COCA Digest: February 5, 2018

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COCA News and Announcements


Topic: Don't Overlook Assessing Environmental Exposures During a Disaster and Every Day

Date: Tuesday, February 13, 2018

Time: 2:00-3:00 pm (Eastern Time)

Environmental hazards are often not considered during patient intake. Taking a full exposure history of patients during intake can ensure an accurate diagnosis, both during a disaster situation, or in an everyday consult. During this COCA call, clinicians will learn how to utilize the expertise and support from the Pediatric Environmental Health Specialty Units (PEHSUs).

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.

Seasonal Influenza


Weekly U.S. Influenza Surveillance Report: FluView

Influenza activity increased again according to the latest FluView report. All U.S. states but Hawaii and Oregon continue to report widespread flu activity and the number of states experiencing high influenza-like illness (ILI) activity increased from 39 states plus New York City and Puerto Rico to 42 states plus New York City and the District of Columbia. At 7.1 percent, influenza-like-illness (ILI) activity is approaching the 7.7 peak of the 2009 pandemic. The overall hospitalization rate is higher than the overall hospitalization rate reported during the same week of the 2014-2015 season; the most severe season in recent years. CDC also is reporting an additional 17 flu-related pediatric deaths, including one of which occurred during the 2015-2016 season, bringing the total number of flu-related pediatric deaths reported this season to 53 so far. Flu activity is likely to remain elevated for several more weeks.

CDC continues to recommend influenza vaccination for all persons 6 months of age and older as flu viruses are likely to continue circulating for weeks. In addition, in the context of widespread influenza activity, CDC is reminding clinicians and the public about the importance of prompt treatment with antiviral medications in people who are severely ill and people who are at high risk of serious flu complications who develop flu symptoms.

Read the full Situational Update here. Read the FluView report for 2017-2018 Influenza Season Week 4 ending January 27, 2018 here. Access the latest media statement transcript for CDC Update of Flu Activity (January 26, 2018) here.  

Flu Map

Current United States Flu Activity Map

The influenza activity reported by state and territorial epidemiologists indicates geographic spread of influenza viruses, but does not measure the severity of influenza activity. To view the current United States Flu Activity Map, go here.


Information for Healthcare Professionals

CDC offers public health and health care professionals key information about vaccination, infection control, prevention, treatment, and diagnosis of seasonal influenza related to the 2017-2018 season. 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, such as the link to the full presentation of the January 16 session of CDC Grand Rounds: Public Health Response to Severe Influenza, the transcript for CDC Telebriefing on Widespread Flu Activity on January 12, links to the latest Morbidity and Mortality Weekly Reports (MMWRs) about influenza, videos as part of the CDC Expert Commentary Series on Medscape, and a link to the CDC Health Advisory: Seasonal Influenza A(H3N2) Activity and Antiviral Treatment of Patients with Influenza 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.

CDC News and Announcements

Prevention of Hepatitis B Virus Infection in the United States: ACIP Recommendations

Hepatitis B virus (HBV) is transmitted via blood or sexual contact. Persons with chronic HBV infection are at increased risk for cirrhosis and liver cancer and require medical care. This report updates and summarizes previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) and CDC regarding the prevention of HBV infection in the United States. Read the full MMWR here.

Antibiocs Aware

New Resources from Be Antibiotics Aware

Be Antibiotics Aware (formerly Get Smart about Antibiotics) is a national effort to help fight antibiotic resistance and improve antibiotic prescribing and use. 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 from antibiotics, and helps make sure life-saving antibiotics will work when we need them. 

CDC has new resources, including a video and animated GIFs, to bring the Be Antibiotics Aware message to life. Add these digital resources to your organization’s website or share them via social media to highlight how smart antibiotic use means that providers are giving – and patients are getting – the best care.

View and download the complete suite of print and digital resources from the Stakeholder Toolkit and learn more about the Be Antibiotics Aware educational effort. Directly view the patient educational video, "Antibiotics Aren't Always the Answer", here.


Fighting antibiotic resistance: CDC tool maps progress in every state, but still more to be done

CDC released new data in its Antibiotic Resistance (AR) Investment Map, which shows early progress by states to combat AR. This year’s AR Investment Map features more than 170 state-reported successes—like rapidly identifying and containing rare and concerning resistant germs to protect communities. Each state reported multiple successes. These are the first comprehensive reports on state progress made following the first year of Congress’ unprecedented investment in CDC’s Antibiotic Resistance Solutions Initiative.

The AR Investment Map displays CDC’s AR activities in printable state- and city-specific fact sheets, providing a comprehensive view of CDC’s resources to protect Americans from antibiotic-resistant infections.

The full press release is available here

CDC Foundation Press Release: Impact of the Zika Contraception Access Network (Z-CAN) for Women in Puerto Rico Highlighted in Lancet Public Health

In 2016 during the Zika virus outbreak, Puerto Rico had the highest number of Zika infections in the United States, a high rate of unintended pregnancy and limited access to contraception, including long-acting reversible contraception (LARC), like intrauterine devices and contraceptive implants. On January 18, The Lancet Public Health published an article examining the initial results of the Zika Contraception Access Network (Z-CAN), one of the strategies established to prevent Zika-related birth defects in Puerto Rico. The article reports that Z-CAN provided services to more than 21,000 women on the island between May 2016 and mid-August 2017 and demonstrated the feasibility of implementing a program to increase access to the full range of reversible contraception within a complex public health response.

Read the full CDC Foundation press release on the article here.

Field Facts

New App for Bioterrorism Responders

When responding to a possible bioterrorism incident, first responders need fast, easy access to information. Experts within CDC’s National Center for Emerging Zoonotic Infectious Diseases developed the new Field Facts mobile app for first responders and laboratories. The app provides crucial information to use in the first few moments and hours of a response to a potential bioterrorism incident.  Designed for first responders, FBI agents who work with weapons of mass destruction, and any other person who might encounter biological agents, the app describes how to recognize signs and symptoms of disease associated with eight biological agents including:

  • Ricin, 
  • Botulism toxin,
  • Bacillus anthracis (anthrax),
  • Yersinia pestis (plague),
  • Francisella tularensis (tularemia, also known as rabbit fever),
  • Brucella (brucellosis),
  • Smallpox virus, and
  • Burkholderia (melioidosis and glanders).

When opening the app, users will receive information on the ways people can be exposed to the pathogen, how the disease is spread, and disease symptoms. The app also gives users general information on biosafety, what kind of protective clothing to wear and emergency contact information. The app, for Apple and Android devices,  also includes descriptions of safety measures and protective clothing to protect individuals from exposure to potential bioterrorism agents.

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 10, Issue 3

Volume 10, Issue 2

Volume 10, Issue 1

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.

Natural Disasters and Severe Weather

Avoid Carbon Monoxide Poisoning: Stay Safe While Staying Warm

When power outages occur after severe weather, using alternative sources of power can cause carbon monoxide (CO) to build up in a home and poison the people and animals inside. Every year, at least 430 people die in the U. S. from accidental CO poisoning. Approximately 50,000 people in the U.S. visit the emergency department each year due to accidental CO poisoning. Please talk to your patients about protecting themselves by following steps available here and here.

For more information on how to prevent carbon monoxide poisoning, go here.


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

Multistate Outbreak of Multidrug-Resistant Campylobacter Infections Linked to Contact with Pet Store Puppies (Final Update)

CDC has issued a final update on the multistate outbreak of multidrug-resistant Campylobacter infections. Epidemiologic and laboratory evidence indicated that contact with puppies sold through Petland stores were a likely source of this outbreak. This outbreak investigation is over. Illnesses could continue to occur because people may be unaware of the risk of Campylobacter infections from puppies and dogs. Read the final update here.


Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection — 15 States and U.S. Territories, 2016

A CDC MMWR report published on January 26 shows that Zika is still a threat to mothers and babies in U.S. areas with local transmission. CDC researchers found a 21% increase in birth defects most strongly linked to Zika virus infection in pregnancy during the last half of 2016.

This report provides the first comprehensive data on the prevalence of birth defects potentially related to Zika virus infection in a birth cohort of nearly 1 million births in 2016. A significant increase in birth defects strongly related to Zika virus during the second half of 2016 compared with the first half was observed in jurisdictions with local Zika virus transmission. Only a small percentage of birth defects potentially related to Zika had laboratory evidence of Zika virus infection, and most were not tested for Zika virus. These data will help communities plan for needed resources to care for affected patients and families and can serve as a foundation for linking and evaluating health and developmental outcomes of affected children. Read the full MMWR here.

Read the CDC Press Release here.

One health

CDC Helps Countries Prioritize Their Top Zoonotic Diseases

CDC’s One Health Office works with countries and partners around the globe to prioritize zoonotic diseases of greatest national concern. CDC experts lead One Health Zoonotic Disease Prioritization Workshops for countries that want to prioritize a list of their most urgent zoonotic disease threats. These workshops bring together experts from many different areas who work to protect the health of people, animals, and the environment. Workshop participants collaborate to identify a country’s top zoonotic diseases to target for One Health collaborations and develop strategies to tackle the newly prioritized zoonotic diseases.

Prioritizing diseases helps countries focus their resources, allowing them to better prevent, detect, and respond to the prioritized diseases and protect human and animal health. To date, CDC has helped 18 countries conduct prioritization workshops on four continents. Zoonotic diseases commonly prioritized include rabies, zoonotic influenza viruses, viral hemorrhagic fevers such as Ebola virus and Rift Valley fever, brucellosis, and anthrax.

Learn more about the One health Zoonotic Disease Prioritization process here.

Food, Drug, and Device Safety

Multistate Outbreak of Shiga toxin-producing Escherichia coli O157:H7 Infections Linked to Leafy Greens (Final Update)

CDC has provided a final update on the multistate outbreak of Shiga toxin-producing E. coli O157:H7 (STEC O157:H7) infections. This outbreak appears to be over as of January 25, 2018. The most recent illness started on December 12, 2017. Information about STEC and what people can do to reduce their chances of infection is available on the CDC website. Read the final update here.

Raw Sprouts

Multistate Outbreak of Salmonella Montevideo Infections Linked to Raw Sprouts

CDC, public health, and regulatory officials in several states and the FDA are investigating a multistate outbreak of Salmonella infections linked to raw sprouts. Eight people have been reported sick from three states. No hospitalizations or deaths have been reported. Ill people in this outbreak report eating raw sprouts served at Jimmy John’s restaurants in Illinois and Wisconsin. The investigation is ongoing to determine where the sprouts came from and where they were distributed. CDC recommends that people do NOT eat raw sprouts served at Jimmy John’s restaurants in Illinois and Wisconsin. For more information about foodborne illnesses and outbreaks, go here. Read the full announcement here.


Multistate Outbreak of Salmonella Infections Linked to Coconut Tree Brand Frozen Shredded Coconut

CDC, public health and regulatory officials in several states, and the FDA are investigating a multistate outbreak of Salmonella infections. Epidemiologic, laboratory, and traceback evidence indicates that Coconut Tree Brand frozen Shredded Coconut is the likely source of this multistate outbreak. This investigation is ongoing. The frozen shredded coconut linked to this outbreak was used as an ingredient in Asian-style dessert drinks served at restaurants. The product was also sold in grocery stores and markets in several states. Read the full announcement here.

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.