Diseases

Seasonal Influenza

2015–2016 Flu Season – (CDC)

Influenza Vaccination Information for Health Care Workers – (CDC)

Information for Health Professionals– (CDC)

Weekly Flu View – October 29 – (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)
Healthcare providers play an important role during flu season. The following guidance and information will assist healthcare providers and service organizations to plan and respond to seasonal flu.

Travel Safety

Current Travel WarningsExternal – November 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

Pharmacists on the Front Lines of Opioid Overdose PreventionCdc-pdf
Pharmacists and prescribers share a common goal of ensuring safe and effective treatment for patients. CDC released a new brochure developed specifically for pharmacists that outlines the pharmacist’s role in curbing the opioid epidemic and offers tips on how to engage with patients. The brochure is part of a suite of CDC-published user-friendly resources for patients and providers, related to the CDC Guideline for Prescribing Opioids for Chronic Pain.

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 of FDA and USDA Food Recalls, Alerts, Reporting, and 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: November 22, 2016 (archived document)