Identification of the relative importance of within-and betweenhost variability in infectiousness and the impact of these heterogeneities on the transmission dynamics of infectious agents can enable efficient targeting of control measures. Cattle, a major reservoir host for the zoonotic pathogen Escherichia coli O157, are known to exhibit a high degree of heterogeneity in bacterial shedding densities. By relating bacterial count to infectiousness and fitting dynamic epidemiological models to prevalence data from a cross-sectional survey of cattle farms in Scotland, we identify a robust pattern: Ϸ80% of the transmission arises from the 20% most infectious individuals. We examine potential control options under a range of assumptions about within-and betweenhost variability in infection dynamics. Our results show that the within-herd basic reproduction ratio, R 0, could be reduced to <1 with targeted measures aimed at preventing infection in the 5% of individuals with the highest overall infectiousness. Alternatively, interventions such as vaccination or the use of probiotics that aim to reduce bacterial carriage could produce dramatic reductions in R 0 by preventing carriage at concentrations corresponding to the top few percent of the observed range of counts. We conclude that a greater understanding of the cause of the heterogeneity in bacterial carriage could lead to highly efficient control measures to reduce the prevalence of E. coli O157.bacterial count ͉ core groups ͉ super shedder ͉ superspreading ͉ targeted control T he role of heterogeneous infectiousness on the course of disease outbreaks was highlighted during the recent severe acute respiratory syndrome outbreak (1), in which a few individuals were responsible for a disproportionate number of transmission events. Awareness of heterogeneities in transmission dynamics can be important for the effective implementation of disease control measures and can lead to efficient targeting of interventions at a subset of the population (2-5). Factors that might lead to such heterogeneities include variability in infectiousness, exposure, genetic susceptibility, contact rates, and behavior (6-10). Quantifying their impact on the transmission dynamics can be achieved through direct methods, such as contact tracing and outbreak reconstruction (1, 11), or indirectly through their effect on the distribution of infected cases (12).Escherichia coli O157 is an important zoonosis with a known reservoir in cattle (13,14). Prevalences of infection are generally low, usually reported to be Ͻ10% of animals carrying the pathogen (14). Typically, however, the distribution of prevalences is highly skewed (15); at any one time, shedding is not detected in the majority of cattle groups, but a small proportion of groups contains high numbers of individuals shedding bacteria in their feces.The range of prevalences of an infectious agent in a small population is expected to be influenced both by stochasticity and underlying heterogeneities in the transmission dynamics. In a recent a...