COCA Digest: December 6, 2018

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CDC Announcements

Weekly Update for Number of U.S. Acute Flaccid Myelitis (AFM) Cases - 2018 Case Count Appears to Have Peaked

Based on the number of reported cases of AFM in the United States through November 30, 2018, it appears that the number of persons under investigation (PUIs) for AFM has peaked and will continue to decline for the remainder of 2018.

So far in 2018, 134 cases of AFM have been confirmed in 33 states out of 299 cases reported to CDC. This is an increase of 18 confirmed cases from the previous week, but most of the latest confirmed AFM cases occurred in September and October. 

CDC expects states to continue reporting likely AFM cases, and medical experts will continue to review them and determine if they are confirmed. CDC will continue to provide updates on the number of confirmed cases of AFM.

Although fewer cases are expected in coming months, CDC and partners continue to carefully study AFM to gain new understanding of the condition so that we can better diagnose, treat, and prevent it in the future.


Multistate Infestation with the Exotic Disease–Vector Tick Haemaphysalis longicornis—Free CE Available

August 2017-September 2018: The presence of the Asian longhorned tick (Haemaphysalis longicornus) in the United States represents a new and emerging disease threat. It is an important vector of human and animal disease agents, which can result in human hemorrhagic fever and substantive reduction in dairy production. CDC is working with public health, agricultural, and academic experts to understand the possible threat posed by the spread of the Asian longhorned tick (Haemaphysalis longicornus) in several U.S. states since its discovery in 2017, according to a new MMWR article. To better understand the full potential impact of this tick discovery in the United States, CDC is working with a network of federal, state, and local experts representing veterinary and agricultural science and public health to:

  • Determine the geographic distribution of the Asian longhorned tick in the United States.
  • Determine the kinds of pathogens carried by Asian longhorned ticks that could infect people in affected states. Pathogens found in these ticks in other parts of the world include Borrelia, Anaplasma, Ehrlichia, Rickettsia, and Babesia.
  • Determine which new laboratory tests are needed to detect pathogens that could be introduced or spread by these ticks in the United States.
  • Establish a clean colony (ticks with no pathogens) for studies.
  • Determine how frequently the Asian longhorned tick bites people and animals in the United States.
  • Determine effective prevention and control strategies. 

This network of collaborators will work to limit the spread of tickborne diseases before they affect people and animals. A concerted, sustained national effort is needed to address the threat posed by the Asian longhorned tick, as well as the threat posed by the ongoing increase in vector-borne diseases in the United States.


National Influenza Vaccination Week

December 2-8, 2018, is National Influenza Vaccination Week!

CDC supports organizations across the country in their vaccination efforts during National Influenza Vaccination Week. You can help in promoting the ongoing flu vaccine efforts by placing graphics found here on your web page.

For more resources and information on events for this week, click here.

COCA Partner News

Caring for Children in a Disaster

A public health emergency—such as a natural disaster, disease outbreak, or terrorist attack—can happen anywhere and at any time. Because children are more vulnerable than adults during disasters, CDC’s Children’s Preparedness Unit and its partners work to protect children before, during, and after an emergency.

Significant and effective collaboration between the pediatric health community, including the American Academy of Pediatrics (AAP), and federal partners, including CDC, Federal Emergency Management Agency, National Institutes of Health, Food and Drug Administration, and other federal agencies over the past 5 years has resulted in substantial gains in addressing the needs of children related to disaster preparedness in general. Read the full article here.

AAP has many resources for healthcare professionals, available here.

Seasonal Influenza


Weekly U.S. Influenza Surveillance Report

Influenza activity in the United States increased slightly. The increase in the percentage of patient visits for Influenza-Like Illness (ILI) may be influenced in part by a reduction in routine healthcare visits during the Thanksgiving holidays, as has occurred in previous seasons. Influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B viruses continue to co-circulate, with influenza A(H1N1)pdm09 viruses reported most commonly by public health laboratories since September 30, 2018. Below is a summary of the key influenza indicators for the week ending November 24, 2018:

  • Viral Surveillance: Influenza A viruses have predominated in the United States since the beginning of July. The percentage of respiratory specimens testing positive for influenza in clinical laboratories was low.
    • Virus Characterization: The majority of influenza viruses characterized antigenically and genetically are similar to the cell-grown reference viruses representing the 2018–2019 Northern Hemisphere influenza vaccine viruses.
    • Antiviral Resistance: All viruses tested since late May show susceptibility to the antiviral drugs oseltamivir, zanamivir, and peramivir.
  • Influenza-like Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) increased to 2.3%, which is above the national baseline of 2.2%. Five of 10 regions reported ILI at or above their region-specific baseline level.
    • ILI State Activity Indictor Map: Two states experienced high ILI activity; three states experienced moderate ILI activity; New York City, the District of Columbia, Puerto Rico and eight states experienced low ILI activity; and 37 states experienced minimal ILI activity.
  • Geographic Spread of Influenza: The geographic spread of influenza in five states was reported as regional; 16 states reported local activity; the District of Columbia, Puerto Rico, the U.S. Virgin Islands and 28 states reported sporadic activity; and Guam and one state reported no influenza activity.
  • Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
  • Influenza-associated Pediatric Deaths: Two influenza-associated pediatric deaths were reported to CDC for week 47.

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.    

Emergency Preparedness and Response


Winter Weather Public Service Announcements (PSAs) and Podcasts

Clinicians, remind your patients about the importance of being prepared and how they can take steps to protect themselves and their families during extreme cold. CDC has Winter Weather Public Service Announcements (PSAs) and Podcasts that you can access here.

Natural Disasters and Severe Weather

See below for information on a variety of health and safety concerns for all disasters, including:  

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. This section includes 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.

Travelers' Health


Your patients travel the globe. Increasingly, they are going to places where they may be exposed to diseases that are rare in the United States. When you think travel and ask about it, you can help your patients before, during, and after international travel. CDC’s "Think Travel" Campaign offers resources and tools to help you do this.

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.