COCA Digest: October 3, 2018

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CDC Health Alert Network (HAN) Advisories


CDC HAN 415: Hurricane Florence—Clinical Guidance For Carbon Monoxide (CO) Poisoning

September 16, 2018: The Centers for Disease Control and Prevention (CDC) is reminding clinicians seeing patients from the areas affected by Hurricane Florence to maintain a high index of suspicion for CO poisoning. Other people who may be exposed to the same CO source may need to be identified and assessed. Although CO poisoning can be fatal to anyone, children, pregnant women, the unborn, persons with sickle cell disease, older adults, and persons with chronic illness (e.g., heart or lung disease) are particularly vulnerable.

Read the full Health Advisory here.

CDC HAN 414: Advice to Clinicians about Leptospirosis in U.S. Travelers Returning from Northern Israel

September 7, 2018: The Israeli Ministry of Health is reporting an outbreak of leptospirosis in persons with exposure to natural water sources in the Golan Heights region of northern Israel after July 1, 2018. As of September 6, 2018, three persons with leptospirosis who traveled to Israel have been identified in the United States, with additional suspected cases reported and under investigation. Early symptoms of leptospirosis include fever, headache, chills, muscle aches, vomiting, diarrhea, cough, conjunctival suffusion (conjunctival redness without exudates), jaundice, and sometimes a rash.

Read the full Health Advisory here.

Sign up to receive CDC HAN messages here.

CDC Emergency Response Activities


Hurricane Florence

CDC activated its Emergency Operations Center (EOC) on Wednesday, September 12, to coordinate all CDC activities for public health needs before, during, and after Hurricane Florence, including the deployment of resources and personnel, as requested.

CDC and Agency for Toxic Substances and Disease Registry (ATSDR) staff are working to support the local, state, and federal response to public health needs resulting from Hurricane Florence including:

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

For more information about CDC and U.S. government activities related to Hurricane Florence, click here.

Emergency Preparedness and Response

Natural Disasters and Severe Weather

Clinicians, remind your patients about the importance of being prepared and how they can take steps to protect themselves and their families when an emergency strikes. CDC has information about many different types of disasters all in one place available here.

Health and Safety Concerns for All Disasters

Information on health and safety concerns for all disasters, including information on:

Resources for Emergency Health Professionals

CDC offers a variety of resources for clinicians, communicators, laboratorians, emergency planners and responders, and disaster relief volunteers to help them prepare to respond to a public health emergency. Included in this section are free educational materials that are suitable for printing and sharing in various languages, including flyers, posters, stickers, and PSAs.

Click here to access the resources.

Disaster Resources and Educational Materials

Be sure to check out CDC’s educational materials including a variety of hazards listed by topic or language, PSAs for disasters, resources for emergency health professionals, and social media channels with featured apps, blogs, content available for syndication, and buttons and badges. Go here to access these free resources, that are suitable for printing and sharing.

Seasonal Influenza

Recent COCA Call

Topic: 2018-2019 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Providers

Date: Thursday, September 27, 2018

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.


Weekly U.S. Influenza Surveillance Report

WHO and NREVSS collaborating laboratories, which include both public health and clinical laboratories located in all 50 states, Puerto Rico, and the District of Columbia, report to CDC the total number of respiratory specimens tested for influenza and the number positive for influenza by virus type. In addition, public health laboratories also report the influenza A subtype (H1 or H3) and influenza B lineage information of the viruses they test and the age or age group of the persons from whom the specimens were collected.    

Read the full situational update here. View the current United States flu activity map here.

Healthcare professionals can find additional resources, recommendations, and guidances here.    

CURRENT Influenza Vaccine Recommendations

For more information on seasonal Influenza, click here

    CDC Announcements


    Think Fungus: Fungal Disease Awareness Week

    Fungal Disease Awareness Week is October 1–5, 2018. CDC and partners have organized this week to highlight the importance of recognizing serious fungal diseases early enough in the course of a patient’s illness to provide life-saving treatment.

    Some fungal diseases go undiagnosed and cause serious infections in people in the United States and around the world, leading to illness and death. Increased awareness about fungal diseases is one of the most important ways we can improve early recognition and reduce delays in diagnosis and treatment.

    For more information on this week, new resources, fact sheets, and posters, click here.

    Travelers' Health

    Ebola in Democratic Republic of the Congo

    An outbreak of Ebola is occurring in the North Kivu (Kivu Nord) and Ituri provinces of the Democratic Republic of the Congo (DRC), including the city of Butembo. North Kivu and Ituri provinces are in the northeastern part of the DRC, approximately 780 miles from the outbreak that ended in July 2018. The DRC Ministry of Health declared this outbreak on August 1, 2018.

    Special Recommendations for Health Care Workers in the Outbreak Area

    If your work puts you at risk of exposure to Ebola, you should:

    • Wear protective clothing, including masks, gloves, gowns, and eye protection whenever you are working with risk of exposure to Ebola virus.
    • Discuss options for vaccination with your sponsoring organization. DRC, WHO, and other partners are offering an investigational vaccine to priority populations such as frontline health care workers. A major clinical trial conducted in Guinea in 2015 showed the vaccine to be highly protective against Ebola.
    • If you choose to get vaccinated against Ebola, get the vaccine before travel, if possible.
    • The National Institutes of Health (NIH) has an open-label clinical trial, entitled “Pre-Exposure Prophylaxis in Individuals at Potential Occupational Risk for Ebola Virus Exposure” or “PREPARE,” to vaccinate adult volunteers (including deploying health care workers and other responders) against Ebola. Study sites are located at the NIH in Bethesda, MD, and Emory University in Atlanta, GA.
    • Practice proper infection control and sterilization measures. For more information, see "Infection Control for Viral Haemorrhagic Fevers in the African Health Care Setting."

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

    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. 

    CDC Current Outbreak List

    Stay up to date on the infectious disease outbreaks that CDC is currently reporting. For a complete list of U.S. outbreaks, travel notices affecting international travelers, food safety recalls, and further sources for content about specific outbreaks, please go here.

    You can also sign up to receive email updates about U.S.-Based Outbreaks and Travel Notices Affecting International Travelers on this page.