COCA Digest: September 5, 2017

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HAN 406: Hurricane Harvey—Clinical Guidance for Carbon Monoxide (CO) Poisoning

An elevated carboxyhemoglobin (COHgb) level of 2% or higher for non-smokers and >9% or higher COHgb level for smokers strongly supports a diagnosis of CO poisoning. The COHgb level must be interpreted in light of the patient’s exposure history and length of time away from CO exposure, as levels gradually fall once the patient is removed from the exposure.

CDC Health Alert Network (HAN) Logo

Read the full health advisory on the CDC HAN webpage.

COCA News and Announcements

September is National Preparedness Month!

Throughout September, CDC and more than 3000 organizations—national, regional, and local governments, as well as private and public organizations, will support emergency preparedness efforts and encourage Americans to take action. CDC's Office of Public Health Preparedness and Response has Clinical Tools and Resources that are intended for clinician use when providing care during a public health emergency. You have the power to prepare!

Upcoming COCA CALL

Topic: The Ecology of Emerging Zoonotic Diseases
Date: Thursday, September 21, 2017
COCA and our partners at the American College of Veterinary Preventive Medicine (ACVPM) cordially invite you to this COCA Call later on this month.

Zoonotic Diseases - small animal being tested

SARS coronavirus, Ebola, Nipah virus, avian influenza, and perhaps most importantly, HIV, are all recently emergent zoonotic viruses that originated in wild animal populations and have caused significant morbidity and mortality in human, and in some cases, animal populations. Zoonotic viruses can have profound health and economic impacts globally, even when occurring in relatively isolated regions, thereby making them a significant challenge for the global health community. The majority of viral pandemics are triggered by human activities such as deforestation, agricultural expansion and intensification, urbanization, hunting, travel, and wildlife trade. To be able to minimize the impact of emerging viral zoonoses requires an understanding of the viral diversity within key wildlife reservoirs, the types of human behaviors that increase exposure to an infection with zoonotic viruses, and the ability to rapidly identify the etiologic agent behind clusters of human or domestic animal disease so that effective interventions can be implemented. During this COCA Call, participants will gain a broad understanding of how spillover and disease emergence occurs.

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

CDC Emergency Response

Photo of palm trees during a hurricane.

2017 Hurricane Harvey Response

CDC's Emergency Operations Center (EOC) is now activated to bring together CDC staff to work efficiently in responding to public health needs in the aftermath of Hurricane Harvey and to deploy resources and personnel as requested. CDC has deployed pharmacy supplies and six 250-bed medical stations.

Specific assistance that CDC staff offer includes recommendations related to:

  • General and medical shelter surveillance for infectious disease outbreaks  
  • Public health messages and risk communication    
  • Water, sanitation, safety evaluations for food/water    
  • Mold abatement    
  • Industrial contamination (HAZMAT) mitigation/abatement    
  • Vector control/management from standing water   

Are you a healthcare professional or an emergency response worker? Find out how you can help people stay safe and recover after a hurricane by visiting Information for Professionals and Response Workers where you can find out information regarding vaccinations, controlling infections, drug safety, reopening health care centers after a disaster, safety recommendations for volunteers and cleanup workers, PSAs, and more.

For more information about CDC and U.S. government activities after hurricanes and other tropical storms, including Hurricane Harvey go to:  and

For updates regarding all HHS activities from related to Hurricane Harvey, please visit To learn more about HHS resources related to Hurricane Harvey, please visit For resources related to emotional distress from hurricanes and tropical storms visit

2016 Zika Virus Response

Aedes aegypti mosquito by Jim Gathany

General Resources

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, Portuguese, 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

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

Guidance for Areas with Local Zika Virus Transmission in the Continental United States and Hawaii

Zika Travel Information

CDC News and Announcements

GIF with signs and symptoms of Sepsis

NEW: September is Sepsis Awareness Month! CDC urges early recognition, prompt treatment of Sepsis New CDC effort encourages clinicians, patients, and caregivers to Get Ahead of Sepsis.

Each year in the U.S., more than 1.5 million people develop sepsis, and at least 250,000 Americans die as a result. Get Ahead of Sepsis is an educational initiative to protect Americans from the devastating effects of sepsis. This initiative emphasizes the importance of early recognition and timely treatment of sepsis, as well as the importance of preventing infections that could lead to sepsis.

“Healthcare professionals, patients, and their family members can work as a team to prevent infections and be alert to the signs of sepsis.” said Lauren Epstein, M.D., medical officer in CDC’s Division of Healthcare Quality Promotion. “Get Ahead of Sepsis encourages healthcare professionals and patients to talk about steps, such as taking good care of chronic conditions, which help prevent infections that could lead to sepsis."

CDC is continuing to:

  • study the risk factors for sepsis;
  • help healthcare professionals, patients and their families to recognize the signs of sepsis;
  • develop more reliable ways to measure the impact of successful interventions; and
  • encourage infection prevention through vaccination programs, chronic disease management, and appropriate antibiotic use.

For more information about Get Ahead of Sepsis and to access materials, visit: which includes resources for healthcare professionals including factsheets, infographics, and brochures.

Public Health Preparedness

Emergency Preparedness and Response for Health Professionals
Find preparedness resources for health professionals.

Emergency Preparedness and Response Training Resources for Clinicians
Find online and in-person training resources.

CDC Science Clips: Volume 9, Issue: 34
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.

Natural Disasters and Severe Weather


Natural Disasters and Severe Weather

Food and Water Needs: Preparing for a Disaster or Emergency

Health and Safety Concerns for All Disasters

Infectious, Vector-Borne, and Zoonotic Diseases

3D Influenza Virus with Cutaway

Seasonal Influenza

Weekly U.S. Influenza Surveillance Report: Flu View—August 26, 2017
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.

NEW: CDC's seasonal flu vaccination campaign materials are available to assist partners in communicating about the importance of vaccination. This digital toolkit includes details on events/activities, sample social media and newsletter content, graphics, web assets, and media prep material. This material is downloadable, shareable, and some of the material is customizable.

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


Multistate Outbreaks of Human Salmonella Infections linked to Live Poultry in Backyard Flocks, 2017 CDC and multiple states are investigating 10 separate multistate outbreaks of Salmonella infections in people who had contact with live poultry in backyard flocks. The outbreak strains of Salmonella have infected 961 people in 48 states resulting in 215 hospitalizations and one death. Epidemiologic, traceback, and laboratory findings link the 10 outbreaks to contact with live poultry, such as chicks and ducklings, from multiple hatcheries.

  • Illnesses started on dates ranging from January 4, 2017 to July 31, 2017.
  • These outbreaks are caused by several DNA fingerprints of different Salmonella bacteria: Salmonella Braenderup, Salmonella Enteritidis, Salmonella Hadar, Salmonella I 4,[5],12:i-, Salmonella Indiana, Salmonella Infantis, Salmonella Litchfield, Salmonella Mbandaka, Salmonella Muenchen, and Salmonella Typhimurium.
  • In interviews, 498 (74%) of 672 ill people reported contact with live poultry in the week before illness started.

Multistate Outbreak of Salmonella Kiambu Infections Linked to Imported Maradol Papayas
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of Salmonella Kiambu infections. As of August 18, 2017, 201 people infected with the outbreak strain of Salmonella Kiambu have been reported from 23 states. A list of the states and the number of cases in each can be found on the Case Count Map page.

Human Salmonella Typhimurium Infections Linked to Exposure to Clinical and Teaching Microbiology Laboratories
CDC and public health officials in several states have identified a multistate outbreak of Salmonella Typhimurium infections linked to various clinical, commercial, and college and university teaching microbiology laboratories. Twenty-four people infected with the outbreak strain of Salmonella Typhimurium have been reported from 16 states.

Food, Drug, and Device Safety

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. Reports of FDA and USDA Food Recalls, Alerts, Reporting, and Resources—(HHS/USDA/FDA/CDC/NIH) 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.