COCA Email Updates: April 11 – 25, 2016

If you have any questions on these or other clinical issues, please write to us at coca@cdc.gov

Sign up for Email Updates and Reminders

Available for download: April 25. 2016, COCA Email UpdateCdc-pdf


COCA News and Announcements

Recent COCA Calls:
Updated Interim Zika Clinical Guidance for Reproductive Age Women and Men, Sexual Transmission of Zika, and the U.S. Zika Pregnancy Registry
Date: Tuesday, April 12, 2016

During this COCA Call, Clinicians learned about:

  • Updated CDC interim guidance for on caring for reproductive age women and men with possible Zika exposure
  • CDC interim guidance for prevention of sexual transmission of Zika
  • Preventing transmission of Zika virus in labor and delivery settings
  • Interpreting pediatric testing guidance
  • US Zika Pregnancy Registry

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

Clinicians Caring for Pregnant Women and Women of Reproductive Age 

NEW: MMWR: Patterns in Zika Virus Testing and Infection, by Report of Symptoms and Pregnancy Status — United States, January 3–March 5, 2016
A low proportion of persons who had testing for Zika virus in the United States had confirmed Zika virus infection. Approximately 99% of asymptomatic pregnant women who were tested had no laboratory evidence of Zika virus infection. Given the potential for adverse pregnancy and infant outcomes associated with Zika virus, healthcare providers can continue to offer Zika virus testing to asymptomatic pregnant women with potential exposure. However, these data suggest that in the current U.S. setting, the likelihood of Zika virus infection among asymptomatic persons is low.

CDC Concludes Zika Causes Microcephaly and Other Birth Defects
Scientists at the Centers for Disease Control and Prevention (CDC) have concluded, after careful review of existing evidence, that Zika virus is a cause of microcephaly and other severe fetal brain defects. In the report published in the New England Journal of Medicine, the CDC authors describe a rigorous weighing of evidence using established scientific criteria. Media Statement:

New England Journal of Medicine Report: “Zika Virus Associated with Microcephaly”External

Tools for Health-Care Providers
View printable and easy to use CDC fact sheets, guidance documents, and testing algorithms for Zika virus infection.

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, email ZikaPregnancy@cdc.gov or call 770-488-7100.

Doctor’s Visit Checklist: For Pregnant Women Who Traveled to an Area with ZikaCdc-pdf

Doctor’s Visit Checklist: For Pregnant Women Living in an Area with ZikaCdc-pdf

US Zika Pregnancy Registry
To understand more about Zika virus infection during pregnancy and congenital Zika virus infection, CDC established the US Zika Pregnancy Registry and is collaborating with state, tribal, local, and territorial health departments. The data collected through this registry will be used to update recommendations for clinical care, to plan for services for pregnant women and families affected by Zika virus, and to improve prevention of Zika virus infection during pregnancy.

MMWR: Interim Guidance for Health-Care Providers Caring for Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016
CDC has updated its interim guidance for U.S. health-care providers caring for women of reproductive age with possible Zika virus exposure to include recommendations for counseling women and men with possible Zika virus exposure who are interested in conceiving. The updated guidelines also include recommendations for Zika virus testing and guidance for women residing along the US-Mexico Border.

Tools for Health-Care Providers
View printable and easy to use CDC testing algorithms for Zika virus infection.

MMWR: Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak — Puerto Rico, 2016

MMWR: Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016
CDC recommends Standard Precautions in all health-care settings to protect both health-care personnel and patients from infection with Zika virus as well as from blood-borne pathogens (e.g., human immunodeficiency virus [HIV] and hepatitis C virus [HCV]).

Questions and Answers For Health-Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure

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.

Clinicians Caring for Infants and Children

Congenital Microcephaly Case Definitions

Questions and Answers For Health-Care Providers Caring for Infants and Children with Possible Zika Virus Infection

MMWR: 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

Interim Guidelines for Health-Care Providers Caring for Infants and Children with Possible Zika Virus Infection — United
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.

Sexual Transmission

new: MMWR: Male-to-Male Sexual Transmission of Zika Virus — Texas, January 2016
Sexual transmission through both vaginal and anal sex is an emerging mode of Zika virus infection that might contribute to more illness than was anticipated when the outbreak was first recognized. Cases of sexually transmitted Zika virus infection should be reported to public health agencies and can help inform recommendations to prevent Zika virus infections.

MMWR: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, 2016
The following recommendations apply to men who have traveled to or reside in areas with active Zika virus transmission and their female or male sex partners. These recommendations replace the previously issued recommendations and are updated to include time intervals after travel to areas with active Zika virus transmission or after Zika virus infection for taking precautions to reduce the risk for sexual transmission.

Zika and Sexual Transmission

MMWR: Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of Ongoing Transmission — Continental United States, 2016

Zika Travel Information

MMWR: Travel-Associated Zika Virus Disease Cases Among U.S. Residents — United States, January 2015–February 2016
During January 1, 2015–February 26, 2016, a total of 116 residents of U.S. states and the District of Columbia had laboratory evidence of recent Zika virus infection based on testing performed at CDC, including one congenital infection and 115 persons who reported recent travel to areas with active Zika virus transmission (n = 110) or sexual contact with such a traveler (n = 5).

MMWR: Revision to CDC’s Zika Travel Notices: Minimal Likelihood for Mosquito-Borne Zika Virus Transmission at Elevations Above 2,000 Meters

Zika Virus Infection Among U.S. Pregnant Travelers — August 2015–February 2016

CDC Issues Advice for Travel to the 2016 Summer Olympic Games

Zika Travel Notices

Conferences and Meetings

Zika Action Plan Summit
CDC is hosting a one-day Zika Action Plan Summit as the nation faces likely local mosquito-borne transmission of Zika virus in some places in the continental United States. Register to watch the Summit live.

Clinical Evaluation and Testing

Biosafety Guidance for Transportation of Specimens and for Work with Zika Virus in the Laboratory

CDC Laboratory Test for Zika Virus Authorized for Emergency Use by FDA
In response to a request from the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration issued an Emergency Use Authorization for the Trioplex Real-time RT-PCR Assay, a diagnostic tool for Zika virus that will be distributed to qualified laboratories.

Clinical Evaluation & Disease
Zika virus is transmitted to humans primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis. Most people infected with Zika virus are asymptomatic. Characteristic clinical findings are acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis. Other commonly reported symptoms include myalgia and headache.

Diagnostic Testing
Contact your state or local health department to facilitate testing.

Collection and Submission of Body Fluids for Zika Virus Testing

State and Local Health Department Resources

new: Survey of Blood Collection Centers and Implementation of Guidance for Prevention of Transfusion-Transmitted Zika Virus Infection — Puerto Rico, 2016
Importation of blood products from nonaffected areas might serve a role in prevention of transfusion-transmitted Zika virus. An approved laboratory test for blood donor screening and implementation of PRT are critical for compliance with FDA guidance and to ensure a safe and sustainable blood supply. Blood collection organizations and public health organizations need to collaborate to prepare for blood safety and adequacy challenges that might arise if Zika virus transmission spreads in the United States.

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

Zika Virus Risk-Based Preparedness and Response Guidance for States

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. . The content is automatically updated when CDC’s website is updated.

CDC News and Announcements

CDC Science Clips: Volume 8, Issue: 16

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.

April 22, 2016 / Vol. 65/Nos. 15 Download .pdf document of this issueCdc-pdf

Infectious, Vector-Borne and Zoonotic Diseases

2014 Ebola in the United States and West Africa

updated: Case Counts

Seasonal Influenza

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

Information for Health Professionals  – (CDC)

Weekly Flu View – March 26 (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  – (HHS)

Travel Safety

Current Travel WarningsExternal – April 21 (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: Sterile Drug Products from Pharmakon Pharmaceuticals: Recall – Lack of Sterility AssuranceExternal
Healthcare professionals should immediately check their medical supplies, quarantine any drug products marketed as sterile from Pharmakon, and not administer them to patients. Administration of a non-sterile drug product intended to be sterile may result in serious and potentially life-threatening infections or death.

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.

FoodSafety.gov Reports FDA and USDA Food Recalls, Alerts, Reporting & ResourcesExternal – (HHS/USDA/FDA/CDC/NIH)

Foodsafety.gov 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: January 21, 2016 (archived document)