COCA Digest: December 4, 2017

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COCA News and Announcements


Upcoming COCA Call

Topic: The Changing Distribution of Ticks and Tick-borne Infections
Date: Thursday, December 7, 2017

Over the last three decades, several tick species have increased in number and distribution worldwide. The reasons for these changes are multifactorial and include shifts in climate, habitat, wildlife hosts, and human land use patterns. The expansion in tick populations has directly led to an increased risk of infection for both people and animals with established tick-borne agents and newly identified pathogens, creating a true One Health crisis. During the call, clinicians will learn specific examples of changes in the distribution of ticks and tick-borne infections in North America and the recommended strategies to limit transmission and disease in the face of increasing risk.

Recent 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 highlighted critical information about this year’s flu season as well as discussed strategies primary care providers and medical subspecialists can use to improve flu prevention and control in children.

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 Travelers' Health

November 21, 2017: Yellow Fever Vaccine for Travelers to Brazil

In early 2017, the Brazilian Ministry of Health reported an outbreak of yellow fever, and subsequently the World Health Organization expanded the list of areas for which yellow fever vaccination is recommended for international travelers. The outbreak has ended. However, vaccination is still recommended for travelers to certain areas. Anyone 9 months or older who travels to or lives in these areas should be vaccinated against yellow fever. Because of current limitations in the availability of yellow fever vaccine, travelers may need to contact a yellow fever vaccine provider well in advance of travel. For clinician information regarding recommendations for yellow fever vaccine booster doses, clinical and laboratory guidance, diagnostic testing, and adverse events testing, go here and scroll to the bottom of the page.

Visit the CDC Travelers' Health page for more information as well as to see a complete list of the current CDC Travel Health Notices. Explore Travel Health with the CDC Yellow Book.

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.

On October 24, CDC issued HAN Advisory 408 CDC Advice for Health Care Providers Treating Patients in or Recently Returned from Hurricane-Affected Areas, Including Puerto Rico and U.S. Virgin Islands 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. The period of heightened risk may last through March 2018, based on current predictions of full restoration of power and safe water systems in Puerto Rico and USVI.

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.

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

Seasonal Influenza

Flu Vaccination

Weekly U.S. Influenza Surveillance Report: Flu View - Influenza Season Week 46 ending November 18, 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. It also includes Information about recommendations from the Advisory Committee on Immunization Practices (ACIP) for the prevention and control of seasonal influenza for the 2017-18 influenza season. Other resources are also provided.

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.


Everyone can be a flu vaccine advocate!

Need some tips for talking about the importance of flu vaccine? CDC is a great source of information about the serious risk of flu illness and the benefits of flu vaccination, as well as information to correct myths about the flu vaccine.

Mark your calendars for the following upcoming dates & events:

  • 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


World AIDS Day is observed each year on December 1 and is opportunity to unite in our efforts to stop new HIV infections, support those affected by HIV, and remember those who have lost their lives to HIV-related diseases.

This year’s theme, Increasing Impact through Transparency, Accountability, and Partnerships, challenges us to work together to accelerate progress toward ending HIV as a public health threat around the world. Since the beginning of the epidemic, partnerships among governments, multilateral institutions, the private sector, community-based organizations, and many others have been key to the programs and scientific achievements that have brought us to this moment—we now have the tools needed to control the epidemic and lay the groundwork for ending this disease. To reach that goal, we must continue to strengthen our partnerships, be accountable in using resources as efficiently and effectively as possible, and be transparent in making sure our work delivers the results we need.

On World AIDS Day, CDC is releasing new data affirming that global efforts to end HIV are working. Recent data demonstrate strong progress against HIV, but achieving epidemic control requires focusing on those groups at greatest risk for transmitting and acquiring the virus. CDC and partners are on the front lines working to accelerate efforts to reach the most vulnerable populations with targeted HIV prevention and treatment.

Mark your calendar for the next Vital Signs Town Hall Conference on Tuesday, December 5 from 2-3pm (ET) where the topic will be:

Increasing HIV Testing to Reduce Diagnosis Delays

Join the conversation: 800-857-0764
Passcode: 795-4413

raw Dough

Say No to Raw Dough

For many people, the holiday season is the perfect time to spend time together in the kitchen and share delicious baked foods and desserts. Remind your patients to follow these safety tips to help them and their loved ones stay healthy when handling raw dough.

Flour is typically a raw agricultural product. This means it hasn’t been treated to kill germs like Escherichia coli (E. coli). Harmful germs can contaminate grain while it’s still in the field or at other steps as flour is produced. The bacteria are killed when food made with flour is cooked. This is why you should never taste or eat raw dough or batter—whether made from recalled flour or any other flour. In 2016, an outbreak of E. coli infections linked to raw flour made 63 people sick. Flour products have long shelf lives and could be in people’s homes for a long time. If you have any recalled flour products in your home, throw them away.

In addition, raw eggs that are used to make raw dough or batter can contain Salmonella that can make you sick if the eggs are eaten raw or lightly cooked. Eggs are safe to eat when cooked and handled properly.


November 15, 2017: CDC Encourages Safe Antibiotic Prescribing and Use (Press Release)

November 13, 2017, kicked off U.S. Antibiotic Awareness Week and World Antibiotic Awareness Week. Antibiotics are critical tools for treating a number of common infections, such as pneumonia, and for life-threatening conditions including sepsis. However, when patients take antibiotics unnecessarily, they are at risk for side effects and get no benefit from the drugs. Prescribing the right antibiotic at the right time, in the right dose, and for the right duration helps fight antibiotic resistance, protects patients from unnecessary side effects, and helps ensure these life-saving medicines will be available for future generations. 

CDC recognizes this week with an updated educational effort, Be Antibiotics Aware: Smart Use, Best Care, to support the nation’s efforts to combat antibiotic resistance through improved use of these life-saving medications. Resources for healthcare professionals can be found here.

Public Health Preparedness

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 44, November 7, 2017

Volume 9, Issue 45, November 14, 2017

volume 9, issue 46, November 21, 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


Winter Weather

When temperatures drop significantly below normal, staying warm and safe can be a challenge. It is important to remind patients to prepare for winter storms, prevent cold-related health problems, and protect themselves before, during, and after a storm. Some serious health problems that can result from prolonged exposure to cold include hypothermia and frostbite.

In addition, when power outages occur during winter storms and other emergencies, the use of alternative sources of fuel or electricity for heating or cooking can cause carbon monoxide (CO) to build up in a home, garage, or camper and potentially cause sudden illness and death to those exposed. For more information, see CDC's clinical guidance for CO poisoning after a disaster.



November 21, 2017: People in Four States May Be Drinking Contaminated Raw Milk

CDC is warning people in the states of Connecticut, New Jersey, New York and Rhode Island, who might have consumed contaminated raw milk and milk products to visit their doctor. People who drank raw milk from a company called Udder Milk may have been infected with a potentially serious germ called Brucella abortus RB51 and are at high risk for brucellosis infection.

The U.S. Department of Agriculture and the U.S. Food and Drug Administration are working with state health and agriculture officials to trace the source of the contaminated raw milk and raw milk products. Read the FDA alert here.

Health care providers should administer post-exposure prophylaxis (PEP) to patients who drank the contaminated raw milk to avoid infection.


November 16, 2017: Multistate Outbreak of Salmonella Agbeni Infections Linked to Pet Turtles, 2017

CDC and multiple states are investigating a multistate outbreak of human Salmonella infections linked to contact with pet turtles. Epidemiologic and laboratory findings link the outbreak to contact with turtles or their environments, such as water from a turtle habitat.


November 14, 2017: Multistate Outbreak of Multidrug-Resistant Salmonella Heidelberg Infections Linked to Contact with Dairy Calves

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 Salmonella Heidelberg infections.

November 9, 2017: Multistate Outbreak of Salmonella Oranienburg Infections Linked to Good Earth Egg Company Shell Eggs (Final Update)

CDC, the Missouri Department of Health and Senior Services and Department of Agriculture, several states, and the U.S. Food and Drug Administration (FDA) investigated a multistate outbreak of Salmonella Oranienburg infections. This outbreak appears to be over, but it is a reminder to always follow food safety steps to handle and cook eggs safely to avoid foodborne illness from raw eggs.


Salmonella Resistome Tracker

This month, the U.S. Food and Drug Administration (FDA) launched an interactive research tool called Resistome Tracker, one of the first publicly available tools to provide displays of antibiotic resistance genes in bacteria. Resistome Tracker’s interactive interface allows users to customize visualizations by antibiotic drug class, compare resistance genes across different sources, identify new resistance genes, and map selected resistance genes to geographic region. Currently, Resistome Tracker is focused on antibiotic resistance genes in Salmonella. Information about antibiotic prescribing and use can be found here.

One Health graphic with animals and human hand

One Health Approach Supports Global Health Security

Diseases, including zoonotic diseases, can spread around the world very quickly, and the One Health approach can help to protect people and animals from illnesses that cross borders. CDC and its partners support One Health activities in the United States and globally, helping to prevent, detect, and respond to emerging global health threats including zoonotic diseases shared between people and animals.

CDC’s Emerging Infectious Diseases journal is featuring a special supplement on Global Health Security, which includes articles highlighting how the One Health approach plays an important role in creating a safer global community.

See the full supplement

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.