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Volume 6, Number 3—June 2000


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 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)

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