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Medscape CME Activity

Medscape, LLC is pleased to provide online continuing medical education (CME) for selected journal articles, allowing clinicians the opportunity to earn Medscape CME credit. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide Medscape CME for physicians. The activities listed below have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.

Volume 18—2012

Volume 18, Number 12—December 2012

image of the 'Thumbnail' version of the Volume 18, Number 12—December 2012 cover of the CDC's EID journal
Medscape CME Activity
Farm Animal Contact as Risk Factor for Transmission of Bovine-associated Salmonella Subtypes PDF Version [PDF - 223 KB - 8 pages]
K. J. Cummings et al.
View Summary

Salmonellosis prevention should focus on safe animal contact as well as food safety.

Medscape CME Activity
Enterovirus 71–associated Hand, Foot, and Mouth Disease, Southern Vietnam, 2011 PDF Version [PDF - 249 KB - 4 pages]
T. Khanh et al.

Volume 18, Number 11—November 2012

image of the 'Thumbnail' version of the Volume 18, Number 11—November 2012 cover of the CDC's EID journal
Medscape CME Activity
Nasopharyngeal Bacterial Interactions in Children PDF Version [PDF - 193 KB - 8 pages]
Q. Xu et al.
View Summary

Pathogen prevalence differs during periods of health and at onset of acute otitis media.

Medscape CME Activity
Coccidioidomycosis-associated Deaths, United States, 1990–2008 PDF Version [PDF - 234 KB - 6 pages]
J. Y. Huang et al.
View Summary

Coccidioidomycosis is a fungal disease that occurs throughout the Americas. It is contracted by inhaling spores, which are carried in dust. Therefore, it occurs most commonly in dry areas and in persons who work in dusty conditions (such as agricultural workers, construction workers, military personnel, and archeological site workers). A substantial number of people die of this disease each year, so researchers examined what other factors increase the risk for death. They found that risk for death was highest among men, elderly persons (>65 years), Hispanics, Native Americans, residents of California and Arizona, and those who also had HIV or other immune-suppressive conditions. Physicians should be aware of which patients are at increased risk and should ask patients about their travel history or occupation to determine possible sources of exposure.

Medscape CME Activity
Invasive Pneumococcal Disease and 7-Valent Pneumococcal Conjugate Vaccine, the Netherlands PDF Version [PDF - 229 KB - 9 pages]
A. van Deursen et al.
View Summary

Disease incidence and case fatality rates declined 4 years after introduction of the vaccine.

Volume 18, Number 10—October 2012

image of the 'Thumbnail' version of the Volume 18, Number 10—October 2012 cover of the CDC's EID journal
Medscape CME Activity
Methicillin-Resistant Staphylococcus aureus Sequence Type 239-III, Ohio, USA, 2007–2009 PDF Version [PDF - 291 KB - 9 pages]
S. Wang et al.
View Summary

Identification of virulent strains emphasizes the need for molecular surveillance.

Medscape CME Activity
Epidemiology of Foodborne Norovirus Outbreaks, United States, 2001–2008 PDF Version [PDF - 215 KB - 8 pages]
A. J. Hall et al.
View Summary

In the United States, the leading cause of foodborne illness is norovirus; an average of 1 foodborne norovirus outbreak is reported every day. The more we know about how this virus is spread and in which foods, the better we can ward off future outbreaks. A recent study identified the most common sources of foodborne norovirus outbreaks as ready-to-eat foods that contain fresh produce and mollusks that are eaten raw, such as oysters. Most implicated foods had been prepared in restaurants, delicatessens, and other commercial settings and were most often contaminated by an infected food worker. Although possible contamination during production, harvesting, or processing cannot be overlooked, food safety during meal preparation should be emphasized. Food handlers should wash their hands, avoid bare-handed contact with ready-to-eat foods, and not work when they are sick.

Volume 18, Number 9—September 2012

image of the 'Thumbnail' version of the Volume 18, Number 9—September 2012 cover of the CDC's EID journal
Medscape CME Activity
Evaluation of Diagnostic and Therapeutic Approaches for Suspected Influenza A(H1N1)pdm09 Infection, 2009–2010 PDF Version [PDF - 335 KB - 8 pages]
V. Vijayan et al.
View Summary

Variations between practice and national recommendations could inform clinical education in future influenza seasons.

Medscape CME Activity
Effectiveness and Timing of Vaccination during School Measles Outbreak PDF Version [PDF - 458 KB - 9 pages]
A. Marinović et al.
View Summary

Implementing a vaccination campaign during an outbreak can effectively reduce the outbreak size.

Medscape CME Activity
Control of Fluoroquinolone Resistance through Successful Regulation, Australia PDF Version [PDF - 230 KB - 8 pages]
A. C. Cheng et al.
View Summary

Restricted Fluoroquinolone use in humans and food animals has result in low rates of resistance in human pathogens

Volume 18, Number 8—August 2012

image of the 'Thumbnail' version of the Volume 18, Number 8—August 2012 cover of the CDC's EID journal
Medscape CME Activity
Vaccination of Health Care Workers to Protect Patients at Increased Risk for Acute Respiratory Disease PDF Version [PDF - 379 KB - 10 pages]
G. P. Dolan et al.
View Summary

Evidence is limited but sufficient to sustain current vaccination recommendations.

Medscape CME Activity
Factors Related to Increasing Prevalence of Resistance to Ciprofloxacin and Other Antimicrobial Drugs in Neisseria gonorrhoeae, United States PDF Version [PDF - 311 KB - 8 pages]
E. Goldstein et al.
View Summary

What would you do if you had a sexually transmitted disease that was untreatable with antibiotics? That is the situation we may be heading toward. In the United States, gonorrhea is the second most common reportable infection. Over the years, the organism that causes it, N. gonorrhoeae, has acquired resistance to several classes of antibiotics including, most recently, the fluoroquinolones. In fact, widespread resistance led CDC to stop recommending fluoroquinolones for gonorrhea treatment in 2007. Today, cephalosporin-based combination therapy is the last remaining option currently recommended for gonorrhea treatment. Understanding of the causes of drug resistance is needed so that control measures can be improved and the effectiveness of the few remaining drugs can be maintained. This article investigates possible causes for the emergence of fluoroquinolone-resistant N. gonorrhoeae that occurred several years ago. Fluoroquinolone-resistant strains spread in the United States in the late 1990s and spread more rapidly among men who have sex with men (MSM) than among heterosexual men. One possible explanation for the rise in drug resistance, especially among heterosexuals, is acquisition of resistant gonorrhea through travel. Certain drug-resistant strains of N. gonorrhoeae, particularly the multidrug resistant strains (also resistant to penicillin and tetracycline) circulating among MSM, seemed to be able to reach high prevalence levels through domestic transmission, rather than through frequent importation. After resistance emerged in a geographic area, resistant strains appeared among MSM and heterosexuals within several months. When resistance is detected in either MSM or heterosexuals, prevention efforts should be directed toward both populations.

Medscape CME Activity
Paragonimus kellicotti Flukes in Missouri, USA PDF Version [PDF - 213 KB - 5 pages]
M. A. Lane et al.
View Summary

You don’t have to be a contestant on Fear Factor to eat unusual things. An investigation of 9 new cases of lung fluke infection in Missouri found that in all cases, patients had eaten raw crayfish while on rafting or camping trips and most had been drinking alcohol. Although all patients recovered after treatment, a few whose diagnosis was delayed had unnecessary procedures and serious illness. Physicians should consider lung fluke infection in patients with nonspecific cough and fever, especially patients who have recently returned from a recreational river trip. Crayfish in Missouri rivers often carry lung flukes and should not be eaten raw.

Volume 18, Number 7—July 2012

image of the 'Thumbnail' version of the Volume 18, Number 7—July 2012 cover of the CDC's EID journal
Medscape CME Activity
Assessment of Public Health Events through International Health Regulations, United States, 2007–2011 PDF Version [PDF - 228 KB - 7 pages]
K. S. Kohl et al.
View Summary

People and goods travel rapidly around the world, and so do infectious organisms. Sometimes a disease has already become widespread before it is detected and reported, which makes control efforts much more difficult. In response to this threat, the World Health Assembly enacted International Health Regulations that require participating countries to report public health events of international concern to the World Health Organization within 72 hours of detection. These health regulations went into effect in 2007 for all WHO Member States including the United States. By December 2011, 24 events reported by the United States were posted on a secure WHO web site, 12 of which were associated with influenza. Others reported were salmonellosis outbreaks, botulism, E. coli infections, Guillain-Barré syndrome, contaminated heparin, Lassa fever, an oil spill, and typhoid fever. International Health Regulations have improved global connectivity through rapid information exchange and increased awareness of threatening situations.

Medscape CME Activity
Low Pathogenic Avian Influenza A (H7N2) Virus Infection in Immunocompromised Adult, New York, USA, 2003 PDF Version [PDF - 185 KB - 4 pages]
B. Ostrowsky et al.

Volume 18, Number 6—June 2012

image of the 'Thumbnail' version of the Volume 18, Number 6—June 2012 cover of the CDC's EID journal
Medscape CME Activity
Iatrogenic Creutzfeldt-Jakob Disease, Final Assessment PDF Version [PDF - 291 KB - 7 pages]
P. Brown et al.
View Summary

The book on iatrogenic Creutzfeldt-Jakob disease (CJD) in humans is almost closed. This form of CJD transmission via medical misadventures was first detected in 1974. Today, only occasional CJD cases with exceptionally long incubation periods still appear. The main sources of the largest outbreaks were tissues from human cadavers with unsuspected CJD that were used for dura mater grafts and growth hormone extracts. A few additional cases resulted from neurosurgical instrument contamination, corneal grafts, gonadotrophic hormone, and secondary infections from blood transfusions. Although the final solution to the problem of iatrogenic CJD is still not available (a laboratory test to identify potential donors who harbor the infectious agent), certain other measures have worked well: applying special sterilization of penetrating surgical instruments, reducing the infectious potential of donor blood and tissue, and excluding donors known to have higher than normal risk for CJD.

Medscape CME Activity
Pretransplant Fecal Carriage of Extended-Spectrum β-Lactamase–producing Enterobacteriaceae and Infection after Liver Transplant, France PDF Version [PDF - 385 KB - 9 pages]
F. Bert et al.
View Summary

Bacterial infection after liver transplant is fairly common, mostly because liver transplant patients are severely ill and the surgery is very complex. Adding to the seriousness of this situation is that some bacteria are resistant to many antimicrobial drugs. However, treating all infections as drug resistant would lead to even more drug resistance, so only patients at highest risk should receive the most powerful drugs. But who is at highest risk? A recent study in France screened fecal samples of liver transplant candidates and found that post-operative infections were most likely for those patients who already had certain bacteria in their feces before surgery. Thus, fecal screening for those multiresistant bacteria should be considered for all liver transplant candidates so that if post-operative infection develops, those at high risk can receive the most specific drugs right away.

Medscape CME Activity
Trends in Invasive Infection with Methicillin-Resistant Staphylococcus aureus, Connecticut, USA, 2001–2010 PDF Version [PDF - 270 KB - 8 pages]
J. L. Hadler et al.
View Summary

Decreases in health care–related isolates accounted for all reductions in MRSA during 2007–2010.

Volume 18, Number 5—May 2012

image of the 'Thumbnail' version of the Volume 18, Number 5—May 2012 cover of the CDC's EID journal
Medscape CME Activity
Risk Factors for Intestinal Invasive Amebiasis in Japan, 2003–2009 PDF Version [PDF - 562 KB - 8 pages]
N. Nagata et al.
View Summary

Amebic colitis is increasing among younger men who have syphilis or HIV.

Medscape CME Activity
Invasive Haemophilus influenzae Serotype e and f Disease, England and Wales PDF Version [PDF - 300 KB - 8 pages]
S. N. Ladhani et al.
View Summary

Incidence of serotype e was 3-fold lower than serotype f, but it caused more severe clinical disease.

Volume 18, Number 4—April 2012

image of the 'Thumbnail' version of the Volume 18, Number 4—April 2012 cover of the CDC's EID journal
Medscape CME Activity
Influenza-associated Hospitalizations by Industry, 2009–10 Influenza Season, United States PDF Version [PDF - 183 KB - 7 pages]
S. E. Luckhaupt et al.
View Summary

Since the 2009 flu pandemic, questions have been raised about the risk for flu to health care workers. But what about other workers? Does having a job put a person at risk for flu? And does the type of job influence this risk? According to a CDC study, having a job is actually associated with a lower risk for hospitalization for flu, possibly because workers are generally young and healthy. But among workers who are hospitalized for flu, certain industries of employment were more common than others. Not surprisingly, the industry posing the highest risk was health care. Others included transportation and warehousing, administrative and support services, waste management and remediation services, and accommodation and food services. In the event of another pandemic, this information can be used to prioritize who should receive vaccine and to decide who needs personal protective equipment like face masks or respirators.

Medscape CME Activity
Determinants for Autopsy after Unexplained Deaths Possibly Resulting from Infectious Causes, United States PDF Version [PDF - 234 KB - 7 pages]
L. Liu et al.
View Summary

Autopsy findings, clinical history, and diagnostic tools can aid surveillance and investigation of infectious diseases.

Volume 18, Number 3—March 2012

image of the 'Thumbnail' version of the Volume 18, Number 3—March 2012 cover of the CDC's EID journal
Medscape CME Activity
Nonpasteurized Dairy Products, Disease Outbreaks, and State Laws—United States, 1993–2006 PDF Version [PDF - 268 KB - 7 pages]
A. J. Langer et al.
View Summary

Most dairy-associated outbreaks occurred in states that permitted sale of these products.

Medscape CME Activity
Community-associated Clostridium difficile Infections, Monroe County, New York, USA PDF Version [PDF - 314 KB - 9 pages]
G. Dumyati et al.
View Summary

Judicious use of antimicrobial drugs will reduce infections.

Volume 18, Number 2—February 2012

image of the 'Thumbnail' version of the Volume 18, Number 2—February 2012 cover of the CDC's EID journal
Medscape CME Activity
Invasive Pneumococcal Disease and Pandemic (H1N1) 2009, Denver, Colorado, USA PDF Version [PDF - 367 KB - 9 pages]
G. E. Nelson et al.
View Summary

Pneumococcal prevention strategies should be emphasized during future influenza pandemics.

Medscape CME Activity
Declining Guillain-Barré Syndrome after Campylobacteriosis Control, New Zealand, 1988–2010 PDF Version [PDF - 322 KB - 8 pages]
M. G. Baker et al.
View Summary

Food safety measures that lower incidence of campylobacteriosis might also prevent Guillain-Barré syndrome.

Volume 18, Number 1—January 2012

image of the 'Thumbnail' version of the Volume 18, Number 1—January 2012 cover of the CDC's EID journal
Medscape CME Activity
Intestinal Toxemia Botulism in 3 Adults, Ontario, Canada, 2006–2008 PDF Version [PDF - 208 KB - 6 pages]
Y. D. Sheppard et al.
View Summary

An underlying gastrointestinal condition is a risk factor for this disease.

Medscape CME Activity
Accelerating Control of Pertussis in England and Wales PDF Version [PDF - 330 KB - 10 pages]
H. Campbell et al.
View Summary

Pertussis incidence among infants can be reduced by early completion of the primary vaccination schedule.

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