CDC COCA Learn: November 21, 2018

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Upcoming COCA Call

Hepatitis A Outbreaks in Multiple States: CDC Recommendations and Guidance

Date: Thursday, November 29, 2018

Time: 2:00-3:00 P.M. (Eastern Time)

Hepatitis A is a highly contagious, vaccine-preventable, viral disease spread via a fecal-oral route or by exposure to contaminated food or water. Hepatitis A rates have declined substantially in the United States since the introduction of the hepatitis A vaccine in 1996. However, since early 2017, the Centers for Disease Control and Prevention (CDC) has observed an increase in the number of community-wide hepatitis A outbreaks in multiple states. For these outbreaks, CDC recommends vaccination for persons who report drug use (injection and non-injection), persons at high risk for drug use (e.g., participating in drug substitution programs, receiving substance abuse counseling or treatment, recently or currently incarcerated), men who have sex with men, and persons experiencing homelessness. CDC also encourages vaccination in certain settings such as emergency departments and corrections facilities in outbreak-affected areas when feasible.

During this COCA call, subject matter experts from CDC will discuss vaccination to stop these outbreaks and current CDC recommendations for the hepatitis A vaccine.

Recent COCA Call

Acute Flaccid Myelitis (AFM): What Health Care Providers Need to Know

CDC is actively investigating acute flaccid myelitis, or AFM, a serious condition that causes weakness in the arms or legs. From August 2014 through October 2018, CDC received information on a total of 396 confirmed cases of AFM across the US; most of the cases have occurred in children. As of October 26, there were 72 confirmed cases of AFM in 2018. The patients’ symptoms have been most similar to complications of infection with certain viruses, including poliovirus, non-polio enteroviruses, adenoviruses, and West Nile virus. CDC has not confirmed the cause for the majority of these cases.

During this COCA call, subject matter experts from CDC highlighted the importance of reporting cases to learn more about this condition and the process for reporting. They also covered specimen collection and testing, and what CDC is doing for its AFM investigation.

Archived COCA Calls

COCA Calls offer the most up-to-date information and guidance for clinicians about key emergency preparedness and response topics and emerging public health threats. If you were unable to attend a live call, archived COCA Calls are available here. Free continuing education (CE) is available for most COCA Calls. More information about free CE is available here.

Emergency Preparedness and Response Training Resources

Emergency Preparedness and Response

This page features scheduled and on-demand access to information on emergency preparedness and response training resources that CDC, other federal agencies, and COCA partners offer—be sure to check out these valuable resources!   

Conference and Training Opportunities


The Conference and Training Opportunities webpage has been updated to include conferences from November 2018–April 2019. Visit the webpage to learn about conferences that CDC, other federal agencies, and COCA partners sponsor.

November COCA Partner Spotlight

Partner Spotlight

COCA is pleased to feature The National Association of EMS Physicians (NAEMSP) in our November COCA Partner Spotlight! NAEMSP was formed in 1984 to serve as a resource and advocate for EMS physicians and EMS professionals. Since its inception, NAEMSP membership has grown from a handful of dedicated founders from a cross-section of the U.S., to more than 1,000 physicians, paramedics, nurses, administrators, educators, researchers, and key EMS personnel. To improve out-of-hospital emergency medical care, NAEMSP promotes meetings, publications and products that connect, serve, and educate its members.

Partnerships with professional healthcare associations are vital to CDC’s ability to share information with clinicians about public health emergencies, CDC guidance, health alert messages, and training opportunities.

To learn more about NAEMSP, visit their website and follow them on Facebook.

Other Training Opportunities

Opioid Training

New Opioid Training for Providers: Dosing and Titration of Opioids: How Much, How Long, and How and When to Stop?

Do you have questions about how to safely dose, titrate, and taper opioids? Complete the CDC module, Dosing and Titration of Opioids: How Much, How Long, and How and When to Stop? to learn about best practices for dosing opioids. This module is the sixth in CDC’s series of interactive online trainings that healthcare providers can use to gain a better understanding of when to start, continue, and stop opioids. In this module, healthcare providers will explore how to weigh the benefits and harms, including comorbidities, unpredictable pharmacokinetics and pharmacodynamics, and determination of total morphine milligram equivalents when making clinical decisions on initiating, continuing, and tapering opioids. This training features recommendations from the CDC Guideline for Prescribing Opioids for Chronic Pain and provides clinical scenarios, clinical tools, and a resource library. This and all the modules in the series have free continuing education, each available on our Training for Providers webpage.

CDC Grand Rounds

Public Health Grand Rounds is a monthly webcast created to foster discussion on major public health issues. The Grand Rounds sessions also highlight how CDC and its partners are already addressing these challenges and discusses recommendations for future research and practice. Visit Grand Rounds On-Demand to browse upcoming and previous presentations.

Free CE is available for most topics.


CDC TRAIN provides access to more than 1,000 courses that CDC programs, grantees, and other funded partners have developed. Courses offered by CDC course providers have been approved and verified by CDC.

cdc train

New CDC Learning Connection

CDC Learning Connection’s Courses: Opioids, Pandemic Flu, Diabetes, & Outbreak Investigation

Visit the CDC Learning Connection this month to take advantage of featured trainings!

  • A recent study shows improvements in opioid prescribing after the release of the CDC Guideline for Prescribing Opioids for Chronic Pain. Access opioid courses on TRAIN via the Hot Training Topic to learn safe prescribing practices and other approaches to the opioid overdose epidemic.
  • “Application and Integration of Nonpharmaceutical Interventions (NPIs) into Pre-Pandemic Influenza Planning, Preparedness, and Response.” Learn the decision-making process for when to implement NPIs to help slow the spread of pandemic flu. Free CE.
  • Are you interested in outbreak investigation? Take “I is for Investigation,” a training plan from the North Carolina Institute for Public Health at the UNC Gillings School of Global Public Health. Learn how to recognize an outbreak, design a study, analyze data, and communicate results.

Sign up for our free monthly e-newsletter to stay up-to-date on similar public health trainings from CDC, other federal agencies, and federally funded partners.

Clinician’s Corner Featuring Sapna Bamrah Morris, MD, MBA


Welcome to the Clinician’s Corner! Each month we will feature a CDC clinician, a clinician who has collaborated with COCA, or someone who has presented on a COCA Call. This month, we’re featuring Sapna Bamrah Morris, MD MBA.

Sapna is a Medical Officer for CDC and the current Incident Manager for the Incident Command Structure coordinating the response for the Hepatitis A outbreaks occurring in 13 states. She has training in infectious disease medicine and is the medical consultation team lead for the Division of TB Elimination. She received her Bachelors of Arts in Social Work in 1995 from Marquette University and proceeded to earn her MD from the Medical College of Wisconsin in 1999. She then received her MBA from Auburn University in 2015.

Sapna has had a longstanding interest in providing health care for persons experiencing homelessness. She has volunteered with health care for the homeless clinics in multiple cities, serves on the board of directors for Mercy Care - the largest health care for the homeless provider in the city of Atlanta, and serves on numerous committees for the National Health Care for the Homeless Council. Sapna continues to bring her connections with the Council and the U.S. Housing and Urban Development, among other partners, to emphasize the importance of partnership in addressing communicable diseases that disproportionately affect persons experiencing homelessness.

Be sure to listen to Sapna and her colleagues during our next COCA Call as they discuss “Hepatitis A Outbreaks in Multiple States: CDC Recommendations and Guidance” on Thursday, November 29, 2018 at 2 PM ET. If you are unable to attend the live call, it will be available here a few days after the call. Free Continuing Education (CE) is available for this COCA Call. More information about free CE is available here.


Clinicians and Health Departments, do you have questions about what to do if you believe a patient has symptoms of Acute Flaccid Myelitis (AFM)?

CDC's Division of Viral Diseases (DVD) in the National Center for Immunization and Respiratory Diseases (NCIRD) has compiled "Frequently Asked Questions by Clinicians and Health Departments" all in one convenient place. You can view those questions and answers here.