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Fwd: COCA Update: New Interim Guidelines for Caring for Women with Possible Zika Virus Exposure

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    Professor Ramon Shaban, ACIPC President
    Participant

    Author:
    Professor Ramon Shaban, ACIPC President

    Email:
    president@ACIPC.ORG.AU

    Organisation:

    State:

    Colleagues

    For your reference.

    Kind regards,
    Ramon

    [image: ACIPC_Logo_Colour_RGB_Hi_Res.jpg]

    *Professor Ramon Z ShabanPRESIDENT*

    Australasian College for Infection Prevention and Control

    GPO Box 3254, Brisbane Qld 4001

    ———- Forwarded message ———-
    cdc@service.govdelivery.com>
    Possible Zika Virus Exposure

    [image: Clinician Outreach and Communication Activity (COCA) Update]

    *February 16, 2016*

    Did a colleague forward this to you?
    Subscribe here

    for future COCA Updates.

    This issue contains guidance documents relevant to current public health
    events and information from *February 1-16.*

    The next COCA Update is scheduled for *February 29.*

    For questions about these or other clinical issues, please write to us at
    coca@cdc.gov.

    *Additional Resources*CDC Emergency on Twitter

    CDC Clinician Outreach and Communication Activity on Facebook

    COCA Home Page

    *Topics and Highlights*

    – COCA News and Announcements
    – CDC Emergency Response
    – CDC News and Announcements
    – Public Health Preparedness
    – Natural Disasters and Severe Weather
    – Morbidity and Mortality Weekly Report (MMWR)

    – Infectious, Vector-Borne, and Zoonotic Diseases

    – Travel Safety
    – Food, Drug, and Device Safety

    COCA News and AnnouncementsUpcoming COCA Calls

    *High Burden, Great Opportunity: Preventing Heart Attacks and Strokes*
    *Date:* Tuesday, February 23, 2016
    *Time: *2:00-3:00 pm (Eastern Time)
    *Dial In Number: *800-857-9697 (U.S. Callers); 212-287-1833 (International
    Callers)
    *Passcode: *4396514
    *Webinar: *https://www.mymeetings.com/nc/join.php?iPW6927490&p4396514&tc

    During this COCA Call, clinicians will learn about the components of
    Million Hearts and the strategies to help find and address the needs of
    those at greatest risk for cardiovascular disease.
    http://emergency.cdc.gov/coca/calls/2016/callinfo_022316.asp

    Recent COCA Calls

    *NEW: 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 CDCs current recommendations for
    vaccination and antiviral medications, and gained insight into data
    supporting the recommendations.
    http://emergency.cdc.gov/coca/calls/2016/callinfo_021616.asp

    *Zika VirusWhat Clinicians Need to Know*
    *Date:* Tuesday, January 26, 2016
    http://emergency.cdc.gov/coca/calls/2016/callinfo_012616.asp

    Archived COCA conference calls are available at
    emergency.cdc.gov/coca/calls/index.asp
    .

    Free continuing education credits (CME, CNE, ACPE, CEU, CECH, and AAVSB*/*RACE)
    are available for most calls. For more information about free CE, visit
    emergency.cdc.gov/coca/continuingeducation.asp

    CDC Emergency Response2016 Zika Virus

    *NEW: MMWR: 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.
    http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2er.htm?s_cidmm6505e2er.htm_w

    *UPDATED: Questions and Answers for Healthcare Providers Caring for
    Pregnant Women and Women of Reproductive Age with Possible Zika Virus
    Exposure*
    http://www.cdc.gov/zika/hc-providers/qa-pregnant-women.html

    *NEW: MMWR: Interim Guidelines for Prevention of Sexual Transmission of
    Zika Virus United States, 2016*
    Sexual transmission of Zika virus is possible, and is of particular concern
    during pregnancy.
    http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1er.htm?s_cidmm6505e1er_w.htm

    *NEW: MMWR: Local Transmission of Zika Virus Puerto Rico, November 23,
    2015January 28, 2016*During November 23, 2015January 28, 2016, a total of
    155 suspected Zika virus disease cases were identified in Puerto Rico,
    including 82 reported through passive surveillance, and 73 specimens tested
    through the enhanced surveillance protocol.
    http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e2er.htm?s_cidmm6506e2er_e

    *NEW: **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 CDCs up-to-date, evidence-based
    content.
    https://tools.cdc.gov/medialibrary/index.aspx#/microsite/id/234558

    *UPDATED: Zika Travel Information*
    http://wwwnc.cdc.gov/travel/page/zika-travel-information

    *UPDATED: Clinical Evaluation *The primary way Zika virus is spread to
    people 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.
    http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html

    *UPDATED: 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.
    http://www.cdc.gov/zika/hc-providers/diagnostic.html

    *NEW: 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.
    http://wwwnc.cdc.gov/eid/article/22/5/16-0107_article

    *NEW: CDCs Zika Virus Digital Press Kit*
    http://www.cdc.gov/media/dpk/2016/dpk-zika-virus.html

    *NEW: Transcript for CDC Telebriefing: Zika*
    http://www.cdc.gov/media/releases/2016/t0205-zika.html

    *NEW: CDC Emergency Operations Center Moves to Highest Level of Activation
    for Zika Response*
    http://www.cdc.gov/media/releases/2016/s0208-zika-eoca-activation.html

    2014 Ebola in the United States and West Africa

    *UPDATED: Case Counts*
    http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html

    CDC News and Announcements

    *NEW: ATSDR and CDC Analysis Finds Possible Health Effects Associated with
    Formaldehyde in Select Laminate Flooring*Formaldehyde levels observed in
    select laminate wood flooring products could cause short-term irritation
    for people in general and in some cases exacerbate asthma.
    http://www.cdc.gov/media/releases/2016/s0210-atsdr-laminate-flooring.html

    *NEW: New Lyme-Disease-Causing Bacteria Species Discovered*The Centers for
    Disease Control and Prevention, in collaboration with Mayo Clinic and
    health officials from Minnesota, Wisconsin, and North Dakota, report the
    discovery of a new species of bacteria (Borrelia mayonii) that causes Lyme
    disease in people.
    http://www.cdc.gov/media/releases/2016/p0208-lyme-disease.html

    *CDC Science Clips: Volume 8, Issue: 6*
    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.
    http://www.cdc.gov/library/sciclips/issues/

    Public Health Preparedness

    *Emergency Preparedness and Response for Health Professionals * (CDC)
    Find preparedness resources for health professionals at
    http://emergency.cdc.gov/health-professionals.asp

    *Emergency Preparedness and Response Training Resources for Clinicians *
    (CDC)
    Find online and in-person training resources at
    emergency.cdc.gov/coca/trainingresources.asp

    Natural Disasters and Severe Weather

    *Food and Water Needs: Preparing for a Disaster or Emergency* (CDC)
    emergency.cdc.gov/disasters/foodwater/prepare.asp

    *Health and Safety Concerns for All Disasters* (CDC)
    emergency.cdc.gov/disasters/alldisasters.asp

    Morbidity and Mortality Weekly Report (MMWR)

    MMWR publications are prepared by CDC. To electronically subscribe, go to
    http://www.cdc.gov/mmwr/mmwrsubscribe.html

    *February 12, 2016 / Vol. 65 / No. 5 *Download .pdf document of this issue

    – Influenza-Related Hospitalizations and Poverty Levels United States,
    20102012

    – Progress Toward Strengthening National Blood Transfusion Services 14
    Countries, 20112014

    – Notes from the Field: Circulating Vaccine-Derived Poliovirus Outbreaks
    Five Countries, 20142015

    *MMWR Supplements**February 12, 2016 / Vol. 65 / No. 1 *Download .pdf
    document of this issue

    – Strategies for Reducing Health Disparities Selected CDC-Sponsored
    Interventions, United States, 2016

    Infectious, Vector-Borne, and Zoonotic Diseases*Seasonal Influenza*

    *What You Should Know for the 2015-2016 Influenza Season * (CDC)
    http://www.cdc.gov/flu/about/season/flu-season-2015-2016.htm

    *Information for Health Professionals* (CDC)
    http://www.cdc.gov/flu/professionals/index.htm

    *Weekly Flu View* February 12 (CDC)
    Flu View is a weekly influenza surveillance report prepared by CDCs
    Influenza Division. All data are preliminary and may change as CDC receives
    more reports.
    http://www.cdc.gov/flu/weekly/

    *Planning and Preparedness: Health Professionals and Seasonal Flu* (HHS)
    Healthcare providers play an important role during flu season. The
    following guidance and information will assist healthcare providers and
    service organizations to plan and respond to seasonal flu.
    http://www.flu.gov/planning-preparedness/hospital/index.html

    Travel Safety

    *Current Travel Warnings * February 11 (U.S. 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.
    travel.state.gov/content/passports/english/alertswarnings.html

    Food, Drug, and Device Safety

    *NEW: Central Venous Catheters and Pressure Monitoring Sets and Trays by
    Cook Medical: Recall – Catheter Tip Fracture and/or Separation* (FDA)
    Potential adverse events that may occur as a result of catheter tip
    fracture and/or separation include loss of device function, the need for
    medical intervention to retrieve a separated segment, and complications
    resulting from a separated tip occluding blood flow to end organs.
    http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm485910.htm

    *NEW: Oxylog 2000 Plus, 3000, and 3000 Plus Emergency Transport Ventilators
    by Drger Medical: Class I Recall – System Error May Lead to a Halt in
    Ventilation Therapy * (FDA)
    An electrical issue may cause the device to stop working if the control
    knobs (adjustment potentiometers) are not regularly used. If the device
    operator does not intervene, the patient may not receive enough oxygen and
    could suffer serious adverse health consequences, including injury or death.
    http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm485807.htm

    *NEW: Multistate Outbreak of Salmonella Virchow Infections Linked to Garden
    of Life RAW Meal Organic Shake & Meal Products * (CDC)
    As of February 1, 2016, 11 people infected with the outbreak strain of
    *Salmonella* Virchow have been reported from nine states. The epidemiologic
    and laboratory evidence available at this time suggests that RAW Meal
    Organic Shake & Meal products made by Garden of Life, LLC are a likely
    source of this outbreak.
    http://www.cdc.gov/salmonella/virchow-02-16/index.html

    *MedWatch: The FDA Safety Information and Adverse Event Reporting Program *
    (FDA)
    MedWatch is your Food and Drug Administration (FDA) gateway for clinically
    important safety information and reporting serious problems with human
    medical products.
    http://www.fda.gov/Safety/MedWatch/default.htm

    *FoodSafety.gov: Reports of FDA and USDA Food Recalls, Alerts, Reporting,
    and Resources * (HHS/USDA/FDA/CDC/NIH)
    Foodsafety.gov 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.
    http://www.foodsafety.gov/recalls/recent/index.html

    *Return to Top *
    ——————————

    The Emergency Risk Communication Branch in the Division of Emergency
    Operations, Office of Public Health 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*

    CDC Clinician Outreach and Communication Activity Facebook page

    connect with COCA on Facebook

    Clinician Outreach and Communication Activity

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    #72766
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Email:
    infexion@ozemail.com.au

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Thanks for posting Ramon.

    Are there any specific recommendations/guidelines coming from the college in relation to some of these topics?

    Regards

    Glenys

    Glenys Harrington

    Consultant

    Infection Control Consultancy (ICC)

    PO Box 5202

    Middle Park

    Victoria, 3206

    Australia

    M: +61 404 816 434

    infexion@ozemail.com.au

    ABN 47533508426

    Colleagues

    For your reference.

    Kind regards,

    Ramon

    ACIPC_Logo_Colour_RGB_Hi_Res.jpg

    Professor Ramon Z Shaban
    PRESIDENT

    Australasian College for Infection Prevention and Control

    GPO Box 3254, Brisbane Qld 4001

    ———- Forwarded message ———-

    Clinician Outreach and Communication Activity (COCA) Update

    February 16, 2016

    Did a colleague forward this to you?
    Subscribe here for future COCA Updates.

    This issue contains guidance documents relevant to current public health events and information from February 1-16.

    The next COCA Update is scheduled for February 29.

    For questions about these or other clinical issues, please write to us at coca@cdc.gov.

    Additional Resources
    CDC Emergency on Twitter
    CDC Clinician Outreach and Communication Activity on Facebook
    COCA Home Page

    Topics and Highlights

    *COCA News and Announcements
    *CDC Emergency Response
    *CDC News and Announcements
    *Public Health Preparedness
    *Natural Disasters and Severe Weather
    *Morbidity and Mortality Weekly Report (MMWR)
    *Infectious, Vector-Borne, and Zoonotic Diseases
    *Travel Safety
    *Food, Drug, and Device Safety

    COCA News and Announcements

    Upcoming COCA Calls

    High Burden, Great Opportunity: Preventing Heart Attacks and Strokes
    Dial In Number: 800-857-9697 (U.S. Callers); 212-287-1833 (International Callers)
    During this COCA Call, clinicians will learn about the components of Million Hearts and the strategies to help find and address the needs of those at greatest risk for cardiovascular disease.
    http://emergency.cdc.gov/coca/calls/2016/callinfo_022316.asp

    Recent COCA Calls

    During this COCA Call, clinicians learned about 2015-2016 influenza activity, heard an overview of CDCs current recommendations for vaccination and antiviral medications, and gained insight into data supporting the recommendations.
    http://emergency.cdc.gov/coca/calls/2016/callinfo_021616.asp

    Zika VirusWhat Clinicians Need to Know
    http://emergency.cdc.gov/coca/calls/2016/callinfo_012616.asp

    Archived COCA conference calls are available at emergency.cdc.gov/coca/calls/index.asp .
    Free continuing education credits (CME, CNE, ACPE, CEU, CECH, and AAVSB/RACE) are available for most calls. For more information about free CE, visit emergency.cdc.gov/coca/continuingeducation.asp

    CDC Emergency Response

    2016 Zika Virus

    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.
    http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2er.htm?s_cidmm6505e2er.htm_w

    http://www.cdc.gov/zika/hc-providers/qa-pregnant-women.html

    Sexual transmission of Zika virus is possible, and is of particular concern during pregnancy.
    http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1er.htm?s_cidmm6505e1er_w.htm

    During November 23, 2015January 28, 2016, a total of 155 suspected Zika virus disease cases were identified in Puerto Rico, including 82 reported through passive surveillance, and 73 specimens tested through the enhanced surveillance protocol.
    http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e2er.htm?s_cidmm6506e2er_e

    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 CDCs up-to-date, evidence-based content.
    https://tools.cdc.gov/medialibrary/index.aspx#/microsite/id/234558

    http://wwwnc.cdc.gov/travel/page/zika-travel-information

    The primary way Zika virus is spread to people 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.
    http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html

    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.
    http://www.cdc.gov/zika/hc-providers/diagnostic.html

    We report additional evidence for this potential route of transmission after identification of an imported case of ZIKV infection into the United Kingdom.
    http://wwwnc.cdc.gov/eid/article/22/5/16-0107_article

    http://www.cdc.gov/media/dpk/2016/dpk-zika-virus.html

    http://www.cdc.gov/media/releases/2016/t0205-zika.html

    http://www.cdc.gov/media/releases/2016/s0208-zika-eoca-activation.html

    2014 Ebola in the United States and West Africa

    http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html

    CDC News and Announcements

    Formaldehyde levels observed in select laminate wood flooring products could cause short-term irritation for people in general and in some cases exacerbate asthma.
    http://www.cdc.gov/media/releases/2016/s0210-atsdr-laminate-flooring.html

    The Centers for Disease Control and Prevention, in collaboration with Mayo Clinic and health officials from Minnesota, Wisconsin, and North Dakota, report the discovery of a new species of bacteria (Borrelia mayonii) that causes Lyme disease in people.
    http://www.cdc.gov/media/releases/2016/p0208-lyme-disease.html

    CDC Science Clips: Volume 8, Issue: 6
    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.
    http://www.cdc.gov/library/sciclips/issues/

    Public Health Preparedness

    Emergency Preparedness and Response for Health Professionals (CDC)
    Find preparedness resources for health professionals at
    http://emergency.cdc.gov/health-professionals.asp

    Emergency Preparedness and Response Training Resources for Clinicians (CDC)
    Find online and in-person training resources at
    emergency.cdc.gov/coca/trainingresources.asp

    Natural Disasters and Severe Weather

    Food and Water Needs: Preparing for a Disaster or Emergency (CDC)
    emergency.cdc.gov/disasters/foodwater/prepare.asp

    Health and Safety Concerns for All Disasters (CDC)
    emergency.cdc.gov/disasters/alldisasters.asp

    Morbidity and Mortality Weekly Report (MMWR)

    MMWR publications are prepared by CDC. To electronically subscribe, go to http://www.cdc.gov/mmwr/mmwrsubscribe.html

    February 12, 2016 / Vol. 65 / No. 5 Download .pdf document of this issue

    *Influenza-Related Hospitalizations and Poverty Levels United States, 20102012
    *Progress Toward Strengthening National Blood Transfusion Services 14 Countries, 20112014
    *Notes from the Field: Circulating Vaccine-Derived Poliovirus Outbreaks Five Countries, 20142015

    MMWR Supplements
    February 12, 2016 / Vol. 65 / No. 1 Download .pdf document of this issue

    *Strategies for Reducing Health Disparities Selected CDC-Sponsored Interventions, United States, 2016

    Infectious, Vector-Borne, and Zoonotic Diseases

    Seasonal Influenza

    What You Should Know for the 2015-2016 Influenza Season (CDC)
    http://www.cdc.gov/flu/about/season/flu-season-2015-2016.htm

    Information for Health Professionals (CDC)
    http://www.cdc.gov/flu/professionals/index.htm

    Weekly Flu View February 12 (CDC)
    Flu View is a weekly influenza surveillance report prepared by CDCs Influenza Division. All data are preliminary and may change as CDC receives more reports.
    http://www.cdc.gov/flu/weekly/

    Planning and Preparedness: Health Professionals and Seasonal Flu (HHS)
    Healthcare providers play an important role during flu season. The following guidance and information will assist healthcare providers and service organizations to plan and respond to seasonal flu.
    http://www.flu.gov/planning-preparedness/hospital/index.html

    Travel Safety

    Current Travel Warnings February 11 (U.S. 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.
    travel.state.gov/content/passports/english/alertswarnings.html

    Food, Drug, and Device Safety

    Potential adverse events that may occur as a result of catheter tip fracture and/or separation include loss of device function, the need for medical intervention to retrieve a separated segment, and complications resulting from a separated tip occluding blood flow to end organs.
    http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm485910.htm

    An electrical issue may cause the device to stop working if the control knobs (adjustment potentiometers) are not regularly used. If the device operator does not intervene, the patient may not receive enough oxygen and could suffer serious adverse health consequences, including injury or death.
    http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm485807.htm

    As of February 1, 2016, 11 people infected with the outbreak strain of Salmonella Virchow have been reported from nine states. The epidemiologic and laboratory evidence available at this time suggests that RAW Meal Organic Shake & Meal products made by Garden of Life, LLC are a likely source of this outbreak.
    http://www.cdc.gov/salmonella/virchow-02-16/index.html

    MedWatch is your Food and Drug Administration (FDA) gateway for clinically important safety information and reporting serious problems with human medical products.
    http://www.fda.gov/Safety/MedWatch/default.htm

    FoodSafety.gov: Reports of FDA and USDA Food Recalls, Alerts, Reporting, and Resources (HHS/USDA/FDA/CDC/NIH)
    Foodsafety.gov 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.
    http://www.foodsafety.gov/recalls/recent/index.html

    Return to Top

    _____

    The Emergency Risk Communication Branch in the Division of Emergency Operations, Office of Public Health 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

    CDC Clinician Outreach and Communication Activity Facebook page connect with COCA on Facebook

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