CDC HAN re Wuhan Coronavirus

CDC has issued a Health Alert Network (HAN) Update for the outbreak of a 2019 novel coronavirus (2019-nCoV) in Wuhan City, Hubei Province, China that began in December 2019.  No human-to-human contagion has been clearly demonstrated yet, but recent history with MERS and SARS CoVs advise caution.  Accordingly, CDC suggests surveillance for patients who report fever and symptoms of lower respiratory illness (cough, shortness of breath), and within the two weeks prior to symptom onset, experienced any of the following:

  • Travel to Wuhan CIty, China
  • Close contact with a person under investigation for 2019-nCOV while that person was ill
  • Close contact with an lab-confirmed 2019-nCoV patient while that patient was ill

The HAN provides instructions for healthcare providers and public health agencies on how to respond to such cases, including evaluation, reporting, testing, and specimen collection.  Find the complete HAN at https://emergency.cdc.gov/han/han00426.asp?deliveryName=USCDC_511-DM17544.

The criteria above can also be found at https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html.  They are intended to serve as guidance for evaluation.  Patients whose clinical presentation or exposure history is not unequivocal should be evaluated and discussed with public health departments on a case-by-case basis.

CDC HAN re Influenza

CDC has issued a HAN Health Advisory on Elevated Influenza Activity: Influenza B/Victoria and A(H1N1)pdm09 Viruses are the Predominant Viruses, summarized by:

“This health advisory notifies clinicians that influenza activity remains high in the United States.  Ongoing elevated activity is due to influenza B/Victoria viruses, increasing circulation of influenza A(H1N1)pdm09 viruses, and low levels of influenza B/Yamagata and influenza A(H3N2) viruses.  CDC’s influenza forecasts suggest that national influenza activity will remain elevated for several more weeks.  Because influenza activity is elevated and both influenza A and B virus infections can cause severe disease and death, this health advisory also serves as a reminder that early treatment with antiviral medications improves outcomes in patients with influenza.  Early treatment with antiviral medications is recommended for hospitalized patients and high-risk outpatients…  Clinicians should continue efforts to vaccinate patients for as long as influenza viruses are circulating, and promptly start antiviral treatment of severely ill and high-risk patients with suspected influenza without waiting for laboratory confirmation.”

Find the full HAN at https://emergency.cdc.gov/han/han00425.asp?deliveryName=USCDC_511-DM17072.

12/18 NHSN Maintenance, Vs 9.4, Newsletter

The NHSN Dialysis Component will be down for “several hours” on December 18, 2019, starting at 6am PST, for scheduled maintenance.

NHSN Version 9.4 was released on December 7, 2019.  It includes many additions and changes, including analysis updates.  Review pages 1 (all Components) and 4-5 (Dialysis Component) of the Version 9.4 Release Notes at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/NHSN9.4ReleaseNotes.pdf for important details.  The new analysis output options require regeneration of datasets.  Email all questions to the NHSN Helpdesk at NHSN@cdc.gov.

The December 2019 NHSN Newsletter has been published.  It includes no dialysis-specific articles, but there are relevant general articles on pages 14ff covering NHSN Training in 2020 and CDA changes for Version 9.4.  Find it at https://www.cdc.gov/nhsn/pdfs/newsletters/nhsn-nl-dec19-508.pdf.

Slides from the December 4-5 NHSN Dialysis Surveillance Call can be found at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/NHSNDialysisEventUpdates2020.pdf.  They include sections on AKI, Data Quality Checks, Annual Training, Missing SIRs, Data Review, QIP Updates, and Version 9.4.

12/12+ Fall 2019 Provider Newsletter and Archive

We’ve published the Fall 2019 ESRD Network 16/18 Provider Newsletters.  Find them at:

We include links to earlier issues at the end of this post.  Most content is the same for both Networks, but not all.  We’ve marked where they differ, and we’ve used blue type where information in one version also applies to the other Network.  The Fall 2019 issue feature articles on:

  • Quality Improvement:
    • 2020 Quality Improvement Activities, which we expect to begin before Christmas.
    • Changes to the ESRD QIP, which include changes to measures for the Transplant Waitlist, Medication Reconciliation, Transfusions, and BSIs.  We’ve scheduled a December 12, 2019 webinar to summarize these QIP changes (and the many other measures that aren’t changing).
    • Opioid Awareness and Pain Management.
    • Diabetes Self-Management.
  • Patient Services:
    • Managing Patient Expectations to help create a calm and conflict-free environment.
    • The Dialysis Patient Depression Toolkit.
    • Patient Newsletters in English and Spanish for each Network.
  • Data:
    • The importance of Keeping Patient Information Up to Date, especially patient addresses, which are critical for tracking everyone in emergencies and disasters, for identifying home facilities and transplant centers near the patient, for receiving notices like the New ESRD Patient Orientation Packet, and for monitoring patient clusters so your organization can effectively plan where to locate new facilities.
    • A mini-lesson on how to admit a new patient into CROWNWeb if they do not have an SSN or MBI.
  • Emergency Preparedness:
    • Fire Danger Power Shutoffs and Fire Resources in California (NW18 version).
    • The new ESRD Facility Emergency Preparedness Final Rule that went into effect on November 29, 2019 (NW18 version but also relevant to NW16).
    • New KCER document on Emergency Disconnect Procedure for In-Center Hemodialysis Patients (NW16 version but also relevant to NW18).
    • Notify the Network of any Interruptions in Service.
    • KCER Newsletter.
  • Notify the Network of any Personnel Changes.
  • Upcoming Events!

We also list events of interest to Dialysis Facilities, Transplant Centers, and staff, on our Facility Calendar, via the link at the top of this page.

Find previous issues at:

12/4+ NHSN Webinar on 2020 Dialysis Component

NHSN will host a one-hour webinar titled NHSN Dialysis Surveillance Call on December 4, 2019, and repeat it on December 5, both at noon PST, that will detail updates to the NHSN Dialysis Component for 2020.  Pre-register for one or the other at the links below:

Use the same links to join the webinars at showtime.  Because Q&A time is limited, NHSN asks that if you have unanswered questions after the webinar, email their helpdesk at nhsn@cdc.gov with “Dialysis” in the subject line, and they will follow up with you directly.