COCA Digest: Upcoming COCA Call—Findings from the US Zika Pregnancy Registry and Updated Clinical Guidance

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COCA News and Announcements

pregnant woman with healthcare provider

Upcoming COCA Call

Zika Update: Findings from the U.S. Zika Pregnancy Registry and Updated Clinical Guidance
Date: Thursday, May 4, 2017
Please join the COCA Call webinar from a PC, Mac, iPad, iPhone, or Android device:
https://cdc.zoom.us/j/445639884
If you cannot join through digital audio, you may join by phone in listen-only mode:
+1 408 638 0968 or +1 646 558 8656
Passcode: 445 639 884
CDC recently released its latest findings from the U.S. Zika Pregnancy Registry (USZPR) on Zika virus infection in pregnant women and infants, which highlight the importance of prevention and early care. Additionally, CDC has released additional considerations for evaluating and managing infants with possible congenital Zika virus infection. Zika virus infection during pregnancy is a cause of microcephaly and other serious brain defects; however, the full range of potential health problems that Zika virus infection during pregnancy may cause is not yet known. Healthcare providers need information to appropriately evaluate and manage patients with possible Zika virus infection. During this COCA Call, clinicians will learn about the latest findings from the USZPR and updated CDC clinical guidance to assist in caring for these patients based on currently available data.

Archived COCA conference calls are available at emergency.cdc.gov/coca/calls/index.asp. Free continuing education (CME, CNE, ACPE, CEU, CECH, and AAVSB/RACE) is available for most calls. For more information about free CE, visit emergency.cdc.gov/coca/continuingeducation.asp

CDC Emergency Response

2016 Zika Virus Response

Aedes aegypti mosquito by Jim Gathany

General Resources

NEW: Interim Guidance for Managing Occupational Exposures to Zika Virus for Healthcare Personnel
This document provides guidance for facilities to determine when healthcare providers should be tested for Zika virus infection following an occupational exposure and recommendations for post-exposure management. This document does not address all occupational healthcare that might be required or the necessary evaluation or follow-up for occupational exposures to other infectious diseases (e.g., bloodborne pathogens). This guidance is not intended for laboratory researchers or laboratory research personnel. The recommendations in this document will be updated as new information becomes available.

Zika Virus Information for Healthcare Providers
CDC's Zika webpage for healthcare provider resources.

Key Messages—Zika Virus
A collection of the most up-to-date, 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 Spanish, Arabic, Tagalog, Vietnamese, Mandarin, Creole, Korean, and other languages. These resources cover a variety of topics, including travel information, insect repellent, sexual transmission, and mosquito control. 

pregnant woman with healthcare provider

Clinicians Caring for Pregnant Women and Women of Reproductive Age

When Should Pregnant Women Be Tested? Widget
CDC has designed an algorithm widget based on current recommendations to assist in clinical decision making about testing for Zika virus infection. Testing recommendations by area of travel are outlined on this page. For more information on testing pregnant women, see:
https://www.cdc.gov/zika/hc-providers/pregnant-women/testing-pregnant-women.html

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 U.S. 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

Clinical Guidance for Healthcare Providers Caring for Infants & Children 

Sexual Transmission

Zika and Sexual Transmission

map of active Zika transmission April 2017

Travel Information

Zika Travel Information

Advice for People Living in or Traveling to South Florida
CDC has issued guidance for people living in or traveling to Miami-Dade County, Florida. CDC designates areas for Zika virus transmission prevention in the continental United States and Hawaii as red or yellow. Miami-Dade County is designated as a Zika cautionary area (yellow area): A geographic area where local transmission has been identified, but evidence is lacking that the intensity of transmission is comparable to that in a red area.

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.

CDC News and Announcements

NEW: World Malaria Day: April 25, 2017
This year’s theme for World Malaria Day is “End Malaria for Good,” reminding us of both the opportunity that exists and the continued commitment that is needed to break the cycle of malaria and eliminate it once and for all. CDC was at the forefront of the original push for malaria elimination, which resulted in eliminating local malaria transmission in the United States, across much of Europe and the Caribbean, and in parts of the Middle East. Current malaria control initiatives led by endemic countries working in partnership with the World Health Organization(WHO); the Roll Back Malaria Partnership; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the U.S. President’s Malaria Initiative (PMI) have contributed to important reductions in malaria incidence and deaths over the last 15 years.

NEW: 66th Annual Epidemic Intelligence Service (EIS) Conference April 24–27, 2017
CDC held its 66th Annual Epidemic Intelligence Service (EIS) Conference April 24–27, 2017, in Atlanta. The event showcases recent groundbreaking and often life-saving investigations by EIS officers—better known as CDC’s disease detectives.
The conference included a special session featuring EIS officers describing their work responding to the Zika virus outbreak, Laboratory Leadership Service (LLS) fellows reporting on their efforts to advance laboratory biosafety and quality, and a media-availability session with EIS officers fresh off of the front lines of battling emerging health threats. Other sessions included reports on diseases spread from animals to people, STDs and HIV, environmental and occupational exposures, emerging infections, disease outbreaks associated with healthcare facilities, foodborne outbreaks, child health, drug-related illness, and unintentional injuries.

CDC Science Clips: Volume 9, Issue: 16 
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.

COCA Partner Resources

NEW: Robert Wood Johnson Foundation’s Preparedness Innovator Challenge
How are you using the National Health Security Preparedness Index to ready your community for an emergency? The new Preparedness Innovator Challenge hosted by the Robert Wood Johnson Foundation and the University of Kentucky wants to hear what you are doing or what you plan to do to improve preparedness, health security, and resilience against a disaster in your community. Has use of the Index in your community sparked conversations with community leaders? Are you using Index data to identify preparedness gaps?  The Preparedness Innovator Challenge is an opportunity for you to help your colleagues by sharing how the Index is helping your community prepare for the unexpected. Teams or individuals with an interest in improving health security and preparedness are invited to apply now.

AAP Zika Support Video

Zika: Ten Tips for Pediatricians Supporting Families Video
Visit the American Academy of Pediatrics' (AAP) website to find videos with tips for pediatricians on how to provide psychosocial support for families affected by Zika:

Public Health Preparedness

Emergency Preparedness and Response for Health Professionals—(CDC) Find preparedness resources for health professionals at http://emergency.cdc.gov/health-professionals.asp

Emergency Preparedness and Response Training Resources for Clinicians—(CDC) Find online and in-person training resources at emergency.cdc.gov/coca/trainingresources.asp

Natural Disasters and Severe Weather

Thunderstorm

Prepare for Spring Weather(CDC) 

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

Health and Safety Concerns for All Disasters(CDC) 

Infectious, Vector-Borne, and Zoonotic Diseases

NEW: HAN 401: CDC Recommendations for Diagnosing and Managing Shigella Strains with Possible Reduced Susceptibility to Ciprofloxacin
This Health Advisory describes the identification of emerging Shigella strains with elevated minimum inhibitory concentration values for ciprofloxacin and outlines new recommendations for clinical diagnosis, management, and reporting, as well as new recommendations for laboratories and public health officials. Current interpretive criteria provided by the Clinical and Laboratory Standards Institute (CLSI) categorize these strains as susceptible to ciprofloxacin, which is a fluoroquinolone antibiotic and a key agent in the management of Shigella infections.
However, recent data from CDC and state and local public health partners show that these strains often have a quinolone resistance gene that may lead to clinically significant reduced susceptibility to fluoroquinolone antibiotics. Clinicians treating patients with multidrug-resistant shigellosis for whom antibiotic treatment is indicated should avoid prescribing fluoroquinolones if the ciprofloxacin MIC is 0.12 μg/mL or higher even if the laboratory report identifies the isolate as susceptible, and should work closely with their clinical microbiology laboratory and infectious disease specialists to determine appropriate antimicrobial therapy.
Shigellosis is a nationally notifiable condition, and all cases of shigellosis should be reported to local health departments.

3D Influenza Virus with Cutaway

Seasonal Influenza

Weekly U.S. Influenza Surveillance Report: Flu View—April 22 (CDC)
Flu View is a weekly influenza surveillance report prepared by CDC’s Influenza Division. All data are preliminary and may change as CDC receives more reports.

Information for Health Professionals—(CDC)
The pages listed offer public health and healthcare professionals key information about vaccination, infection control, prevention, treatment, and diagnosis of seasonal influenza 

2016–2017 Flu Season—(CDC) 

Food, Drug, and Device Safety

NEW: Campylobacter, Salmonella Led Bacterial Foodborne Illnesses in 2016—(CDC)
Campylobacter and Salmonella caused the most reported bacterial foodborne illnesses in 2016, according to preliminary data published April 20, 2017 in CDC’s Morbidity and Mortality Weekly Report. CDC’s Foodborne Diseases Active Surveillance Network (FoodNet) report provides the most up-to-date information about foodborne illnesses in the United States.

MedWatch: The FDA Safety Information and Adverse Event Reporting Program—(FDA)
MedWatch is your 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 the U.S. Department of Agriculture. Visitors to the site can report a problem or make inquiries.