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A case-control study of restaurant patrons and a retrospective cohort study of catered event attendees were conducted coupled with an environmental investigation to determine the outbreak's source and mode of transmission. Of 1823 persons interviewed, 341 (18\u00b77%) met the outbreak case definition; 70 (20\u00b75%) were hospitalized, 25 (7\u00b73%) developed haemolytic uraemic syndrome, and one died. Multiple food items were significantly associated with illness by both bivariate and multivariate analyses, but none stood out as a predominant transmission vehicle. All water, food, and restaurant surface swabs, and stool cultures from nine ill employees were negative for the presence of Shiga toxin and<jats:italic>E. coli<\/jats:italic>O111:NM although epidemiological evidence suggested the outbreak resulted from cross-contamination of restaurant food from food preparation equipment or surfaces, or from an unidentified infected food handler.<\/jats:p>","DOI":"10.1017\/s0950268811002329","type":"journal-article","created":{"date-parts":[[2011,11,25]],"date-time":"2011-11-25T13:11:37Z","timestamp":1322226697000},"page":"1644-1654","source":"Crossref","is-referenced-by-count":39,"title":["Epidemiology of a large restaurant-associated outbreak of Shiga toxin-producing<i>Escherichia coli<\/i>O111:NM"],"prefix":"10.1017","volume":"140","author":[{"given":"K. K.","family":"BRADLEY","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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