COCA Digest: November 6, 2017

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COCA News and Announcements


Upcoming COCA Call

Topic: What’s New for the 2017-2018 Flu Season: Recommendations for Children
Date: Tuesday, November 7, 2017

Influenza remains a serious threat to child morbidity and mortality. More than 100 flu-associated deaths in children during the 2016–2017 influenza season were reported to the Centers for Disease Control and Prevention (CDC). Clinicians play a critical role in taking action to immunize children, children’s family members, caregivers, and themselves. The early use of antiviral drugs in children can reduce the duration of symptoms, and prevent serious complications of influenza. However, immunization remains the most effective way to prevent influenza illness and its complications. During this COCA call, subject matter experts from the American Academy of Pediatrics (AAP) and CDC will highlight critical information about this year’s flu season, and discuss strategies primary care providers and medical subspecialists can use to improve flu prevention and control in children.

Recent COCA Calls

Topic: The Ecology of Emerging Zoonotic Diseases
Date: Thursday, November 2, 2017

Zoonotic viruses, those which are transmitted between animals and people, represent an important group of pathogens that are responsible for a growing number of significant epidemics. SARS coronavirus, Ebola, Nipah virus, avian influenza, and 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, 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. Minimizing 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 gained a broad understanding of how spillover and disease emergence occurs. This COCA Call used Nipah virus and Ebola virus as case studies and discuss effective interventions that reduce the risk of spillover of both known and unknown pathogens from wildlife. We also discussed efforts that are currently underway to enhance the global community’s capacity to detect and respond to the emergence of novel zoonoses. 

Topic: Primary Care Providers' Role in Supporting Children, Families, and Professional Self-Care Following Hurricanes and Other Disasters
Date: Thursday, October 26, 2017

Primary care providers are essential for promoting children’s mental health and well-being throughout the recovery process following hurricanes. Disasters such as Hurricanes Harvey, Irma and Maria can cause short and long-term effects on the psychological functioning, emotional adjustment, health, and developmental trajectory of children. Additionally, disasters often impact healthcare providers to at least the same degree they impact others in the community, and being with suffering children and families can be distressing for providers. During this COCA Call, clinicians learned to identify common adjustment difficulties in children, practical strategies to promote effective coping skills in children and their parents, and the importance of professional self-care and strategies to address this need.

Topic: The Role of Healthcare Professionals in Protecting Older Adults against Influenza
Date: Thursday, October 12, 2017

Healthcare professionals (HCPs) play a critical role in protecting older adults (age 65 years and older) against influenza (flu). Despite concerted efforts to promote annual influenza vaccination for older adults, persistent knowledge gaps exist regarding the burden of disease and the risk of flu and related complications for this vulnerable population. According to recent research, the phenomenon known as immunosenescence leaves older adults less responsive to standard influenza vaccines. HCPs play a critical role in strongly recommending and ensuring flu vaccination for older adults. During this COCA Call, presenters shared easy-to-use education materials available to support HCPs in discussing flu prevention with older adult patients.

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

CDC Health Advisory

HAN 408: Advice for Providers Treating Patients in or Recently Returned from Hurricane-Affected Areas, Including Puerto Rico and US Virgin Islands

The CDC is working with federal, state, territorial, and local agencies and global health partners in response to recent hurricanes. CDC is aware of media reports and anecdotal accounts of various infectious diseases in hurricane-affected areas, including Puerto Rico and the US Virgin Islands (USVI). Because of compromised drinking water and decreased access to safe water, food, and shelter, the conditions for outbreaks of infectious diseases exist.

The purpose of this HAN advisory is to remind clinicians assessing patients currently in or recently returned from hurricane-affected areas to be vigilant in looking for certain infectious diseases, including leptospirosis, dengue, hepatitis A, typhoid fever, vibriosis, and influenza. Additionally, this Advisory provides guidance to state and territorial health departments on enhanced disease reporting.

Read the full health advisory here.


For more information about CDC's Health Alert Network (HAN) program, please visit

CDC Emergency Response

medical symbol

2017 Hurricane Response

CDC’s Emergency Operations Center (EOC) activated on August 31, 2017 to bring together CDC staff to work efficiently in responding to public health needs in the aftermath of Hurricanes Harvey, Irma, and Maria and to deploy resources and personnel as requested.

For information used to improve safety and reduce exposure risks during the emergency response in the U.S. Virgin Islands and Puerto Rico, see Guidance for Emergency Responders in U.S. Virgin Islands and Puerto Rico,

For information on vaccines, controlling infections, drug safety, and reopening healthcare centers after a disaster, see Safety Information for Health Care Professionals.

See Coping with a Disaster or Traumatic Event for tips you, as an emergency responder, can take to ensure you are able to do your job and cope with challenging situations.

For facts on safety, cleanup, and health recommendations for volunteers and cleanup workers, see Safety Information for Response and Cleanup Workers.

Public Service Announcements (PSAs) for Disasters are available to help the media and other professionals get information to the public about preparing for hurricanes and staying safe during and after.


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   

For a collection of the most up-to-date, cleared information on the ongoing hurricane season, see CDC Hurricane 2017 Key Messages in English and Spanish. In addition, see CDC's Hurricane 2017 Key Messages: For Employers, Workers, and Volunteers – available in English, Spanish, Chinese, and Vietnamese.

Seasonal Influenza

Recommend a flu vaccine to your patients

Weekly U.S. Influenza Surveillance Report: Flu View - 2016-17 Influenza Season Week 43 ending October 28, 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.

Information for Health Professionals

This page offers public health and health care professionals key information about vaccination, infection control, prevention, treatment, and diagnosis of seasonal influenza. Information including recommendations from the Advisory Committee on Immunization Practices (ACIP) for the prevention and control of seasonal influenza for the 2017-18 influenza season and other resources are also included.

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.

Mark your calendars for the following upcoming dates and events:

  • November 7 - Join the  Clinician Outreach and Communication Activity (COCA) call from 2-3pm ET. During the call, subject matter experts from the American Academy of Pediatrics (AAP) and CDC will highlight critical information about this year’s flu season, and discuss strategies primary care providers and medical subspecialists can use to improve flu prevention and control in children.
  • November 6-11 - CDC will host a blog-a-thon, encouraging partners to blog and post on their websites about the importance of flu vaccine. This year, CDC will focus our post on encouraging providers to make a strong flu vaccine recommendation to patients and arming them with the information they need to respond to questions about flu season and the available vaccines. The blog-a-thon will kick off on CDC’s Public Health Matters blog on November 6.
  • December 3-9 - National Influenza Vaccination Week
  • December 6 -  #FluStory Twitter Storm. To encourage vaccination and emphasize the seriousness of flu, CDC will launch a “Twitter storm” on December 6 at 1 pm ET that will continue throughout the week. You can participate in the event by using the hashtag #FluStory and sharing why flu vaccination is important to you.

CDC News and Announcements


November 3, 2017: Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 — 10 States, July–December 2016

Sharp increases in opioid overdose deaths since 2013 are partly explained by the introduction of illicitly manufactured fentanyl into the heroin market. Outbreaks related to fentanyl analogs also have occurred. One fentanyl analog, carfentanil, is estimated to be 10,000 times more potent than morphine. Fentanyl analogs are not routinely detected because specialized toxicology testing is required.

October 19, 2017: CDC Reports Rising Rates of Drug Overdose Deaths in Rural Areas (Press Release)

Rates of drug overdose deaths are rising in nonmetropolitan (rural) areas, surpassing rates in metropolitan (urban) areas, according to a new report in the Morbidity and Mortality Weekly Report (MMWR) released by the CDC.

Public Health Preparedness

Medicine cabinet

October 16, 2017: Public Health Matters: Preparing your Medicine Cabinet for an Emergency: A Checklist

You are probably familiar with the important items you should keep in your emergency kit – water, food, a flashlight, and a battery-powered radio. What you may not think about is personalizing your kit for your unique medical needs or the needs of your family. As a pharmacist whose job is focused on emergency preparedness and response, COCA's own Dr. Ibad Khan, PharmD gives 10 pointers on how to prepare your medications for an emergency so you can decrease the risk of a life-threatening situation.

CDC Science Clips
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.

Volume 9, Issue 43, October 31, 2017

Volume 9, Issue 42, October 24, 2017

Volume 9, Issue 41, October 17, 2017

Volume 9, Issue 40, October 10, 2017


The Advisory Committee on Immunization Practices (ACIP) comprises medical and public health experts who develop recommendations on the use of vaccines in the civilian population of the United States. The recommendations stand as public health guidance for safe use of vaccines and related biological products.

Updated information is available about vaccine-specific recommendations and immunization schedules. More information about ACIP is available here.  

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.

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

One Health graphic with animals and human hand

One Health Concept: Did you know that 6 out of every 10 infectious diseases in humans are spread from animals?

The One Health concept recognizes that the health of people is connected to the health of animals and the environment. CDC uses a One Health approach by working with physicians, veterinarians, ecologists, and many others to monitor and control public health threats and to learn about how diseases spread among people, animals, and the environment.

CDC has created different types of resources to increase awareness of One Health work to protect people from global and infectious disease threats. For more information, including recent Medscape Commentaries about infectious disease and One Health topics, please visit here.

Multidrug-Resistant Campylobacter

October 30, 2017: Multistate Outbreak of Multidrug-Resistant Campylobacter Infections Linked to Contact with Pet Store Puppies

CDC, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) are investigating a multistate outbreak of multidrug-resistant Campylobacter infections. A list of the number of cases by state can be found on the Case Count Map page. Additional information and advice is available for clinicians and veterinarians.



October 19, 2017 - CDC updates guidance for infants born to mothers with possible Zika virus infection during pregnancy

CDC has updated its interim guidance for U.S. health care providers caring for infants with possible congenital Zika virus infection (1) in response to recently published updated guidance for health care providers caring for pregnant women with possible Zika virus exposure (2), unknown sensitivity and specificity of currently available diagnostic tests for congenital Zika virus infection, and recognition of additional clinical findings associated with congenital Zika virus infection.

Food, Drug, and Device Safety

November 3, 2017: Multistate Outbreak of Salmonella Urbana Infections Linked to Imported Maradol Papayas, 2017 (Final Update)

CDC has provided a final update on the four separate multistate outbreaks of Salmonella infections linked to imported Maradol papayas from Mexico. Each outbreak was linked to papayas imported from a different farm in Mexico.

October 19, 2017: Multistate Outbreaks of Human Salmonella Infections Linked to Live Poultry in Backyard Flocks, 2017 (Final Update)

Salmonella outbreak investigations are over. However, people can still get a Salmonella infection from live poultry, including those in backyard flocks. Read more information about Salmonella from live poultry and how people can reduce the chance they or their children will get an infection.

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.