Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

Multistate Outbreak of E. coli O157:H7 Infection

Target Audience

Public health practitioners with knowledge of basic epidemiologic concepts and experience in data collection and analysis.

Learning Objectives

After completing this case study, the student should be able to:

  • Describe the unique role the laboratory can play in the detection and investigation of a foodborne disease outbreak.
  • Perform in-depth interviews of selected case-patients to generate hypotheses about the source of an outbreak and mode of transmission.
  • Determine the most efficient epidemiologic study design to test a hypothesis (including the case definition and appropriate comparison group).
  • List three ways to select a comparison group for a case-control study and the advantages and disadvantages of each method.
  • List detailed product information that will facilitate a traceback procedure.
  • Discuss the relative merits of an intervention based on changes in product processing (or design) versus changes in consumer or producer behaviors.


Successful completion of training in descriptive epidemiology, epidemic curves, measures of association, stratified analysis, study design, and outbreak investigation.


English and German




3 to 4 hours

Continuing Education

Continuing education credits are not available for completing this case study.

Developed By

Jeanette K. Stehr-Green, MD, developed this case study in close collaboration with individuals from the Centers for Disease Control and Prevention (CDC) who represented the following organizations:

  • National Center for Infectious Diseases, Division of Bacterial and Mycotic Diseases, Foodborne and Diarrheal Diseases Branch, Food Safety Office, Division of Parasitic Diseases
  • Epidemiology Program Office, Division of International Health
  • Public Health Practice Program Office, Division of Professional Development and Evaluation

Original Investigation Team

The following individuals investigated the original outbreak of E. coli O157:H7 infection in Michigan and Virginia: Thomas Breuer, Denise H. Benkel, Roger L. Shapiro, William N. Hall, Mary M. Winnett, Mary Jean Linn, Jakob Neimann, Timothy Barrett, Stephen Dietrich, Francis P. Downes, Denise M. Toney, James L. Pearson, Henry Rolka, Laurence Slutsker, and Patricia M. Griffin.

Contact Us:
  • Centers for Disease Control and Prevention
    Office of Surveillance, Epidemiology, and Laboratory Services
    Mail Stop E-96
    1600 Clifton Rd
    Atlanta, GA 30333
  • 800-CDC-INFO
    TTY: (888) 232-6348
    8am-8pm ET/Mon-Fri
    Closed Holidays
  • The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #