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Volume 6, Number 3—June 2000

Dispatch

Costs and Benefits of a Subtype-Specific Surveillance System for Identifying Escherichia coli O157:H7 Outbreaks

Elamin H. Elbasha*Comments to Author , Thomas D. Fitzsimmons*†, and Martin I. Meltzer*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and †Colorado Department of Public Health and Environment, Denver, Colorado, USA

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Table 3

Discounted costs of an Escherichia coli O157:H7 infection, discounted costs of the surveillance system, and threshold number of cases, 1996

Discount Ratea
3% 0% 5%
Discounted average cost of an E. coli O157:H7 infection $7,788 $15,927 $5,847
Discounted costs of installing and operating the system $182,042 $192,000 $176,018
Baseline (best estimate)
Cases that need to be averted every year for 5 yearsb 5.0 2.4 6.6
Cases that need to be averted in the first year alonec 14.2 7.2 18.5
One-way sensitivity analysis
Increasing labor and equipment costs from $20,000 to $50,000
Cases that need to be averted every year for 5 yearsb 6.4 3.1 8.6
Cases that need to be averted in the first year alonec 20.9 10.6 27.2
Decreasing the costs of an infection from $7,788 to $3,894
Cases that need to be averted every year for 5 yearsb 9.9 4.8 13.2
Cases that need to be averted in the first year alonec 28.4 14.5 36.9
Increasing the probability of death from 0.4% to 2.3%
Cases that need to be averted every year for 5 yearsb 1.5 0.5 2.6
Cases that need to be averted in the first year alonec 4.3 1.5 7.3

aThe most frequently assumed discount rate is 5%. However, 3% is the recommended rate. No discounting is suggested for testing the sensitivity of the results (10).
bThreshold number of cases averted every year for 5 years above which the system is cost-beneficial.
cThreshold number of cases averted in the first year above which the system is cost-beneficial, assuming the system does not avert any cases in subsequent years and continues to incur costs.

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