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Epidemiologic Case Studies

Classroom Overview

A Multistate Outbreak of
E. coli O157:H7 Infection

Download this Classroom Case Study
English and German

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 staff from the Centers for Disease Control and Prevention:

  • National Center for Infectious Diseases (Division of Bacterial and Mycotic Diseases/Foodborne and Diarrheal Diseases Branch and Food Safety Office and 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.

Translation to German for the student and instructor versions was provided by: Wiebke Hellenbrand and Andrea Ammon, Centre for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.

Page Last Modified: January 25, 2006


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