COCA Email Updates: February 29 – March 14, 2016

If you have any questions on these or other clinical issues, please write to us at

Sign up for Email Updates and Reminders

Available for download: March 14. 2016, COCA Email UpdateCdc-pdf

COCA News and Announcements

Upcoming COCA Calls:
NEW: Synthetic Cannabinoids: Information and Guidance for Clinicians
Date: Thursday, March 31, 2016
Time: 1:00-2:00 pm (Eastern Time)
Dial In Number: 800-857-9697 (U.S. Callers); 312-470-7286 (International Callers)
Passcode: 8433871
During this COCA Call, clinicians will learn about synthetic cannabinoids, their clinical effects, and the role clinicians can play in the public health response.

Recent COCA Calls:
Update on Interim Zika Virus Clinical Guidance and Recommendations
Date: Thursday, February 25, 2016
During this COCA Call, participants learned about the epidemiology and clinical manifestation of Zika virus disease and how early recognition and reporting of suspected cases can mitigate the risk of local transmission.

High Burden, Great Opportunity: Preventing Heart Attacks and Strokes
Date: Tuesday, February 23, 2016
During this COCA Call, clinicians learned about the components of Million Hearts® and the strategies to help find and address the needs of those at greatest risk for cardiovascular disease.

2015-2016 Influenza Activity and Clinical Recommendations
Date: Tuesday, February 16, 2016
During this COCA Call, clinicians learned about 2015-2016 influenza activity, heard an overview of CDC’s current recommendations for vaccination and antiviral medications, and gained insight into data supporting the recommendations.

Zika Virus — What Clinicians Need to Know
Date: Tuesday, January 26, 2016
Presenters reviewed with participants the epidemiology and clinical manifestation of Zika virus disease and how early recognition and reporting of suspected cases can mitigate the risk of local transmission.

Archived COCA Conference Calls

Free continuing education credits (CME, CNE, ACPE, CEU, CECH, and AAVSB/RACE) are available for most calls. More information about free CE.

CDC Emergency Response

2016 Zika Virus

Morbidity and Mortality Weekly Report (MMWR)

NEW: Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy — Brazil, 2015
The birth prevalence of microcephaly in Brazil increased sharply during 2015–2016. The suggested link between maternal exposure to Zika virus infection during the first trimester of pregnancy and the increased birth prevalence of microcephaly provide additional evidence for congenital infection with Zika virus. Ongoing surveillance is needed to identify additional cases and to fully elucidate the clinical spectrum of illness. Pregnant women should protect themselves from mosquito bites by wearing protective clothing, applying insect repellents, and when indoors, ensuring that rooms are protected with screens or mosquito nets.

Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of Ongoing Transmission — Continental United States, 2016
This report provides information on six confirmed and probable cases of sexual transmission of Zika virus from male travelers to female nontravelers.

Zika Virus Infection Among U.S. Pregnant Travelers — August 2015–February 2016
This report provides preliminary information on testing for Zika virus infection of U.S. pregnant women who have traveled to areas with Zika virus transmission.

Interim Guidelines for Health Care Providers Caring for Infants and Children with Possible Zika Virus Infection — United States, February 2016
CDC has updated its interim guidelines for U.S. health care providers caring for infants born to mothers who traveled to or resided in areas with Zika virus transmission during pregnancy and expanded guidelines to include infants and children with possible acute Zika virus disease.

Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016
Updated guidelines include a new recommendation to offer serologic testing to asymptomatic pregnant women (women who do not report clinical illness consistent with Zika virus disease) who have traveled to areas with ongoing Zika virus transmission. This update also expands guidance to women who reside in areas with ongoing Zika virus transmission. Local health officials should determine when to implement testing of asymptomatic pregnant women on the basis of information about levels of Zika virus transmission and laboratory capacity.

Health Alert Network (HAN)

Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016
CDC is issuing this HAN Advisory as a strong reminder to state, local, and US territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners.

Zika Travel Information

NEW: CDC Issues Advice for Travel to the 2016 Summer Olympic Games

NEW: CDC Adds 1 Destination to Interim Travel Guidance Related to Zika Virus

Zika Travel Notices

Questions and Answers

Zika and Sexual Transmission

For Healthcare Providers Caring for Infants and Children with Possible Zika Virus Infection

For Healthcare Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure

Additional Resources

NEW: Clinical Consultation Service for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Infection
CDC maintains a 24/7 consultation service for health care providers caring for pregnant women with possible Zika virus infection. This consultation service is NOT for patients or the general public. To contact the service, call 770-488-7100 or email

NEW: Top 10 Zika Response Planning Tips: Brief Information for State, Tribal, Local, and Territorial Health Officials

NEW: Zika Virus Risk-Based Preparedness and Response Guidance for States

NEW: Zika Action Plan Summit

NEW: CDC Director travels to Puerto Rico to assess Zika response

Collection and Submission of Body Fluids for Zika Virus Testing

Zika Virus Microsite
CDC has developed an easily embeddable collection of Zika Virus information for partner and stakeholder websites. This collection, called a microsite, can supplement partner web sites with CDC’s up-to-date, evidence-based content.

Clinical Evaluation
The primary way Zika virus is spread to people is through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis. Transmission of the virus from mother to newborn can occur if the mother is infected with the Zika virus near the time of delivery.

Diagnostic Testing
Zika virus disease can often be diagnosed by performing reverse transcriptase-polymerase chain reaction (RT-PCR) on serum. Testing is performed at the CDC Arbovirus Diagnostic Laboratory. Contact your state health department to facilitate testing.

CDC’s Zika Virus Digital Press Kit

Emerging Infections Diseases Letter: Detection of Zika Virus in Semen
“We report additional evidence for this potential route of transmission after identification of an imported case of ZIKV infection into the United Kingdom.”

2014 Ebola in the United States and West Africa

updated: Case Counts

CDC News and Announcements

CDC Science Clips: Volume 8, Issue: 10

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.

Public Health Preparedness

Emergency Preparedness and Response – (CDC)

Find preparedness resources for all hazards.

Emergency Preparedness and Response Training Resources for Clinicians – (CDC)

Find online and in-person training resources.

Natural Disasters and Severe Weather

Be Prepared to Stay Safe and Healthy in Winter – (CDC)

Food and Water Needs: Preparing for a Disaster or Emergency – (CDC)

Health and Safety Concerns for All Disasters – (CDC)

Morbidity and Mortality Weekly Report (MMWR)

The MMWR series is CDC’s primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. To subscribe electronically, go to. Electronically Subscribe.

March 11, 2016 / Vol. 65/Nos. 9 Download .pdf document of this issueCdc-pdf

Infectious, Vector-Borne and Zoonotic Diseases

Seasonal Influenza

What You Should Know for the 2015-2016 Influenza Season  – (CDC)

Information for Health Professionals  – (CDC)

Weekly Flu View – February 12 (CDC)

Flu View is a weekly influenza surveillance report prepared by CDC Influenza Division. All data are preliminary and may change as CDC receives more reports.

Planning and Preparedness: Health Professionals and Seasonal FluExternal  – (HHA)

Travel Safety

Current Travel WarningsExternal – February 23 (US Department of State)

The U.S. Department of State issues Travel Warnings when long-term, protracted conditions make a country dangerous or unstable. Travel Warnings recommend that Americans avoid or carefully consider the risk of travel to that country. The State Department also issues Travel Warnings when the U.S. Government’s ability to assist American citizens is constrained due to the closure of an embassy or consulate, or because of a drawdown of State Department staff.

Food, Drug and Device Safety

NEW: Amikacin Sulfate Injection USP, 1 gram/4mL (250 mg/mL) Vials by Teva: Recall – Glass Particulate MatterExternal
Teva Pharmaceuticals announced a voluntary recall of one lot of amikacin sulfate injection USP, 1 gram/4mL (250 mg/mL) vials due to the potential presence of particulate matter identified as glass in one vial. The recalled lot # is 4750915, Expiration Date 9/2017.

NEW: Human and Animal Sterile Drug Products by I.V. Specialty: FDA Alert – Lack of Sterility AssuranceExternal
On March 7, 2016, FDA recommended that I.V. Specialty cease sterile production until appropriate corrective actions are implemented, and recall all non-expired drug products intended to be sterile. The company has neither ceased sterile production nor initiated a recall. Therefore, FDA is alerting health care professionals and patients to dispose of and not use drug products intended to be sterile that were produced and distributed by I.V. Specialty.

NEW: Fluconazole Injection, USP, (in 0.9 Percent Sodium Chloride) 200mg per 100ml: Recall – Elevated ImpurityExternal
Sagent has initiated a voluntary recall of one lot of Fluconazole Injection, USP, 200mg per 100mL to the user level due to the discovery of an out of specification impurity result detected during routine quality testing of stability samples at the 18-month interval. This impurity has been identified as Metronidazole. An elevated impurity has the potential to decrease effectiveness of the product in patients.

MedWatch: The FDA Safety Information and Adverse Event Reporting ProgramExternal – (FDA)

MedWatch is your Food and Drug Administration (FDA) gateway for clinically important safety information and reporting serious problems with human medical products. Reports FDA and USDA Food Recalls, Alerts, Reporting & ResourcesExternal – (HHS/USDA/FDA/CDC/NIH) lists notices of recalls and alerts from both FDA and USDA. Visitors to the site can report a problem or make inquiries.

The CDC and HHS logos are the exclusive property of the Department of Health and Human Services and may not be used for any purpose without prior express written permission. Use of trade names and commercial sources is for identification only and does not imply endorsement by the US Department of Health and Human Services.

Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organizations.

Page last reviewed: March 14, 2016 (archived document)