Health Alert Network (HAN)

An RSS feed of information from the Health Alert Network (HAN).

10/24/2017 01:30 PM
New: Health Alert Network (HAN) No. 408 - Advice for Providers Treating Patients in or Recently Returned from Hurricane-Affected Areas, Including Puerto Rico and US Virgin Islands
The Centers for Disease Control and Prevention (CDC) is working with federal, state, territorial, and local agencies and global health partners in response to recent hurricanes. CDC is aware of media reports and anecdotal accounts of various infectious diseases in hurricane-affected areas, including Puerto Rico and the US Virgin Islands (USVI). Because of compromised drinking water and decreased access to safe water, food, and shelter, the conditions for outbreaks of infectious diseases exist. The purpose of this HAN advisory is to remind clinicians assessing patients currently in or recently returned from hurricane-affected areas to be vigilant in looking for certain infectious diseases, including leptospirosis, dengue, hepatitis A, typhoid fever, vibriosis, and influenza. Additionally, this Advisory provides guidance to state and territorial health departments on enhanced disease reporting.

09/13/2017 12:30 PM
New: Health Alert Network (HAN) No. 407 - Rifampin/Penicillin-Resistant Strain of RB51 Brucella Contracted from Consumption of Raw Milk
The Texas Department of State Health Services, with assistance from CDC, is investigating Brucella RB51 exposures and illnesses that may be connected to the purchase and consumption of raw (unpasteurized) milk from K-Bar Dairy in Paradise, Texas. Symptoms of brucellosis can include: fever, sweats, malaise, anorexia, headache, fatigue, muscle & joint pain, and potentially more serious complications (e.g., swelling of heart, liver, or spleen, neurologic symptoms).

09/09/2017 09:30 PM
New: Health Alert Network (HAN) No. 406 - Hurricane Harvey—Clinical Guidance for Carbon
Carbon monoxide (CO) is an odorless, colorless, poisonous gas that can cause sudden illness and death if present in sufficient concentration in the ambient air. During a significant power outage, persons using alternative fuel or power sources such as generators or gasoline powered engine tools such as pressure washers might be exposed to toxic CO levels if the fuel or power sources are placed inside or too close to the exterior of the building causing CO to build up in the structure. The purpose of this HAN advisory is to remind clinicians evaluating persons affected by the storm to maintain a high index of suspicion for CO poisoning.

08/07/2017 02:00 PM
New: Health Alert Network (HAN) No. 405 - Increase in Reported cases of Cyclospora cayetanensis Infection, United States, Summer 2017
The Centers for Disease Control and Prevention (CDC), State and Local Health Departments, and the Food and Drug Administration (FDA) are investigating an increase in reported cases of cyclosporiasis. The purpose of this HAN Advisory is to notify public health departments and healthcare facilities and to provide guidance to healthcare providers of the increase in reported cases. Please disseminate this information to healthcare providers in hospitals and emergency rooms, to primary care providers, and to microbiology laboratories. Healthcare providers should consider a diagnosis of cyclosporiasis in patients with prolonged or remitting-relapsing diarrheal illness. Testing for Cyclospora is not routinely done in most U.S. laboratories, even when stool is tested for parasites. Healthcare providers must specifically order testing for Cyclospora, whether testing is requested by ova and parasite (O&P) examination, by molecular methods, or by a gastrointestinal pathogen panel test. Cyclosporiasis is a nationally notifiable disease; healthcare providers should report suspect and confirmed cases of infection to public health authorities.

07/07/2017 11:00 AM
Health Alert Network (HAN) No. 404 - Patients Receiving Eculizumab (Soliris®) at High Risk for Invasive Meningococcal Disease Despite Vaccination
Eculizumab (Soliris®) recipients have a 1,000 to 2,000-fold greater risk of invasive meningococcal disease compared to the general U.S. population. The Food and Drug Administration (FDA)-approved prescribing information for eculizumab includes a black box warning for increased risk of meningococcal disease, and the Advisory Committee on Immunization Practices (ACIP) recommends meningococcal vaccination for all patients receiving eculizumab. Recent data show that some patients receiving eculizumab who were vaccinated with the recommended meningococcal vaccines still developed meningococcal disease, most often from nongroupable Neisseria meningitidis, which rarely causes invasive disease in healthy individuals.

05/17/2017 09:00 AM
Health Alert Network (HAN) No. 403 - Potential for Falsely Low Blood Lead Test Results from LeadCare® Analyzers
The U.S. Food and Drug Administration (FDA) has issued a safety communication warning about the use of Magellan Diagnostics’ LeadCare® analyzers (LeadCare, LeadCare II, LeadCare Ultra and LeadCare Plus) with venous blood samples because they might result in falsely low test results. FDA is now advising that Magellan Diagnostics’ LeadCare® analyzers should no longer be used with venous blood samples. The safety alert does not apply to capillary blood lead test results collected by fingerstick or heelstick. The purpose of this Health Advisory is to notify state and local health departments, healthcare providers, and laboratories about CDC’s re-testing guidance in light of the safety alert.

05/05/2017 11:30 AM
Health Alert Network (HAN) No. 402 - Prolonged IgM Antibody Response in People Infected with Zika Virus: Implications for Interpreting Serologic Testing Results for Pregnant Women
In July 2016, CDC issued Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure – United States, July 2016 (https://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm) that includes Zika virus immunoglobulin M (IgM) testing of pregnant women. However, some flavivirus infections can result in prolonged IgM responses (>12 weeks) that make it difficult to determine the timing of infection, especially in testing of asymptomatic people. Emerging epidemiologic and laboratory data indicate that Zika virus IgM can persist beyond 12 weeks in a subset of infected people. Therefore, detection of IgM may not always indicate a recent infection. Although IgM persistence could affect IgM test interpretation for all infected people, it would have the greatest effect on clinical management of pregnant women with a history of living in or traveling to areas with Zika virus transmission. Pregnant women who test positive for IgM antibody may have been infected with Zika virus and developed an IgM response before conception.

04/18/2017 04:00 PM
Health Alert Network (HAN) No. 401 - CDC Recommendations for Diagnosing and Managing Shigella Strains with Possible Reduced Susceptibility to Ciprofloxacin
This Health Advisory describes the identification of emerging Shigella strains with elevated minimum inhibitory concentration values for ciprofloxacin and outlines new recommendations for clinical diagnosis, management, and reporting, as well as new recommendations for laboratories and public health officials. Current interpretive criteria provided by the Clinical and Laboratory Standards Institute (CLSI) categorize these strains as susceptible to ciprofloxacin, which is a fluoroquinolone antibiotic and a key agent in the management of Shigella infections.

01/24/2017 01:00 PM
Health Alert Network (HAN) No. 400 - Investigation of Seoul Virus Outbreak Associated with Home-based, Rat-breeding Facilities in Wisconsin and Illinois
CDC and health officials from Wisconsin and Illinois are conducting an investigation of Seoul virus infections among pet rats and persons exposed to rats at rat-breeding facilities in Wisconsin and Illinois. Seoul virus is a member of the hantavirus group of rodent-borne viruses. Trace-back and trace-out investigations of possibly infected rodents have identified distribution chains in other states that may require additional investigations. People who become infected with this virus often exhibit relatively mild or no symptoms, but some will develop a form of hemorrhagic fever with renal syndrome (HFRS) with death in approximately 1–2% of HFRS cases. Although serologic studies have indicated the presence of Seoul virus in wild rats in the United States, this is the first known outbreak associated with pet rats in the United States.

12/14/2016 04:57 PM
Health Alert Network (HAN) No. 399 -CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Brownsville, Cameron County, Texas
On November 28, 2016, the Texas Department of State Health Services (TDSHS) reported the first case of locally acquired mosquito-borne Zika virus infection in the city of Brownsville, Cameron County, Texas. On December 9, 2016, four additional cases in people living in proximity to the first case were reported. TDSHS continues to investigate Zika virus transmission in Brownsville.

10/19/2016 04:00 PM
Health Alert Network (HAN) No. 398 - CDC Updates Guidance for Pregnant Women and Women and Men of Reproductive Age for Zika Virus Infection Related to the Ongoing Investigation of Local Mosquito-borne Zika Virus Transmission in Miami-Dade County, Florida
The U.S. Centers for Disease Control and Prevention (CDC) previously issued travel, testing, and other guidance related to areas of active Zika virus transmission in Florida. Because local transmission of Zika virus continues to be reported in Miami-Dade County, CDC is strengthening travel recommendations for pregnant women to Miami-Dade County and also reinforcing recommendations for use of protective measures to prevent exposure to Zika. CDC is updating recommendations to emphasize testing for pregnant women with an epidemiologic link to Miami-Dade County. An epidemiologic link means that they lived in, traveled to, or had unprotected sex with someone who lived in or traveled to, the designated area. In addition, CDC has made specific recommendations for areas of identified active transmission.

10/13/2016 12:00 PM
Health Alert Network (HAN) No. 397 - CDC Advises Hospitals to Alert Patients at Risk from Contaminated Heater-Cooler Devices Used during Cardiac Surgery
The Centers for Disease Control and Prevention (CDC) is advising hospitals to notify patients who underwent open-heart (open-chest) surgery involving a Stöckert 3T heater-cooler that the device was potentially contaminated, possibly putting patients at risk for a life threatening infection. New information indicates that these devices, manufactured by LivaNova PLC (formerly Sorin Group Deutschland GmbH), were likely contaminated with the rare bacteria Mycobacterium chimaera during manufacturing. Hospitals should advise potentially exposed patients to seek medical care if they are experiencing symptoms such as night sweats, muscle aches, unexplained weight loss, fatigue, or unexplained fever. In addition, hospitals that use or have used this device are strongly encouraged to make and execute a plan to communicate with potentially exposed patients and to increase awareness among healthcare providers.

09/20/2016 10:45 AM
Health Alert Network (HAN) No. 396 - CDC Updates Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Ongoing Investigation of Local Mosquito-borne Zika Virus Transmission in Miami-Dade County, Florida
CDC previously issued travel, testing, and other guidance related to local mosquito-borne Zika virus transmission (active Zika virus transmission) that the Florida Department of Health (FL DOH) identified in two areas of Miami-Dade County: (1) a one-square-mile area in Wynwood, and (2) a 1.5-square-mile area in Miami Beach. CDC has updated the guidance for people who live in or traveled to these areas.

08/25/2016 04:00 PM
NEW: Health Alert Network (HAN) No. 395 - Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds Further Increases Risk of Fentanyl-related Overdose and Fatalities
On October 26, 2015, CDC issued HAN 384 (http://emergency.cdc.gov/han/han00384.asp) that alerted (1) public health departments, health care professionals, first responders, and medical examiners and coroners of the increase in fentanyl-related unintentional overdose fatalities in multiple states primarily driven by illicitly manufactured fentanyl (IMF) (i.e., non-pharmaceutical fentanyl); (2) provided recommendations for improving detection of fentanyl-related overdose outbreaks; and (3) encouraged states to expand access to naloxone and training for administering naloxone to reduce opioid overdose deaths.

08/19/2016 03:35 PM
Health Alert Network (HAN) No. 394 - CDC Expands Guidance for Travel and Testing of Pregnant Women, Women of Reproductive Age, and Their Partners for Zika Virus Infection Related to Mosquito-borne Zika Virus Transmission in Miami-Dade, Florida
CDC has previously issued travel, testing, and other guidance for local mosquito-borne Zika virus transmission (active Zika virus transmission) for a one-square-mile area in the Wynwood area of Miami that the Florida Department of Health (FL DOH) identified. The guidance for those who live in or traveled to this area any time after June 15, 2016, remains in effect. FL DOH continues to investigate active Zika virus transmission in South Florida. Investigation has revealed a new area of active transmission in a 1.5-square-mile section of Miami Beach. In addition, FL DOH has identified multiple other individual instances of mosquito-borne Zika virus infection and an increase in travel-related cases.

08/01/2016 01:05 PM
Health Alert Network (HAN) No. 393 - CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Miami-Dade and Broward Counties, Florida
The Florida Department of Health (FL DOH) has identified an area with local mosquito-borne Zika virus transmission (active Zika virus transmission) in Miami (http://www.cdc.gov/zika/intheus/florida-update.html). Based on the earliest time of symptom onset and a maximal two-week incubation period for Zika virus, this guidance applies to women of reproductive age and their partners who live in or traveled to this area after June 15, 2016. This is an ongoing investigation, and CDC is rapidly learning more about the extent of active Zika virus transmission in the area identified by the FL DOH. With the recommendations below, CDC is applying existing guidance to the occurrence of Zika virus transmission in this area of Florida. As more information becomes available, we will update these recommendations.

06/21/2016 10:40 AM
NEW: Health Alert Network (HAN) No. 392 - CDC Recommendations for Subsequent Zika IgM Antibody Testing
Testing for Zika virus infection using real-time reverse-transcription polymerase chain reaction (rRT-PCR) molecular assays is now commercially available. When requesting Zika rRT-PCR testing from a commercial laboratory, providers should be aware that commercial laboratories performing rRT-PCR currently do not also offer Zika IgM enzyme-linked immunosorbent assay (ELISA) or confirmatory serologic testing (plaque reduction neutralization test, or PRNT). Therefore, if possible, providers should store a serum aliquot for subsequent Zika IgM ELISA testing if the rRT-PCR assay is negative. Otherwise, collection of an additional serum sample may be necessary.

06/17/2016 12:30 PM
NEW: Health Alert Network (HAN) No. 391 - Best Practices for Using PCR to Diagnose Haemophilus influenzae and Neisseria meningitidis and Identify Serotype or Serogroup
Determining serotype for Haemophilus influenzae (Hi) and serogroup for Neisseria meningitidis (Nm) is crucial for identifying potential outbreaks and determining appropriate public health responses. Several new commercial multiplex polymerase chain reaction (PCR) assays capable of simultaneously testing a single specimen for an array of pathogens that cause blood infections, meningitis, or encephalitis are available. These assays can rapidly identify Hi and Nm species, but most do not determine serotype or serogroup. Laboratories should continue to perform culture and use validated, specific real-time PCR assays capable of detecting and differentiating all six serotypes (a-f) of Hi and six serogroups (A, B, C, W, X, and Y) of Nm; otherwise, additional steps need to be taken including performing a reflex culture or at a minimum retaining a clinical sample for further testing.

06/13/2016 12:35 PM
NEW: Health Alert Network (HAN) No. 390 - Alert to U.S. Healthcare Facilities: First mcr-1 Gene in E. coli Bacteria found in a Human in the United States
The Centers for Disease Control and Prevention (CDC) is collaborating in a coordinated public health response to the Department of Defense (DoD) announcement on May 26 of the first mcr-1 gene found in bacteria from a human in the United States. Escherichia coli (E. coli) bacteria carrying the mcr-1 gene were found in a urine sample from a person in Pennsylvania with no recent travel outside of the United States who presented to a clinic with a urinary tract infection. The mcr-1 gene makes bacteria resistant to the antibiotic colistin, which is used as a last-resort drug to treat patients with infections caused by multidrug-resistant bacteria, including carbapenem-resistant Enterobacteriaceae (CRE). The mcr-1 gene exists on a plasmid, a small piece of DNA that is capable of moving from one bacterium to another, potentially spreading antibiotic resistance to other bacterial species. CDC is issuing this HAN notice as a reminder to U.S. healthcare facilities about recommendations to prevent antibiotic resistant infections and alert them to additional recommendations for detecting and reporting bacteria with the mcr-1 gene.

05/25/2016 04:00 PM
NEW: Health Alert Network (HAN) No. 389 - Diagnostic Testing of Urine Specimens for Suspected Zika Virus Infection
On May 13, 2016, the Centers for Disease Control and Prevention (CDC) issued interim guidance (http://www.cdc.gov/mmwr/volumes/65/wr/mm6518e1.htm) that recommends Zika virus rRT-PCR testing of urine collected less than 14 days after symptom onset, along with testing of patient-matched serum samples, for the diagnosis of suspected Zika virus infection (1). The purpose of this Health Alert Network (HAN) health update is to further disseminate information about the interim guidance to clinical and public health professionals.

02/23/2016 01:16 PM
NEW: Health Alert Network (HAN) No. 388 - Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016
The Centers for Disease Control and Prevention (CDC) recently published recommendations for protecting people against sexual transmission of Zika virus (1). As stated in that report, information about possible sexual transmission of Zika virus was based on one published report of transmission from a man to a woman, one published report in which Zika virus was detected in semen of a man with hematospermia, and one case of possible sexual transmission then under investigation in Texas. An additional case of Zika virus detected in semen in a man was reported after the CDC recommendations were published (2). As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, 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. These recommendations may change as more information becomes available.

02/01/2016 07:50 AM
NEW: Health Alert Network (HAN) No. 387 - Flu Season Begins: Severe Influenza Illness Reported - CDC urges rapid antiviral treatment of very ill and high risk suspect influenza patients without waiting for testing
Influenza activity is increasing across the country and CDC has received reports of severe influenza illness. Clinicians are reminded to treat suspected influenza in high-risk outpatients, those with progressive disease, and all hospitalized patients with antiviral medications as soon as possible, regardless of negative rapid influenza diagnostic test (RIDT) results and without waiting for RT-PCR testing results. Early antiviral treatment works best, but treatment may offer benefit when started up to 4-5 days after symptom onset in hospitalized patients. Early antiviral treatment can reduce influenza morbidity and mortality

01/27/2016 09:30 AM
NEW: Health Alert Network (HAN) No. 386 - CDC Urging Dialysis Providers and Facilities to Assess and Improve Infection Control Practices to Stop Hepatitis C Virus Transmission in Patients Undergoing Hemodialysis
The Centers for Disease Control and Prevention (CDC) has received an increased number of reports of newly acquired hepatitis C virus (HCV) infection among patients undergoing hemodialysis. Infection control lapses in dialysis care could expose patients to HCV.

01/15/2016 08:30 PM
NEW: Health Alert Network (HAN) No. 385 - Recognizing, Managing, and Reporting Zika Virus Infections in Travelers Returning from Central America, South America, the Caribbean, and Mexico
In May 2015, the World Health Organization reported the first local transmission of Zika virus in the Western Hemisphere, with autochthonous (locally acquired) cases identified in Brazil. As of January 15, 2016, local transmission had been identified in at least 14 countries or territories in the Americas, including Puerto Rico (See Pan American Health Organization [PAHO] link below for countries and territories in the Americas with Zika virus transmission). Further spread to other countries in the region is likely.

10/26/2015 07:15 AM
NEW: Health Alert Network (HAN) No. 384 - Increases in Fentanyl Drug Confiscations and Fentanyl-related Overdose Fatalities
The Centers for Disease Control and Prevention (CDC) and the Drug Enforcement Administration (DEA) are investigating recent increases in fentanyl-related unintentional overdose fatalities in multiple states across the U.S. The purpose of this HAN advisory is to: (1) alert public health departments, health care providers, first responders, and medical examiners and coroners to the possibility of additional increases in other jurisdictions, (2) provide recommendations for improving detection of fentanyl-related overdose outbreaks and (3) encourage states to expand access to naloxone and training for administering naloxone to reduce opioid overdose deaths.

10/02/2015 07:00 AM
NEW: Health Alert Network (HAN) No. 383 - CDC/FDA Health Update about the Immediate Need for Healthcare Facilities to Review Procedures for Cleaning, Disinfecting, and Sterilizing Reusable Medical Devices
On September 11, 2015, CDC issued HAN 00382 alerting healthcare providers and facilities about the public health need to properly maintain, clean, and disinfect or sterilize reusable medical devices. Recent infection control lapses due to non-compliance with recommended reprocessing procedures highlight a critical gap in patient safety. Healthcare facilities (e.g., hospitals, ambulatory surgical centers, clinics, and doctors’ offices) that utilize reusable medical devices are urged to immediately review current reprocessing practices at their facility to ensure they (1) are complying with all steps as directed by the device manufacturers, and (2) have in place appropriate policies and procedures that are consistent with current standards and guidelines. After considering feedback from vendors that perform servicing and repair of reusable medical devices, we are amending HAN Advisory 382 to remove the following sentence: “If healthcare facilities contract maintenance and repair of these devices to third-party vendors, healthcare facilities should verify that these vendors are approved or certified by the manufacturer to provide those services.” We are making this change because there are currently no formal standardized programs or processes through which all manufacturers certify third-party vendors. We are also further clarifying that healthcare facilities which hire contractors to perform device reprocessing should verify that the contractor has an appropriate training program (i.e., consistent with what would be required in the healthcare facility) and that the training program includes the specific devices used by the healthcare facility.

09/11/2015 11:15 AM
NEW: Health Alert Network (HAN) No. 382 - Immediate Need for Healthcare Facilities to Review Procedures for Cleaning, Disinfecting, and Sterilizing Reusable Medical Devices
The Centers for Disease Control and Prevention (CDC) and U.S. Food and Drug Administration (FDA) are alerting healthcare providers and facilities about the public health need to properly maintain, clean, and disinfect or sterilize reusable medical devices. Recent infection control lapses due to non-compliance with recommended reprocessing procedures highlight a critical gap in patient safety. Healthcare facilities (e.g., hospitals, ambulatory surgical centers, clinics, and doctors’ offices) that utilize reusable medical devices are urged to immediately review current reprocessing practices at their facility to ensure they (1) are complying with all steps as directed by the device manufacturers, and (2) have in place appropriate policies and procedures that are consistent with current standards and guidelines.

06/19/2015 12:45 PM
NEW: Health Alert Network (HAN) No. 381 - Clinical Considerations for the Evaluation of Ill Travelers from Liberia to the United States
CDC recommends that healthcare providers consider not only Ebola virus disease (EVD), but also other much more likely infectious diseases, including malaria, when evaluating ill travelers from Liberia to the United States. Signs and symptoms of EVD are non-specific and overlap with many other more prevalent infectious diseases in West Africa. For any patient returning from West Africa and presenting with non-specific signs and symptoms consistent with EVD, providers should use clinical judgment, taking into account the patient’s epidemiological history for management, diagnostic testing, and treatment and coordinate healthcare as needed with the state or local health department to ensure that these patients get appropriate care without delay. The rapid identification of the cause of an acute illness in a Person Under Investigation (PUI) enables rapid treatment and resolution of symptoms.

06/11/2015 01:00 PM
NEW: Health Alert Network (HAN) No. 380 - Updated Information and Guidelines for Evaluation of Patients for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection
The Centers for Disease Control and Prevention (CDC) continues to work with the World Health Organization (WHO) and other partners to closely monitor Middle East Respiratory Syndrome Coronavirus (MERS-CoV) globally, including the cases of MERS-CoV infection recently reported by China and the Republic of Korea, to better understand the risks to public health. The purpose of this HAN Advisory is to provide updated guidance to state health departments and healthcare providers in the evaluation of patients for MERS-CoV infection, which have been revised in light of the current situation in the Republic of Korea. Healthcare providers and public health officials should maintain awareness of the need to consider MERS-CoV infection in ill persons who have recently traveled from countries in or near the Arabian Peninsula1 or in the Republic of Korea as outlined in the guidance below. Please disseminate this information to healthcare providers, especially infectious diseases specialists, intensive care physicians, internists, infection preventionists, and to emergency departments and microbiology laboratories.

06/04/2015 03:15 PM
NEW: Health Alert Network (HAN) No. 379 - Ciprofloxacin- and Azithromycin-Nonsusceptible Shigellosis in the United States
CDC continues to receive new reports of infections with Shigella strains that are not susceptible to ciprofloxacin and/or azithromycin, the antimicrobial agents most commonly used to treat shigellosis. Most cases have been reported among gay, bisexual, and other men who have sex with men (collectively referred to as MSM) in Illinois, Minnesota, and Montana and among international travelers, but cases are also occurring among other populations. Shigellosis is very contagious and can spread quickly through communities and across different segments of the population. CDC recommends meticulous handwashing and other hygiene practices to prevent shigellosis and encourages patients with symptoms of shigellosis such as diarrhea and fever to visit a healthcare provider. Clinicians should obtain stool cultures from patients suspected of having shigellosis, counsel patients about shigellosis prevention, and, when treatment is required, select drugs based on antimicrobial susceptibility test results.

06/02/2015 02:30 PM
NEW: Health Alert Network (HAN) No. 378 - Bird Infections with Highly-Pathogenic Avian Influenza A (H5N2), (H5N8), and (H5N1) Viruses: Recommendations for Human Health Investigations and Response
Highly-pathogenic avian influenza A H5 viruses have been identified in birds in the United States since December 2014. The purpose of this HAN Advisory is to notify public health workers and clinicians of the potential for human infection with these viruses and to describe CDC recommendations for patient investigation and testing, infection control including the use personal protective equipment, and antiviral treatment and prophylaxis.

04/24/2015 10:00 AM
NEW: Health Alert Network (HAN) No. 377 - Outbreak of Recent HIV and HCV Infections among Persons Who Inject Drugs
The Indiana State Department of Health (ISDH) and the Centers for Disease Control and Prevention (CDC) are investigating a large outbreak of recent human immunodeficiency virus (HIV) infections among persons who inject drugs (PWID). Many of the HIV-infected individuals in this outbreak are co-infected with hepatitis C virus (HCV). The purpose of this HAN Advisory is to alert public health departments and healthcare providers of the possibility of HIV outbreaks among PWID and to provide guidance to assist in the identification and prevention of such outbreaks.

01/23/2015 03:00 PM
Health Alert Network (HAN) No. 376 - U.S. Multi-state Measles Outbreak, December 2014-January 2015
The Centers for Disease Control and Prevention (CDC) and State Health Departments are investigating a multi-state outbreak of measles associated with travel to Disneyland Resort Theme Parks (which includes Disneyland and Disney California Adventure). The purpose of this HAN Advisory is to notify public health departments and healthcare facilities about this measles outbreak and to provide guidance to healthcare providers. Healthcare providers should ensure that all of their patients are current on MMR (measles, mumps, and rubella) vaccine. They should consider measles in the differential diagnosis of patients with fever and rash and ask patients about recent international travel or travel to domestic venues frequented by international travelers. They should also ask patients about their history of measles exposures in their community. Please disseminate this information to healthcare providers in hospitals and emergency rooms, to primary care providers, and to microbiology laboratories.

01/09/2015 10:00 AM
Health Alert Network (HAN) No. 375 - CDC Health Update Regarding Treatment of Patients with Influenza with Antiviral Medications
Widespread influenza activity is being reported in most U.S. states, with influenza A (H3N2) viruses most common. H3N2-predominant flu seasons have been associated with more hospitalizations and deaths in older people and young children in the past. In addition, approximately two-thirds of H3N2 viruses that have been tested at CDC are antigenically or genetically different from the H3N2 vaccine virus. This difference suggests that vaccine effectiveness may be reduced this season. High hospitalization rates are being observed, similar to what was seen during the 2012-2013 influenza season. Hospitalization rates are especially high among people 65 years and older. In this context, the use of influenza antiviral drugs as an adjunct to vaccination becomes even more important than usual in protecting people from influenza. Antiviral medications are effective in treating influenza and reducing complications. Antivirals are available and recommended, but evidence from the current and previous influenza seasons suggests that they are severely underutilized.

12/03/2014 05:00 PM
Health Alert Network (HAN) No. 374 - CDC Health Advisory Regarding the Potential for Circulation of Drifted Influenza A (H3N2) Viruses
Influenza activity is currently low in the United States as a whole, but is increasing in some parts of the country. This season, influenza A (H3N2) viruses have been reported most frequently and have been detected in almost all states. During past seasons when influenza A (H3N2) viruses have predominated, higher overall and age-specific hospitalization rates and more mortality have been observed, especially among older people, very young children, and persons with certain chronic medical conditions compared with seasons during which influenza A (H1N1) or influenza B viruses have predominated.

11/25/2014 02:30 PM
Health Alert Network (HAN) No. 373 - Fatal Gastrointestinal Mucormycosis in an Infant Following Ingestion of Contaminated Dietary Supplement – Connecticut, 2014
The Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and Connecticut Departments of Public Health and Consumer Protection are investigating a fatal case of gastrointestinal (GI) mucormycosis caused by Rhizopus oryzae in a premature infant. The infant received ABC Dophilus® Powder, a dietary supplement product containing viable microbial ingredients purchased from Solgar, Inc., Leonia, New Jersey. The product claimed to have “probiotic” properties and is marketed for infants and children. Subsequent testing of the same lot of unopened Solgar ABC Dophilus® Powder revealed contamination with Rhizopus oryzae. The purpose of this HAN advisory is to provide awareness about this fatal case of GI mucormycosis following ingestion of a contaminated dietary supplement and to provide guidance to state health departments and health care providers. Please disseminate this information to healthcare workers in neonatal intensive care units, hospital pharmacies, pediatricians, and primary care providers, as well as to microbiology and pathology laboratories.

11/24/2014 02:30 PM
Health Alert Network (HAN) No. 372 - Enhanced Airport Entry Screening and Active Post-Arrival Monitoring for People Traveling to the United States from Mali
On November 13, 2014, the Centers for Disease Control and Prevention (CDC) released a travel alert (Level 2) for Mali following reports of a cluster of Ebola cases in Bamako, Mali, that were linked to a man who had become sick in Guinea and traveled to Bamako, Mali. CDC is working with the government of Mali, the World Health Organization (WHO), and other partners to control further spread of Ebola in Mali. In addition, CDC is working with the Department of Homeland Security (DHS) to expand enhanced entry screening at U.S. airports and post-arrival monitoring of people whose travel originates in Mali.

10/02/2014 07:00 PM
Health Alert Network (HAN) No. 371 - Evaluating Patients for Possible Ebola Virus Disease: Recommendations for Healthcare Personnel and Health Officials
The first case of Ebola Virus Disease (Ebola) diagnosed in the United States was reported to CDC by Dallas County Health and Human Services on September 28, 2014, and laboratory-confirmed by CDC and the Texas Laboratory Response Network (LRN) laboratory on September 30. The patient departed Monrovia, Liberia, on September 19, and arrived in Dallas, Texas, on September 20. The patient was asymptomatic during travel and upon his arrival in the United States; he fell ill on September 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on September 26. He was treated and released. On September 28, he returned to the same hospital, and was admitted for treatment.

09/26/2014 04:00 PM
Health Alert Network (HAN) No. 370 - Acute Neurologic Illness with Focal Limb Weakness of Unknown Etiology in Children
The Centers for Disease Control and Prevention (CDC) is working closely with the Colorado Department of Public Health and Environment (CDPHE) and Children’s Hospital Colorado to investigate a cluster of nine pediatric patients hospitalized with acute neurologic illness of undetermined etiology. The illness is characterized by focal limb weakness and abnormalities of the spinal cord gray matter on MRI. These illnesses have occurred since August 1, 2014 coincident with an increase of respiratory illnesses among children in Colorado. The purpose of this HAN Advisory is to provide awareness of this neurologic syndrome under investigation with the aim of determining if children with similar clinical and radiographic findings are being cared for in other geographic areas. Guidance about reporting cases to state and local health departments and CDC is provided. Please disseminate this information to infectious disease specialists, intensive care physicians, pediatricians, neurologists, radiologists/neuroradiologists, infection preventionists, and primary care providers, as well as to emergency departments and microbiology laboratories.

09/12/2014 04:00 PM
Health Alert Network (HAN) No. 369 - Severe Respiratory Illness Associated with Enterovirus D68 – Multiple States, 2014
The Centers for Disease Control and Prevention (CDC) is working closely with hospitals and local and state health departments to investigate recent increases in hospitalizations of patients with severe respiratory illness. Enterovirus D68 (EV-D68) has been detected in specimens from children with severe illness in Missouri and Illinois. Investigations into suspected clusters in other jurisdictions are ongoing. The purpose of this HAN Advisory is to provide awareness of EV-D68 as a possible cause of acute unexplained respiratory illness, and to provide guidance to state health departments and health care providers. Please disseminate this information to infectious disease specialists, intensive care physicians, pediatricians, internists, infection preventionists, and primary care providers, as well as to emergency departments and microbiology laboratories.

08/28/2014 11:00 AM
Health Alert Network (HAN) No. 368 - CDC Ebola Response Update #4
The Centers for Disease Control and Prevention (CDC) is working with other U.S. government agencies, the World Health Organization, and other domestic and international partners in an international response to the current Ebola outbreak in West Africa. This document summarizes key messages about the outbreak and the response. It will be updated as new information becomes available and distributed regularly. Please share the document with others as appropriate.

08/22/2014 09:30 PM
Health Alert Network (HAN) No. 367 - CDC Ebola Response Update #3
The Centers for Disease Control and Prevention (CDC) is working with other U.S. government agencies, the World Health Organization, and other domestic and international partners in an international response to the current Ebola outbreak in West Africa. This document summarizes key messages about the outbreak and the response. It will be updated as new information becomes available and distributed regularly. Please share the document with others as appropriate.

08/21/2014 02:30 PM
Health Alert Network (HAN) No. 366 - CDC Ebola Update #2
The Centers for Disease Control and Prevention (CDC) is working with other U.S. government agencies, the World Health Organization, and other domestic and international partners in an international response to the current Ebola outbreak in West Africa. This document summarizes key messages about the outbreak and the response. It will be updated as new information becomes available and distributed regularly. Please share the document with others as appropriate.

08/13/2014 11:00 AM
Health Alert Network (HAN) No. 365 - CDC Ebola Update #1
The Centers for Disease Control and Prevention (CDC) is working with other U.S. government agencies, the World Health Organization, and other domestic and international partners in an international response to the current Ebola outbreak in West Africa. This document summarizes key messages about the outbreak and the response. It will be updated as new information becomes available and distributed regularly. Please share the document with others as appropriate.

08/01/2014 07:00 PM
Health Alert Network (HAN) No. 364 - Guidelines for Evaluation of US Patients Suspected of Having Ebola Virus Disease
The Centers for Disease Control and Prevention (CDC) continues to work closely with the World Health Organization (WHO) and other partners to better understand and manage the public health risks posed by Ebola Virus Disease (EVD). To date, no cases have been reported in the United States. The purpose of this health update is 1) to provide updated guidance to healthcare providers and state and local health departments regarding who should be suspected of having EVD, 2) to clarify which specimens should be obtained and how to submit for diagnostic testing, and 3) to provide hospital infection control guidelines. U.S. hospitals can safely manage a patient with EVD by following recommended isolation and infection control procedures. Please disseminate this information to infectious disease specialists, intensive care physicians, primary care physicians, hospital epidemiologists, infection control professionals, and hospital administration, as well as to emergency departments and microbiology laboratories.

07/28/2014 03:30 PM
Health Alert Network (HAN) No. 363 - Ebola Virus Disease Confirmed in a Traveler to Nigeria, Two U.S. Healthcare Workers in Liberia
Nigerian health authorities have confirmed a diagnosis of Ebola Virus Disease (EVD) in a patient who died on Friday in a hospital in Lagos, Nigeria, after traveling from Liberia on July 20, 2014. The report marks the first Ebola case in Nigeria linked to the current outbreak in the West African countries of Guinea, Sierra Leone, and Liberia. Health authorities also reported this weekend that two U.S. citizens working in a hospital in Monrovia, Liberia, have confirmed Ebola virus infection. These recent cases, together with the continued increase in the number of Ebola cases in West Africa, underscore the potential for travel-associated spread of the disease and the risks of EVD to healthcare workers. While the possibility of infected persons entering the U.S. remains very low, the Centers for Disease Control and Prevention (CDC) advises that healthcare providers in the U.S. should consider EVD in the differential diagnosis of febrile illness, with compatible symptoms, in any person with recent (within 21 days) travel history in the affected countries and consider isolation of those patients meeting these criteria, pending diagnostic testing.

06/02/2014 07:45 PM
Health Alert Network (HAN) No. 362 - Guidance to US Clinicians Regarding New WHO Polio Vaccination Requirements for Travel by Residents of and Long-term Visitors to Countries with Active Polio Transmission
On 5 May 2014, the Director-General of the World Health Organization (WHO) accepted the recommendations of an Emergency Committee, declaring the international spread of polio to be a public health emergency of international concern (PHEIC) under the authority of the International Health Regulations (IHR) (2005) and issued vaccination requirements for travelers in order to prevent further spread of the disease. IHR is an international agreement among countries to prevent, protect or control the international spread of disease. All countries have agreed to be bound by recommended activities under IHR.

05/03/2014 03:30 PM
Health Alert Network (HAN) No. 361 - Confirmed Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Case in Indiana, 2014
The first case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in the United States, identified in a traveler, was reported to CDC by the Indiana State Department of Health (ISDH) on May 1, 2014, and confirmed by CDC on May 2. The patient is in a hospital in Indiana after having flown from Saudi Arabia to Chicago via London. The purpose of this HAN is to alert clinicians, health officials, and others to increase their index of suspicion to consider MERS-CoV infection in travelers from the Arabian Peninsula and neighboring countries. Please disseminate this information to infectious disease specialists, intensive care physicians, primary care physicians, and infection preventionists, as well as to emergency departments and microbiology laboratories.

01/15/2014 06:00 PM
Health Alert Network (HAN) No. 360 - Human Infection with Avian Influenza A (H5N1) Virus
On January 8, 2014, the Public Health Agency of Canada reported the first confirmed case of human infection with avian influenza A (H5N1) virus identified in North America. The patient exhibited symptoms while returning from travel to Beijing, China, on December 27, 2013.

12/24/2013 04:30 PM
Health Alert Network (HAN) No. 359 - Notice to Clinicians: Early Reports of pH1N1-Associated Illnesses for the 2013 - 14 Influenza Season
From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus.

12/13/2013 03:45 PM
Health Alert Network (HAN) No. 358 - Notice to Public Health Officials and Clinicians: Recognizing, Managing, and Reporting Chikungunya Virus Infections in Travelers Returning from the Caribbean
On December 7, 2013, the World Health Organization (WHO) reported the first local (autochthonous) transmission of chikungunya virus in the Americas.

11/27/2013 01:45 PM
Health Alert Network (HAN) No. 357 - Notice to Healthcare Providers: Recognizing and Reporting Serogroup B Meningococcal Disease Associated with Outbreaks at Princeton University and the University of California at Santa Barbara
Eight cases of serogroup B meningococcal disease have been reported in Princeton University students or persons with links to Princeton University during the last eight months, including three cases reported since September.

10/08/2013 04:00 PM
Health Alert Network (HAN) No. 356 - Acute Hepatitis and Liver Failure Following the Use of a Dietary Supplement Intended for Weight Loss or Muscle Building
On September 9, 2013, the Hawaii Department of Health (DOH) was notified of seven patients with severe acute hepatitis and sudden liver failure of unknown cause.

09/04/2013 04:00 PM
Health Alert Network (HAN) No. 355 - Recurrent Nationwide Shortage of Tuberculin Skin Test Antigen Solutions: CDC Recommendations for Patient Care and Public Health Practice
This notice updates and supersedes the advice in HAN 345 and advises public health officials, clinicians, and workers in occupational health and infection control about how to adapt testing protocols to the recurrent shortage.

08/23/2013 01:30 PM
Health Alert Network (HAN) No. 354 - Investigational Drug Available Directly from CDC for the Treatment of Free-Living Ameba Infections
CDC now has an expanded access investigational new drug (IND) protocol in effect with the Food and Drug Administration (FDA) to make miltefosine available directly from CDC to clinicians for treatment of free-living ameba (FLA) infections in the United States.

08/14/2013 07:00 PM
Health Alert Network (HAN) No. 353 - Nationwide Voluntary Recall of All Products for Sterile Use from Compounding Pharmacy Located in Cedar Park, Texas
The U.S. Food and Drug Administration (FDA) is alerting health care providers and patients of a voluntary nationwide recall of all products produced and distributed for sterile use by Specialty Compounding, LLC, Cedar Park, Texas.

08/12/2013 04:00 PM
Health Alert Network (HAN) No. 352 - Notice to Healthcare Providers and Public Health Officials: Updated Guidance for the Evaluation of Severe Respiratory Illness Associated with Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
The Centers for Disease Control and Prevention (CDC) continues to work closely with the World Health Organization (WHO) and other partners to better understand the public health risks posed by Middle East Respiratory Syndrome Coronavirus (MERS-CoV).

07/05/2013 02:00 PM
Health Alert Network (HAN) No. 351 - Variant Influenza Virus (H3N2v) Infections
This Health Alert Network Health Advisory provides an update on H3N2 variant virus (or “H3N2v”) activity and summarizes CDC’s updated H3N2v case definitions and recommendations for H3N2v surveillance for the summer and fall of 2013. It supersedes the last H3N2v-related HAN Health Advisory, HAN 325, which was issued August 3, 2012.

06/20/2013 04:30 PM
Health Alert Network (HAN) No. 350 - Recommendations for Laboratory Testing for Acetyl Fentanyl and Patient Evaluation and Treatment for Overdose with Synthetic Opioids
Recently, a number of intravenous drug users have overdosed on a new, non-prescription injected synthetic opioid, acetyl fentanyl. Acetyl fentanyl is a fentanyl analog previously undocumented in illicit drug use that is up to five times more potent than heroin.

06/12/2013 04:30 PM
NEW: Health Alert Network (HAN) #349
Nationwide Shortage of Doxycycline: Resources for Providers and Recommendations for Patient Care

06/07/2013 09:45 PM
NEW: Health Alert Network (HAN) #348
Notice to Health Care Providers: Updated Guidelines for Evaluation of Severe Respiratory Illness Associated with Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

06/07/2013 05:00 PM
NEW: Health Alert Network (HAN) #347
Human Infections with Avian Influenza A (H7N9) Viruses

04/17/2013 09:45 PM
NEW: Health Alert Network (HAN) #346
Resources Available for Local and State Public Health Officials: Preparing for and Responding to Bombing Events

04/12/2013 10:00 AM
NEW: Health Alert Network (HAN) #345
Nationwide Shortage of Tuberculin Skin Test Antigens: CDC Recommendations for Patient Care and Public Health Practice

04/05/2013 09:00 AM
NEW: Health Alert Network (HAN) #344
Human Infections with Novel Influenza A (H7N9) Viruses

03/08/2013 11:00 AM
NEW: Health Alert Network (HAN) #343
Notice to Health Care Providers: Updated Guidelines for Evaluation of Severe Respiratory Illness Associated with a Novel Coronavirus

03/04/2013 03:30 PM
NEW: Health Alert Network (HAN) #342
Notice to Clinicians: Continued Vigilance Urged for Fungal Infections among Patients Who Received Contaminated Steroid Injections

02/13/2013 11:30 PM
NEW: Health Alert Network (HAN) #341
New Carbapenem-Resistant Enterobacteriaceae Warrant Additional Action by Healthcare Providers

01/28/2013 10:00 AM
NEW: Health Alert Network (HAN) #340
Recommendations for Drug Allocation, Tuberculosis Prevention, and Patient Care During Isoniazid Shortages

01/17/2013 08:00 AM
NEW: Health Alert Network (HAN) - HAN #339 Notice to Clinicians: Summary of CDC Recommendations for Influenza Antiviral Medications
Health Concerns about Misuse of Pesticides for Bed Bug Control Notice to Clinicians: Summary of CDC Recommendations for Influenza Antiviral Medications

12/20/2012 12:30 PM
NEW: Health Alert Network (HAN) #338
Update: Multistate Outbreak of Fungal Infections among Persons Who Received Injections with Contaminated Medication

02/09/2012 12:30 PM
New: CDC Recommendations for Influenza Antiviral Medications Remain Unchanged
A recent review of randomized clinical trial data for the influenza neuraminidase inhibitor antiviral medications, and two related commentaries, raised questions about the value of antiviral medications for the prevention and treatment of influenza. On February 7, 2012, the Centers for Disease Control and Prevention (CDC) posted a "Have You Heard?" piece in response. The CDC response states "After careful consideration of all available evidence, CDC guidance on the use of antiviral medications remains unchanged." CDC continues to recommend the use of neuraminidase inhibitor antiviral drugs (oral oseltamivir and inhaled zanamivir) as an important adjunct in the prevention and treatment of influenza.

06/22/2011 04:30 PM
High Number of Reported Measles Cases in the U.S. in 2011—Linked to Outbreaks Abroad
The United States is experiencing a high number of reported measles cases in 2011, many of which were acquired during international travel. From January 1 through June 17 this year, 156 confirmed cases of measles were reported to CDC. This is the highest reported number since 1996. Most cases (136) were associated with importations from measles-endemic countries or countries where large outbreaks are occurring.

06/03/2011 08:30 AM
Notice to Health Care Providers — Shiga Toxin-producing E. coli O104 (STEC O104:H4) Infections in U.S. Travelers Returning from Germany
CDC is monitoring a large outbreak of Shiga toxin-producing Escherichia coli O104:H4 (STEC O104:H4) infections ongoing in Germany.

05/27/2011 11:30 AM
FDA Warns Not to Feed SimplyThick® to Premature Infants
NOTE TO READERS: This advisory is an FDA notice that is being distributed via CDC’s Health Alert Network. The U.S. Food and Drug Administration (FDA) is recommending that parents, caregivers, and health care providers should not feed the thickening product called SimplyThick to infants born before 37 weeks gestation because it may cause necrotizing enterocolitis (NEC), a life-threatening condition characterized by inflammation and death of intestinal tissue.

03/26/2011 11:20 PM
Monitoring for Increased Levels of Radioactive Material in the US as a Result of the Incident with the Fukushima Nuclear Incident in Japan
As a result of the incident with the Fukushima nuclear plant in Japan, highly sensitive radiation monitors operated by EPA and others are detecting very low levels of radioactive material in the air in the United States. These levels were expected and consistent with estimated releases from the damaged nuclear reactors and are far below levels of public health concern.

02/16/2011 10:45 PM
Best Practices for Health Care Professionals on the Use of Polymerase Chain Reaction (PCR) for Diagnosing Pertussis
With the continuing resurgence of pertussis, health care professionals will likely see more patients with suspected pertussis. Proper testing criteria, timing of testing, specimen collection techniques, protocols for avoiding specimen contamination, and appropriate interpretation of test results are all necessary to ensure that Polymerase Chain Reaction (PCR) reliably informs patient diagnosis.

01/14/2011 03:11 PM
CDC Guidance on the Use of Influenza Antiviral Agents and Rapid Influenza Diagnostic Tests During the 2010-2011 Influenza Season
As influenza activity increases in the United States, clinicians are urged to consult CDC guidance on the use of influenza antiviral agents and rapid influenza diagnostic tests this season. Updated recommendations on the use of antiviral medications will be published in an upcoming Morbidity and Mortality Weekly Report (MMWR), but an interim version of the recommendations is currently available on CDC's website at http://www.cdc.gov/flu/professionals/antivirals/index.htm.