Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
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

Main Article

Table 1

Costs of installing and operating the subtype-specific surveillance system, Colorado, 1996

Labor and equipment costs Total costs Escherichia coli-related costsa
Equipment $40,000 $16,000
Laboratory scientist (per year)b $10,000 $4,000
Analyzing the isolates (per year)c $12,000 $12,000
Investigating an outbreakd,e $9,600 $9,600
Present value of outbreak costs (in 5 years)f $90,568 $90,568
Annual operating costsg $41,200 $35,520

aFrom the proportion of E. coli isolates among the total number of isolates expected to be subtyped each year, we extrapolated that 40% of the equipment and labor costs were E. coli-related.
bThe salary and fringe benefits of a full-time laboratory analyst.
cAnalyzing 300 isolates at a cost of $40 per isolate.
dThis cost included, but was not limited to, the value of time (15 days) spent investigating an outbreak, answering telephone calls, conducting meetings, improving and transferring pulsed-field gel electrophoresis image files to various groups, creating databases, requesting information, responding to media calls, and handling legal issues. We assumed that, as a result of the system, two outbreaks would be investigated each year (6).
eThe costs of additional labor and the epidemiologic investigation of an outbreak were estimated at $5,000 and $4,600, respectively.
fAt a discount rate of 3%.
gLaboratory scientist ($10,000) + analyzing the isolates ($12,000) + investigating two outbreaks (2 x $9,600 = $19,200)

Main Article

References
  1. Griffin  PM, Tauxe  RV. The epidemiology of infections caused by Escherichia coli O157:H7, other enterohemorrhagic E. coli, and the associated hemolytic uremic syndrome. Epidemiol Rev. 1991;13:6098.PubMedGoogle Scholar
  2. American Gastroenterological Association. Consensus statement: Escherichia coli O157:H7 infections: an emerging national health crisis, July 11-13, 1994. Gastroenterology. 1995;108:192334. DOIPubMedGoogle Scholar
  3. Roberts  T, Buzby  J, Lin  J, Mead  P, Nunnery  P, Tarr  PI. Economic aspects of E. coli O157:H7: disease outcome trees, risk, uncertainty, and social cost of disease estimates. In: Prediction, detection, and management of tomorrow's epidemics. Greenwood B, De Cock K, eds. John Wiley & Sons, Chichester, UK. pp 156-72.
  4. Buzby  JC, Roberts  T, Lin  JC-T, MacDonald  JM. Bacterial foodborne disease: medical costs and productivity losses. Washington: U.S. Department of Agriculture, Economic Research Service. AER No. 741. August 1996.
  5. Centers for Disease Control and Prevention. Preliminary report: foodborne outbreak of Escherichia coli O157:H7 infections from hamburgers--western United States, 1993. MMWR Morb Mortal Wkly Rep. 1993;42:856.PubMedGoogle Scholar
  6. Bender  JB, Hedberg  CW, Besser  JM, Boxrud  DJ, MacDonald  KL, Osterholm  MT. Surveillance for Escherichia coli O157:H7 infections in Minnesota by molecular subtyping. N Engl J Med. 1997;337:38894. DOIPubMedGoogle Scholar
  7. Kolata  G. Detective work and science reveal a new lethal bacteria. New York Times. 1998 Jan 6;147:A1, A14.
  8. Bell  BP, Goldoft  M, Griffin  PM, Davis  MA, Gordon  DC, Tarr  PI, A multiple outbreak of Escherichia coli O157:H7-associated bloody diarrhea and hemolytic uremic syndrome from hamburgers: the Washington State experience. JAMA. 1994;272:134953. DOIPubMedGoogle Scholar
  9. Haddix  AC, Teutsch  SM, Shaffer  PA, Dunet  DO, eds. A guide to decision analysis and economic evaluation. New York: Oxford University Press; 1996.
  10. Gold  MR, Siegel  JE, Russell  LB, Weinstein  MC, eds. Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.
  11. Landefeld  JS, Seskin  EP. The economic value of life: linking theory to practice. Am J Public Health. 1982;6:55566. DOIGoogle Scholar
  12. Centers for Disease Control and Prevention. Enhanced detection of sporadic Escherichia coli O157:H7 infections--New Jersey, July, 1994. MMWR Morb Mortal Wkly Rep. 1993;44:4178.
  13. Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1998. MMWR Morb Mortal Wkly Rep. 1999;47:193.

Main Article

Page created: December 16, 2010
Page updated: December 16, 2010
Page reviewed: December 16, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external