Healthcare providers are required to report cases of STEC infection to the LHD within one working day of identification or immediately by telephone if an outbreak of STEC or case of post-diarrheal HUS is suspected. Clinical laboratories are required to submit clinical STEC isolates or Shiga toxin-positive specimens to a local public health laboratory or the California Department of Public Health Microbial Diseases Laboratory for serotyping and molecular subtyping. Please follow up with the clinical laboratory to make sure that the isolate has been appropriately submitted, and document the final laboratory reports in the STEC case report form (either in CalREDIE or in the hardcopy version). Due to the low infectious dose of STEC, LHDs may need to restrict the activities of persons with STEC infection from certain work or activities (such as food handling, health care, or day care) until they have been examined and cleared by their LHD. All patients with STEC infection should be educated regarding disease transmission and appropriate infection control measures.