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Volume 20, Number 7—July 2014

CME ACTIVITY - Research

Epidemiology of Influenza Virus Types and Subtypes in South Africa, 2009–20121

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 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-recognition-award.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™. 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:
Epidemiology of Influenza Virus Types and Subtypes in South Africa, 2009–2012

CME Questions

1. You are consulting for a hospital in South Africa regarding treatment of patients with severe acute respiratory illness (SARI). According to the surveillance study by Cohen and colleagues, which of the following statements about differences in characteristics of patients hospitalized with SARI by infection with different influenza types and subtypes is correct?

A. Patients with influenza A were more likely to be infected with HIV than patients with influenza B

B. Multivariate analysis showed significant differences between influenza A and B in co-infection with another virus, longer duration of hospitalization, and fever

C. Findings from this study make it easy to distinguish influenza A from influenza B clinically and to treat appropriately

D. Adjusted odds ratio for HIV infection was 1.4 for patients with influenza B vs those with influenza A

2. According to the surveillance study by Cohen and colleagues, which of the following statements about characteristics of patients hospitalized with SARI in South Africa by infection with different influenza types and subtypes during the first and second influenza A(H1N1)pdm09 waves is correct?

A. A lower proportion of patients infected during the first A(H1N1)pdm09 wave were 5 to 24 years old compared with patients in the second wave

B. During the first influenza A(H1N1)pdm09 wave, 19% of patients were 5 to 24 years old

C. The age distribution during the second wave did not have a bimodal distribution

D. HIV did not affect age distribution for the second wave

3. According to the surveillance study by Cohen and colleagues, which of the following statements about case fatality and severity rates among infections with different types and subtypes and between the first and second influenza A(H1N1)pdm09 waves would most likely be correct?

A. Influenza B had a significantly higher case fatality and severity rate than influenza A

B. The first influenza A(H1N1)pdm09 wave had a significantly higher case fatality and severity rate than the second wave

C. Case fatality rate was 2.8% for influenza A(H3N2), 1.5% for influenza A(H1N1)pdm09, and 3.9% for influenza B

D. Influenza B has a significantly higher rate of admission to intensive care, mechanical ventilation, oxygen requirement, and prolonged duration of hospitalization than influenza A

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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