Investigating Foodborne Illness Outbreaks Linked to Events

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An organization is investigating outbreaks of foodborne illnesses associated with two different events: a wedding in Pueblo and the National Western Stock Show. The wedding outbreak involves confirmed cases of Norovirus, affecting several guests, while the stock show outbreak is linked to E. coli O157:H7. Rapid responders are conducting interviews and administering questionnaires to identify the cause of these illnesses and prevent future outbreaks. Participants are urged to play out scenarios to practice effective interviewing techniques. Stay informed and take necessary precautions to address these health concerns promptly.


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  1. Exercise Instructions

  2. OUTBREAK OUTBREAK 1 1

  3. Norovirus Outbreak Associated with Wedding Norovirus Outbreak Associated with Wedding [ Organization name ] is investigating an outbreak linked to a wedding, which was held at a restaurant in Pueblo on April 20. Five people from the wedding are ill with diarrhea including the bride, the bride s father, and one of the bridesmaids. Three of the five have a laboratory confirmed Norovirus infection. To determine the cause of the outbreak, [ Organization name ] has decided to conduct a cohort study among wedding guests. The bride and groom, John and Sally Brown, have supplied [ Organization Name ] with their guest list.

  4. Rapid Responders Rapid Responders You have responded to a request from [ Organization Name ] to help with this cohort study Your job is to call people who attended the wedding on April 20thand interview them about the foods they ate during the wedding and whether or not they subsequently had a gastrointestinal illness

  5. Questionnaire instructions Questionnaire instructions Administer this questionnaire to people who attended the John and Sally Brown Wedding on April 20th Script A number of persons who attended the John and Sally Brown Wedding on April 20thdeveloped gastrointestinal illness after the event. In order to determine the cause of illness, we are asking everyone who attended the wedding to complete a brief questionnaire. YOUR HELP in completing this questionnaire (whether or not you or your child were ill) IS IMPORTANT to identify the cause of the illness, and prevent future illness in others.

  6. Exercise Instructions Exercise Instructions Break into pairs - Find person with matching Pathogen Decide who will be the interviewer and who will be the interviewee Interviewers: Review the questionnaire again Interviewees: Carefully read scenario cards - Play your part convincingly. These real-life scenarios are good practice for the interviewer! Switch roles when instructed and repeat

  7. OUTBREAK OUTBREAK 2 2

  8. E. coli O E. coli O157 157:H :H7 7 Outbreak a Stock Show Outbreak a Stock Show [ Organization Name ] is investigating an outbreak linked to the National Western Stock show. 20 people, including 17 children, became ill with E. coli O157. The stock show was from Jan. 10 to Jan. 25. There were 643,100 visitors over 16 days. To determine the cause of the outbreak, [ Organization Name ] is conducting a case- control study among persons <18 years of age who attended the stock show. The stock show has provided [ Organization Name ] with the names, addresses, and phone numbers for a random sample of people who purchased tickets for the stock show in advance.

  9. Rapid Responders Rapid Responders You have responded to a request from [ Organization Name ] to help with this case- control study Your job is to call people who attended the stock show, identify a suitable control, and interview that control (or their parent) about the events and exhibits that they visited while at the stock show FOR THE PURPOSES OF THIS EXERCISE THE DATE OF THIS INTERVEIW IS JANUARY 26th

  10. Questionnaire instructions Questionnaire instructions We are attempting to enroll two controls for each case. Controls are needed for the following age groups: - 15 months 4 years, 5 11 years, and 12 17 years Please use the following script as a guide to enrolling controls If you reach a stock show attendee who falls within an age group we are looking for, please administer the questionnaire to that person/parent. If there are multiple persons in the household who attended the stock show, please ask about the youngest person who attended. Our priority is to enroll controls in the younger age groups. When enrolling a control less than 18 years of age, please ensure you are speaking with a parent/guardian of the child

  11. Exercise Instructions Exercise Instructions Break into pairs - Find person with matching Outbreak Decide who will be the interviewer and who will be the interviewee Interviewers: Review the questionnaire again Interviewees: Carefully read scenario cards - Play your part convincingly. These real-life scenarios are good practice for the interviewer! Switch roles when instructed and repeat

  12. OUTBREAK OUTBREAK 3 3

  13. Multi Multi- -state outbreak of E. coli O state outbreak of E. coli O157 cookie dough cookie dough [ Organization Name ] is investigating a multi- state outbreak of E. coli O157 believed to be linked to the consumption of raw cookie dough. There are 20 cases in the state with a matching Pulsed-field Gel Electrophoresis (PFGE) pattern. To determine the cause of the outbreak, [ Organization Name ] is conducting a case- control study. Neighborhood controls will be contacted by phone using reverse-look-up based off of the case s address. 157 linked to raw linked to raw

  14. Rapid Responders Rapid Responders You have responded to a request from [ Organization Name ] to help with this case- control study. Your job is to randomly call people using sequential digit dialing (anchored on the case s telephone number) to recruit and interview controls. The questionnaire asks about foods and other exposures in the 7 days before the case became ill. FOR THE PURPOSES OF THIS EXERCISE THE DATE OF ILLNESS ONSET WAS MARCH 15th

  15. Questionnaire instructions Questionnaire instructions Please attempt to contact each potential control phone number until you successfully complete two control interviews. Please record your attempts on the control log. It is fine to leave a message for someone to call you back, or if you are more comfortable, you can leave Nicole s name and phone number. The questionnaire contains a script that guides you through the enrollment process. You do not need to follow the script verbatim it is simply a guide. There are eligibility criteria that a control must meet. If you find an eligible age-matched control who agrees participate, administer the questionnaire to the control (or parent/guardian for controls under the age of 18 years). If the household has more than one child in the age-group you are matching to, please ask the questions about the child whose birthday was the most recent. Write the corresponding case ID number of the top of each page of the questionnaire. Please answer EVERY question on this questionnaire if the answer is unknown , please check the unknown box.

  16. Exercise Instructions Exercise Instructions Break into pairs - Find person with matching Pathogen Decide who will be the interviewer and who will be the interviewee Interviewers: Review the questionnaire again Interviewees: Carefully read scenario cards - Play your part convincingly. These real-life scenarios are good practice for the interviewer! Switch roles when instructed and repeat

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