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Volume 17, Number 5—May 2011

CME ACTIVITY

Lessons Learned about Pneumonic Plague Diagnosis from 2 Outbreaks, Democratic Republic of the Congo

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 and earn continuing medical education (CME) credit, please go to 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 New Users: Free Registration link on the left 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/category/2922.html. 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™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit is acceptable as evidence of participation in CME activities. If you are not licensed in the US and want to obtain an AMA PRA CME credit, please complete the questions online, print the certificate and present it to your national medical association.

Lessons Learned about Pneumonic Plague Diagnosis from 2 Outbreaks, Democratic Republic of the Congo

Medscape CME Questions

1. You are a public health official asked to consult in a war-torn region of Africa nonendemic for pneumonic plague. Based on the above report by Dr. Bertherat and colleagues, which of the following observations concerning a new outbreak of respiratory infection would make pneumonic plague most likely?

A. Productive cough

B. Gradual progression of symptoms over 1-2 weeks

C. Spontaneous recovery in most cases

D. High mortality rate within 2–4 days after respiratory exposure

2. Based on the above report, which of the following statements about recent outbreaks of pneumonic plague in the Democratic Republic of the Congo (DRC) is most likely correct?

A. Diagnostic strategies used for the 2005 and 2006 outbreaks were similar

B. The Oriental Province where the outbreaks occurred had pre-existing stable infrastructure facilitating diagnosis

C. In the second outbreak, detecting the F1-antigen by rapid diagnostic tests (RDT) strengthened the frontline response strategy

D. Specialized sampling kits allowed rapid recognition of the first outbreak

3. As a public health official (described in Question 1), which of the following are you most likely to consider for frontline response strategy to pneumonic plague based on the above report?

A. Transporting specimens to distant laboratories with better facilities is preferred

B. Specimen collection kits and RDT must be provided for first-line detection and collection

C. RDT is sufficient for surveillance

D. Outbreaks in previously plague-free areas can be managed locally

Activity Evaluation

1. The activity supported the learning objectives.
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2. The material was organized clearly for learning to occur.
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3. The content learned from this activity will impact my practice.
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4. The activity was presented objectively and free of commercial bias.
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