Upcoming COCA Call


Update: Interim Guidance for Health Care Providers regarding the Management Approach of Patients with Suspected E-cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI)


Date: Thursday, November 21, 2019
Time: 2:00pm-3:00pm (Eastern Time)


CDC, the U.S. Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders continue to investigate a national outbreak of electronic cigarette (e-cigarette), or vaping, product use–associated lung injury (EVALI).

EVALI remains a diagnosis of exclusion because, at present, no specific test or marker exists for its diagnosis, and evaluation should be guided by clinical judgment. Because patients with EVALI can present with symptoms similar to influenza or other respiratory infections (e.g., fever, cough, headache, myalgias, or fatigue), it might be difficult to differentiate EVALI from influenza or CAP (community-acquired pneumonia) on initial presentation, and EVALI may cooccur with respiratory infections. A large number of patients will be presenting to healthcare facilities with respiratory symptoms during the winter season who may not meet criteria for hospital admission, and this will be happening in the context of a national outbreak of EVALI.

During this COCA Call, US health care providers will learn recommendations for managing patients with suspected or known EVALI when respiratory infections such as influenza are more prevalent in the community, as published in MMWR on November 19, 2019.


If you are unable to attend this live COCA Call, it will be available on-demand a few days after the call.


Updated Guidance for Using Intravenous Artesunate to Treat Severe Malaria in the United States

Date: Tuesday, December 10, 2019
Time: 2:00pm-3:00pm (Eastern Time)


In the United States, about 2,000 cases of malaria are imported each year, 300 of which are severe. There is no FDA-approved drug available to treat severe malaria. Intravenous (IV) artesunate, which is neither FDA-approved nor commercially available, is currently the first-line drug to treat severe malaria in the United States. Since April 1, 2019, all U.S. clinicians must call CDC to obtain IV artesunate to treat cases of severe malaria.

During this COCA Call, clinicians will learn about CDC’s updated guidance for using IV artesunate—a life-saving drug—to treat patients with severe malaria in the United States, and will receive an update on CDC’s artesunate program. 


If you are unable to attend this live COCA Call, it will be available on-demand a few days after the call. Free Continuing Education (CE) will be available. 

Recent COCA Call


Preventing the Spread of Novel or Targeted Multidrug-resistant Organisms (MDROs) in Nursing Homes through Enhanced Barrier Precautions


October 24, 2019

Enhanced Barrier Precautions are a new approach recently introduced by CDC that are recommended for preventing the transmission of novel or targeted MDROs in US nursing homes involved in a public health containment response. During this COCA Call, clinicians learned about Enhanced Barrier Precautions, with a detailed discussion of the residents and high-contact resident care activities for which they apply.

Free CE is available for this COCA Call. 

On-Demand 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, you may view it on-demand. Free CE is available for most COCA Calls.

Training and Conference Opportunities


COCA Partner Trainings
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Find information about upcoming trainings and conferences organized or sponsored by federal agencies or COCA partner organizations, including non-federal organizations. The webpage includes updated information about conferences from November–December 2019.


Public Health Grand Rounds


Public Health Grand Rounds is a monthly webcast created to foster discussion about major public health issues. The Grand Rounds sessions highlight how CDC and its partners are already addressing these challenges and discuss recommendations for future research and practice. 


The November session of Grand Rounds, “Polyfluoroalkyl substances (PFAS) and Protecting Your Health” addressed current research needs and the many unknowns about per- and PFAS. Presenters discussed Michigan’s public health response efforts, a new CDC supported multi-site health study, and a community perspective on PFAS contamination.


Free CE is available for this session. 


Visit Grand Rounds On-Demand to browse upcoming and previous presentations.


CDC Learning Connection

Boost your immunization knowledge and communication skills with CDC Learning Connection's featured trainings! 

Sign up on the Learning Connection home page for a free monthly e-newsletter to stay up to date on public health trainings from CDC, other federal agencies, and federally funded partners.



Looking for training about other public health topics? CDC TRAIN, CDC's online learning system, provides access to more than 1,000 courses that CDC programs, grantees, and other funded partners have developed. CDC has approved and verified courses offered by CDC providers. 

Emergency Preparedness and Response Training Resources


Learn about emergency preparedness and response training resources that CDC, other federal agencies, and COCA partners offer, including scheduled and on-demand courses. Be sure to view these valuable resources.

COCA partners, do you have a training course that is related to emergency preparedness and response? If so, send an email to coca@cdc.gov and we will include your course.

COCA Partner Spotlight 


COCA is pleased to feature The Centers for Medicare & Medicaid Services (CMS) as our November COCA Partner Spotlight!

CMS is a federal agency within the U.S. Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov.


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

Clinician's Corner 


Welcome to the Clinician’s Corner! This month COCA is excited to feature Fatimah S. Dawood, MD who has presented during several COCA Calls. 

For nearly a decade, Dr. Dawood has been a medical epidemiologist in the Influenza Division in CDC's National Center for Immunization and Respiratory Diseases.

Dr. Dawood received her undergraduate degree from Harvard College and obtained her medical degree and pediatric residency training at Johns Hopkins University. She subsequently completed a fellowship with the Epidemic Intelligence Service at CDC. During her tenure at CDC as a medical officer with the United States Public Health Service, Dr. Dawood has worked on analyses and studies in the United States, Thailand, India, and Central America that focused on describing the burden of influenza, identifying risk factors for severe outcomes with influenza virus infection, evaluating influenza vaccine efficacy, and effectiveness, and evaluating the efficacy of influenza antiviral medications.

Dr. Dawood is currently CDC principle investigator for the Pregnancy and Influenza Multinational Epidemiologic (PRIME) study, a large multinational prospective cohort study designed to evaluate the effect of influenza during pregnancy on pregnancy and perinatal outcomes, and a randomized controlled trial comparing the immunogenicity of egg-based and non-egg-based influenza vaccines among healthcare personnel in the US. 

Listen to Dr. Dawood present during a past COCA Call: 2019–2020 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Providers. Free CE is available.



Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products (11/19/2019)


CDC has identified vitamin E acetate as a chemical of concern among people with e-cigarette, or vaping, product use associated lung injury (EVALI). Recent CDC laboratory testing of bronchoalveolar lavage (BAL) fluid samples (fluid samples collected from the lungs) from 29 patients with EVALI submitted to CDC from 10 states found vitamin E acetate in all of the samples. Vitamin E acetate might be used as an additive, most notably as a thickening agent in THC-containing e-cigarette, or vaping, products.

CDC recommends that people should not use THC-containing e-cigarette, or vaping, products, particularly from informal sources like friends, or family, or in-person or online dealers. While this investigation is ongoing, vitamin E acetate should not be added to e-cigarette, or vaping, products.

In addition, people should not add any substance to e-cigarette or vaping products that are not intended by the manufacturer, including products purchased through retail establishments. CDC will continue to update guidance, as appropriate, as new data become available from this outbreak investigation.


We will continue to provide updates as more data become available.


Learn more about the outbreak on the Lung Injury webpage


The Emergency Risk Communication Branch in the Division of Emergency Operations, Center for Preparedness and Response is responsible for the management of all COCA products.

For information about this update or other clinical issues, or to send your feedback, please contact us at coca@cdc.gov

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