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Volume 19, Number 2—February 2013

CME ACTIVITY

Eastern Equine Encephalitis in Children, Massachusetts and New Hampshire,USA, 1970–2010

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 70% passing score) 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 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:
Eastern Equine Encephalitis in Children, Massachusetts and New Hampshire, USA, 1970–2010

CME Questions

1. You are evaluating a 10-year-old girl with a 2-day history of fever and malaise. The girl’s parents are worried because of reports of 2 confirmed cases of Eastern equine encephalitis (EEE) in the state during the past 3 weeks. Based on the current study by Silverman and colleagues, which of the following statements regarding the clinical presentation of EEE is most accurate?

A. Cases were diagnosed between November and February

B. Half of patients had fever at the time of presentation for medical care

C. All patients had symptoms or signs of meningoencephalitis at the time of presentation for medical care

D. The mean age of patients was approximately 10 years

2. What should you consider regarding findings on ancillary studies of children with EEE in the current study?

A. Neutrophilic cerebrospinal fluid (CSF) pleocytosis was present in all patients

B. CSF protein levels were generally normal

C. Epileptiform activity was universal among patients who received EEG

D. Lesions were most common in the pons on neuroimaging studies

3. The patient is diagnosed with EEE. Which of the following variables was most important in predicting a worse outcome in the current study?

A. Younger age

B. Seizure at the time of presentation

C. Higher levels of total protein in CSF

D. Shorter prodrome

4. The patient’s parents are very concerned regarding the prognosis for their daughter. What was the most common outcome of EEE in the current study?

A. Death or severe neurologic deficits

B. Some form of mild neurologic impairment only

C. Seizure disorder only

D. Complete recovery with no sequelae

Activity Evaluation

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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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