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Thank you for submitting your exhibit to the International Outbreak Museum. The details you give on this form will be the basis for your outbreak exhibit. All fields are required, and will appear on the exhibit museum page.

Museum exhibits must include at least one picture (attachment buttons are below)
   Optional materials are encouraged: publication citation, presentations, investigation tools.

Exhibit Submitted By:
   

Submitter's Organization:
   

Investigational Jurisdiction:
Local Health DepartmentState Health DepartmentFederal Health Department
Other:

Pathogen:
   

Vehicle, venue, or both:
   

Case Counts:
   Confirmed:     Presumptive:     Suspect:

Geographic Distribution of Cases:
Single CountyMultiple CountiesState-WideMulti-stateInternational

First Onset Date:
   

Last Onset Date:
   

Positive non-human specimens (estimate okay):
   Water:       Environmental:  

      Food:                           Other:  

Please limit the two sections below to a total of 1,000 words.
   Recommendation (because web browsers aren't perfect): Type your Summary and Abstract text in a word processor first, then copy and paste.

Summarize the outbreak investigation (1-2 paragraphs):

Abstract (background, methods, results, conclusions):

Maximum attachment file size: 5mb each. File type must be one of the following:
PNG; JPG; JPEG; TXT; XLSX; PDF; DOC; PPTX; FMP12; or DOCX
Attachments outside these requirements should be emailed directly to fomes.comments@state.or.us



I consent to the release of digital rights and copyright for all materials for this exhibit. (Required)

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