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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

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

  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.

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