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Volume 23, Number 10—October 2017

Economic Assessment of Waterborne Outbreak of Cryptosporidiosis

Aksana Chyzheuskaya, Martin Cormican, Raghavendra Srivinas, Diarmuid O’Donovan, Martina Prendergast, Cathal O’Donoghue, and Dearbháile MorrisComments to Author 
Author affiliations: National University of Ireland Galway, Galway, Ireland (A. Chyzheuskaya, M. Cormican, R. Srivinas, D. O’Donovan, M. Prendergast, D. Morris); Health Service Executive, Galway (M. Cormican, D. O’Donovan); Teagasc, Athenry, Ireland (C. O’Donoghue)

Main Article

Table 1

Description of costs included in economic assessment of waterborne outbreak of cryptosporidiosis, Galway, Ireland, 2007*

Characteristic Value and assumption Source
Private sector
No. households 45,160 (17)
Cost of extra bottled water 48% reported buying bottled water; 80% increased bottled water use from 3.2 L to 16 L/wk; 20% increased use from 3.2 L to 20 L/wk; €0.50/L HSE, 2007; estimated bottled water retail price
Cost of boiling water Use of boiled water/household: drinking >12%, 2.1L/adult/d, 1 L/child/d; cooking >30%, 2 L/household/d; dishwashing >43%, 10 L/household/d; hygiene >14% 250 mL/person/d; €0.01/L (15)
Sick persons
No. reported 242 HSE, 2007
No. not reported 498, 71% not reported (16); HSE, 2007
GP visits €50/visit, 1 GP visit/confirmed case; all reported patients consulted GP; GMS cost €50.46 (assumed to be €50) HSE primary care reimbursement service, 2008
Self-medication €9.26 for antidiarrheal medication; €6.99 for ORS (1 pack); 30% self-medication for reported; 17.6% self-medication for not reported Pharmacy prices; (7)
Loss of income €122.85/d; 5 d of work missed (all nonhospitalized reported patients and 17.4% of not reported patients); 10 d of work missed for hospitalized patients Central Statistics Office, 2007; HSE, 2007
Loss of income for caregivers €122.85/day; children <15 and persons >65 years of age (n = 195); 1 caregiver took 5 d off from work; average 10 d off from work for hospitalized patients Central Statistics Office, 2007; (4); HSE, 2007
Cost of missing college/school Reported: €69.20/student/d; 5 d missed (10 d for hospitalized patients); not reported: 19% took time off from school/college; average 5 d missed, €69.20/student/d Central Statistics Office, 2007; (16); HSE, 2007
Cost to businesses
Productivity loss €134/person/d; average 5 d; 10 d for hospitalized persons and caregivers Health and Safety Times, 2011
Hotels, B and Bs, hostels
Extra water 4.2 L/room/d; 2.1 L/person/day (18)
Cancellations 13% cancelation rate; 57% occupancy rate IPSOS Mori survey
Other assumptions No. businesses: 70 hotels, 134 B and B, and 18 hostels; no. rooms: 79/hotel, 5/B and B, and 134/hostel; price: €66 hotels, €65 B and B, and €17 hostels
Care industry†
Bottled water 2.1 L/person/d (18)
Boiled water 1.5 L/person/d
Other factors 18 nursing homes in boil water–alert area; average no. residents 41, total no. residents for analysis 742; 168 nurseries/day care centers and 19 child minders; assume 3 children/child minder; average 29 children/nursey or day care center; no. children in nurseries or day care centers 4,929
Public sector costs, €
Galway City Council 3,388,840.33 Galway City Council
Galway County Council 2,472,837 Galway County Council
EPA 20,000 EPA
Emergency department cost 100; 1.3% of reported patients visited ED           HSE, (14)
5,810 extra species detection tests 46.06 University Hospital Galway (no. laboratory tests); commercial service provider (cost)
3,000 extra fecal culture tests 59.58 University Hospital Galway (no. laboratory tests); commercial service provider (cost)
Hospital admissions 753/person/d; 35% admitted to hospital for 10 d HSE, 2007
Response team (representatives from all public sector categories)
Opportunity cost of labor 356/consultant/meeting; 16 persons; 28 meetings IPS

*B and Bs, bed and breakfast; ED, emergency department; EPA, Environmental Protection Agency of Ireland; GMS, general medical scheme; GP, general practitioner; HSE, Health Service Executive; IPS, Institute of Public Administration; ORS, oral rehydration solution.
†Nursing homes, nurseries, and day care centers.

Main Article

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Main Article

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