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Earning CME Credit.

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions (with a minimum 75% passing score) and earn continuing medical education (CME) credit, please go to http://www.medscape.org/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.org. If you are not registered on Medscape.org, please click on the "Register" link on the right hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association's Physician's Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/about-ama/awards/ama-physicians- recognitionaward.page. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits[TM]. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit may be acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questions online, print the certificate and present it to your national medical association for review.

Article Title

Pregnancy, Labor, and Delivery after Ebola Virus Disease and Implications for Infection Control in Obstetric Services, United States

1. You are evaluating a 26-year-old woman at 8 weeks' estimated gestational age of her first pregnancy. She has no complaints, and the only significant risk factor she has for her pregnancy is a history of Ebola virus disease (EVD) 6 months ago. She has been asymptomatic and free of the virus for the past 4 months. What should you consider regarding special considerations for the maternity care of this patient?

A. Ebola virus is rarely transmitted vertically among women with active infection

B. Ebola virus is not shed into breast milk

C. Ebola virus may persist in amniotic fluid after the period of active infection

D. Good evidence exists that the Ebola virus persists in the female genital tract for months after acute symptoms have resolved

2. According to the current report on Ebola virus, which of the following statements about the labor and delivery of the patient with a history of EVD is most accurate?

A. The infant was delivered at a normal weight for gestational age and had normal Apgar scores

B. Her first detailed anatomy ultrasound in the United States demonstrated microcephaly

C. She underwent induction of labor because of early signs of fetal distress

D. Epidural anesthesia was contraindicated because of the potential for Ebola virus retained in the cerebrospinal fluid

3. Which of the following statements regarding precautions taken during the patient's labor and delivery is most accurate?

A. The care team neglected to call public health officials

B. No additional precautions were recommended beyond routine standards for delivery

C. The number of care providers attending the delivery was limited to 3

D. One member of the environmental staff team had contact with the patient's room once daily

4. Which of the following laboratory assessments yielded a positive result in the current case of this patient?

A. Cord blood for immunoglobulin G (IgG) against Ebola virus

B. Amniotic fluid for IgG against Ebola virus

C. Amniotic fluid for immunoglobulin M (IgM) against Ebola virus

D. Neonatal ear swabs for Ebola virus by real-time reverse transcription polymerase chain reaction
CME Questions Activity Evaluation

1. The activity supported the
learning objectives.

Strongly Disagree                Strongly Agree

1                    2   3   4         5

2. The material was organized clearly
for learning to occur.

Strongly Disagree                Strongly Agree

1                    2   3   4         5

3. The content learned from this
activity will impact my practice.

Strongly Disagree                Strongly Agree

1                    2   3   4         5

4. The activity was presented objectively
and free of commercial bias.

Strongly Disagree                Strongly Agree

1                    2   3   4         5


Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions (with a minimum 75% passing score) and earn continuing medical education (CME) credit, please go to http://www.medscape.org/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.org. If you are not registered on Medscape.org, please click on the "Register" link on the right hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association's Physician's Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/about-ama/awards/ama-physicians- recognitionaward.page. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits[TM]. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit may be acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questions online, print the certificate and present it to your national medical association for review.

Article Title

Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States

1. You are advising a large health maintenance organization regarding Lyme disease diagnostics. According to the review by Moore and colleagues, which of the following statements about current US testing guidelines for Lyme disease is correct?

A. Patients with an erythema migrans lesion and epidemiologic risk who live in or have traveled to Lyme-endemic areas require laboratory testing to confirm the diagnosis

B. The diagnostic test of choice for all patients presenting with signs of extracutaneous Lyme disease is a 3-tiered serologic test

C. Recommended diagnostic testing is an enzyme-linked immunoassay (EIA or ELISA) or immunofluorescence assay (IFA) followed by a reflex Western immunoblot

D. The US Food and Drug Administration (FDA) has approved IFA, but not EIA, for first-tier serologic testing for Lyme disease

2. According to the review by Moore and colleagues, which of the following statements about appropriate use and interpretation of tests for Lyme disease is correct?

A. To accurately order and interpret tests for Lyme disease, clinicians must consider the patient's history, timeline of symptoms, and pretest probability

B. Sensitivity of 2-tiered testing is high during early infection

C. Sensitivity of 2-tiered testing is 30% to 40% for disseminated Lyme disease

D. Specificity of 2-tiered testing is low during early infection, so clinicians should use alternative laboratory tests

3. According to the review by Moore and colleagues, which of the following statements about recent developments in Lyme disease diagnostics would most likely be correct?

A. Used as a standalone test, C6 EIA is more prone to false-negative results than the current 2-tiered test in patients with early Lyme disease

B. Novel 2-tiered approaches still require Western immunoblotting for the second-tier

C. Proteomics and metabolomics are useful only for diagnosis

D. The Centers for Disease Control and Prevention/ National Institutes of Health repository of sera from patients with Lyme disease, potentially cross-reactive conditions, and healthy control participants allows validation of novel diagnostic tests
CME Questions Activity Evaluation

1. The activity supported the
learning objectives.

Strongly Disagree                  Strongly Agree
1                      2   3   4         5

2. The material was organized clearly
for learning to occur.

Strongly Disagree                  Strongly Agree
1                      2   3   4         5

3. The content learned from this activity
will impact my practice.

Strongly Disagree                  Strongly Agree
1                      2   3   4         5

4. The activity was presented objectively
and free of commercial bias.

Strongly Disagree                  Strongly Agree
1                      2   3   4         5


Emerging Infectious Diseases is a peer-reviewed journal established expressly to promote the recognition of new and reemerging infectious diseases around the world and improve the understanding of factors involved in disease emergence, prevention, and elimination.

The journal is intended for professionals in infectious diseases and related sciences. We welcome contributions from infectious disease specialists in academia, industry, clinical practice, and public health, as well as from specialists in economics, social sciences, and other disciplines. Manuscripts in all categories should explain the contents in public health terms. For information on manuscript categories and suitability of proposed articles, see below and visit http://wwwnc.cdc.gov/eid/pages/author-resource-center.htm.

Summary of Authors' Instructions

Author's Instructions. For a complete list of EID's manuscript guidelines, see the author resource page: http://wwwnc.cdc.gov/eid/page/author-resource-center.

Manuscript Submission. To submit a manuscript, access Manuscript Central from the Emerging Infectious Diseases web page (www.cdc.gov/eid). Include a cover letter indicating the proposed category of the article (e.g., Research, Dispatch), verifying the word and reference counts, and confirming that the final manuscript has been seen and approved by all authors. Complete provided Authors Checklist.

Manuscript Preparation. For word processing, use MS Word. Set the document to show continuous line numbers. List the following information in this order: title page, article summary line, keywords, abstract, text, acknowledgments, biographical sketch, references, tables, and figure legends. Appendix materials and figures should be in separate files.

Title Page. Give complete information about each author (i.e., full name, graduate degree(s), affiliation, and the name of the institution in which the work was done). Clearly identify the corresponding author and provide that author's mailing address (include phone number, fax number, and email address). Include separate word counts for abstract and text.

Keywords. Use terms as listed in the National Library of Medicine Medical Subject Headings index (www.ncbi.nlm.nih.gov/mesh).

Text. Double-space everything, including the title page, abstract, references, tables, and figure legends. Indent paragraphs; leave no extra space between paragraphs. After a period, leave only one space before beginning the next sentence. Use 12-point Times New Roman font and format with ragged right margins (left align). Italicize (rather than underline) scientific names when needed.

Biographical Sketch. Include a short biographical sketch of the first author--both authors if only two. Include affiliations and the author's primary research interests.

References. Follow Uniform Requirements (www.icmje.org/index.html). Do not use endnotes for references. Place reference numbers in parentheses, not superscripts. Number citations in order of appearance (including in text, figures, and tables). Cite personal communications, unpublished data, and manuscripts in preparation or submitted for publication in parentheses in text. Consult List of Journals Indexed in Index Medicus for accepted journal abbreviations; if a journal is not listed, spell out the journal title. List the first six authors followed by "et al." Do not cite references in the abstract.

Tables. Provide tables within the manuscript file, not as separate files. Use the MS Word table tool, no columns, tabs, spaces, or other programs. Footnote any use of boldface. Tables should be no wider than 17 cm. Condense or divide larger tables. Extensive tables may be made available online only.

Figures. Submit editable figures as separate files (e.g., Microsoft Excel, PowerPoint). Photographs should be submitted as high-resolution (600 dpi) .tif or .jpeg files. Do not embed figures in the manuscript file. Use Arial 10 pt. or 12 pt. font for lettering so that figures, symbols, lettering, and numbering can remain legible when reduced to print size. Place figure keys within the figure. Figure legends should be placed at the end of the manuscript file.

Videos. Submit as AVI, MOV, MPG, MPEG, or WMV. Videos should not exceed 5 minutes and should include an audio description and complete captioning. If audio is not available, provide a description of the action in the video as a separate Word file. Published or copyrighted material (e.g., music) is discouraged and must be accompanied by written release. If video is part of a manuscript, files must be uploaded with manuscript submission. When uploading, choose "Video" file. Include a brief video legend in the manuscript file.

Types of Articles

Perspectives. Articles should not exceed 3,500 words and 40 references. Use of subheadings in the main body of the text is recommended. Photographs and illustrations are encouraged. Provide a short abstract (150 words), 1-sentence summary, and biographical sketch. Articles should provide insightful analysis and commentary about new and reemerging infectious diseases and related issues. Perspectives may address factors known to influence the emergence of diseases, including microbial adaptation and change, human demographics and behavior, technology and industry, economic development and land use, international travel and commerce, and the breakdown of public health measures.

Synopses. Articles should not exceed 3,500 words in the main body of the text or include more than 40 references. Use of subheadings in the main body of the text is recommended. Photographs and illustrations are encouraged. Provide a short abstract (not to exceed 150 words), a 1-line summary of the conclusions, and a brief biographical sketch of first author or of both authors if only 2 authors. This section comprises case series papers and concise reviews of infectious diseases or closely related topics. Preference is given to reviews of new and emerging diseases; however, timely updates of other diseases or topics are also welcome. If detailed methods are included, a separate section on experimental procedures should immediately follow the body of the text.

Research. Articles should not exceed 3,500 words and 40 references. Use of subheadings in the main body of the text is recommended. Photographs and illustrations are encouraged. Provide a short abstract (150 words), 1-sentence summary, and biographical sketch. Report laboratory and epidemiologic results within a public health perspective. Explain the value of the research in public health terms and place the findings in a larger perspective (i.e., "Here is what we found, and here is what the findings mean").

Policy and Historical Reviews. Articles should not exceed 3,500 words and 40 references. Use of subheadings in the main body of the text is recommended. Photographs and illustrations are encouraged. Provide a short abstract (150 words), 1-sentence summary, and biographical sketch. Articles in this section include public health policy or historical reports that are based on research and analysis of emerging disease issues.

Dispatches. Articles should be no more than 1,200 words and need not be divided into sections. If subheadings are used, they should be general, e.g., "The Study" and "Conclusions." Provide a brief abstract (50 words); references (not to exceed 15); figures or illustrations (not to exceed 2); tables (not to exceed 2); and biographical sketch. Dispatches are updates on infectious disease trends and research that include descriptions of new methods for detecting, characterizing, or subtyping new or reemerging pathogens. Developments in antimicrobial drugs, vaccines, or infectious disease prevention or elimination programs are appropriate. Case reports are also welcome.

Another Dimension. Thoughtful essays, short stories, or poems on philosophical issues related to science, medical practice, and human health. Topics may include science and the human condition, the unanticipated side of epidemic investigations, or how people perceive and cope with infection and illness. This section is intended to evoke compassion for human suffering and to expand the science reader's literary scope. Manuscripts are selected for publication as much for their content (the experiences they describe) as for their literary merit. Include biographical sketch.

Letters. Letters commenting on recent articles as well as letters reporting cases, outbreaks, or original research, are welcome. Letters commenting on articles should contain no more than 300 words and 5 references; they are more likely to be published if submitted within 4 weeks of the original article's publication. Letters reporting cases, outbreaks, or original research should contain no more than 800 words and 10 references. They may have 1 figure or table and should not be divided into sections. No biographical sketch is needed.

Commentaries. Thoughtful discussions (500-1,000 words) of current topics. Commentaries may contain references (not to exceed 15) but no abstract, figures, or tables. Include biographical sketch.

Books, Other Media. Reviews (250-500 words) of new books or other media on emerging disease issues are welcome. Title, author(s), publisher, number of pages, and other pertinent details should be included.

Conference Summaries. Summaries of emerging infectious disease conference activities (500-1,000 words) are published online only. They should be submitted no later than 6 months after the conference and focus on content rather than process. Provide illustrations, references, and links to full reports of conference activities.

Online Reports. Reports on consensus group meetings, workshops, and other activities in which suggestions for diagnostic, treatment, or reporting methods related to infectious disease topics are formulated may be published online only. These should not exceed 3,500 words and should be authored by the group. We do not publish official guidelines or policy recommendations.

Photo Quiz. The photo quiz (1,200 words) highlights a person who made notable contributions to public health and medicine. Provide a photo of the subject, a brief clue to the person's identity, and five possible answers, followed by an essay describing the person's life and his or her significance to public health, science, and infectious disease.

Etymologia. Etymologia (100 words, 5 references). We welcome thoroughly researched derivations of emerging disease terms. Historical and other context could be included.

Announcements. We welcome brief announcements of timely events of interest to our readers. Announcements may be posted online only, depending on the event date. Email to eideditor@cdc.gov.
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Title Annotation:continuing medical education
Publication:Emerging Infectious Diseases
Date:Jul 1, 2016
Words:3005
Previous Article:Upcoming infectious disease activities.
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