COCA Email Updates: January 30 - February 13

Available for download: February 13, 2017, COCA Email Update

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COCA News and Announcements

COCA's New Webinar System
COCA is excited to announce that we will be switching COCA Calls to the Adobe Connect webinar platform! Our first call using Adobe Connect will be 2016–2017 Influenza Season Activity and Recommendations for Clinicians , this Thursday, February 16, from 2–3 pm (Eastern Time). You do not need to register for this webinar.
To view the webinar, you will need the latest version of Flash installed on your computer. Remember that if you are unable to access the webinar, the slides will be available for download on the call’s webpage and you may call in to participate.
Although you will now be able to hear the webinar audio through Adobe Connect, you will need to call in using the numbers provided in order to ask the presenters questions over the phone. You will still be able to ask questions through the webinar system by typing questions into the Q&A box that will be available during the webinar.
Mobile users: You can now view the webinar on your mobile devices! Download the app now so you have it before the webinar, or click the Adobe Connect webinar link a few minutes before the COCA Call begins and follow the prompts to download the app. Remember that you can type and submit questions to the presenters through the Adobe Connect app and you will need to dial in to ask questions through the phone lines.

Upcoming COCA Calls:

NEW: 2016–2017 Influenza Season Activity and Recommendations for Clinicians
Date: Thursday, February 16, 2017
Time: 2:00-3:00 pm (Eastern Time)
Dial in: 888-469-3010 (U.S. Callers); 1-773-756-4803 (International Callers)
Influenza activity in the United States began to increase in early December, remained elevated through mid-January, and is expected to continue for several more weeks. Influenza A(H3N2) viruses have been most common this season, and influenza A(H3N2)-predominant seasons are often associated with more severe illness, particularly among young children and people 65 years and older.
Annual influenza vaccination is recommended for all persons aged 6 months and older, and is the best way to prevent influenza. Available evidence consistently indicates that antiviral treatment, when initiated as early as possible, can be a useful second line of defense to treat influenza illness when indicated and can reduce severe outcomes of influenza.
During this COCA Call, clinicians will learn about 2016 –2017 influenza activity to date, and hear an overview of CDC’s recommendations for healthcare providers including influenza vaccination and the use of antiviral medications for the treatment of influenza. https://emergency.cdc.gov/coca/calls/2017/callinfo_021617.asp

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.

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CDC Emergency Response

2016 Zika Virus

General Resources

Zika Virus Information for Healthcare Providers

Key Messages - Zika Virus
A collection of the most up-to-date and cleared information on the ongoing Zika virus outbreak.

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 

Pregnancy and Zika Testing
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

NEW: Prevalence and Clinical Attributes of Congenital Microcephaly — New York, 2013–2015
Zika infection during pregnancy or around the time of birth can cause severe congenital microcephaly, a condition in which a baby’s head is smaller than expected, as well as other serious brain abnormalities. Before evidence of travel-related Zika virus infections in New York , the overall prevalence of microcephaly was 7.4 per 10,000 live births, similar to national estimates for the period 2009–2013. During 2013–2015, 284 newborns in New York (prevalence = 4.2 per 10,000 live births) met the case definition for severe congenital microcephaly.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6605a1.htm?s_cid=mm6605a1_w

Clinical Guidance for Healthcare Providers Caring for Infants & Children

Sexual Transmission

Zika and Sexual Transmission

Travel Information

Advice For People Living In or Traveling to Brownsville, Texas
On December 14, 2016, CDC issued guidance related to Zika for people living in or traveling to Brownsville, Cameron County, TX and has designated Brownsville as a Zika cautionary area (yellow area).. On November 28, the Texas Department of State Health Services reported the state’s first case of local mosquito-borne Zika virus infection in Brownsville. Additional cases of mosquito-borne Zika have been identified in the area, suggesting that there is a risk of continued spread of Zika virus in Brownsville.

Zika Travel Information

Advice for People Living in or Traveling to South Florida
On December 9, 2016, CDC removed the red area designation for the remaining 1.5-square-mile area of South Miami Beach after three mosquito incubation periods (45 days) passed without any new locally transmitted cases of Zika. Guidance for yellow areas now applies to the South Miami Beach area and all of Miami-Dade County.

Clinical Evaluation and Testing

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 Plan
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

CDC Science Clips: Volume 9, Issue: 5

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

Winter 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)

MMWR publications are prepared by CDC. To electronically subscribe, go to
https://www.cdc.gov/mmwr/mmwrsubscribe.html

February 10, 2017 / Vol. 66/No. 5 Download .pdf document of this issue

• Elevated Blood Lead Levels Associated with Retained Bullet Fragments — United States, 2003–2012
• Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger — United States, 2017
• Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2017
• Vital Signs: Noise-Induced Hearing Loss Among Adults — United States 2011–2012

Infectious, Vector-Borne, and Zoonotic Diseases

Seasonal Influenza

Weekly Flu View - December 31 – (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.

Information for Health Professionals– (CDC)

2016–2017 Flu Season - (CDC)

Weekly Flu View

Travel Safety

Current Travel Warnings - January 13 (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

MedWatch: The FDA Safety Information and Adverse Event Reporting Program – (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 Resources – (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.