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 2

Assumptions about disease severity following an Escherichia coli O157:H7 infectiona

Severity category Assumptions
No. 1 Patient does not seek medical care, recovers, and misses 2 days of work
No. 2 Patient seeks medical care for hemorrhagic colitis, has one laboratory test, recovers, and misses 4 days of work
No. 3 Patient is hospitalized for hemorrhagic colitis for 6.5 days and recovers after missing 14 days of work
No. 4 Patient is hospitalized for hemorrhagic colitis for 6.5 days, misses 14 days of work, and dies in the first year
No. 5 Patient is hospitalized for acute HUSb for 5 days in ICUc and 10 days in a regular room, and recovers after missing 32 days of work
No. 6 Patient is hospitalized for acute HUSb for 5 days in ICUc and 10 days in a regular room, requires dialysis for 12 days, and recovers after missing 32 days of work
No. 7 Patient is hospitalized for hemorrhagic colitis; comes down with chronic HUSb; may require dialysis, transplants, or drug therapy; cannot work for an extended period; and recovers
No. 8 Patient is hospitalized for hemorrhagic colitis; comes down with chronic HUSb; may require dialysis, transplants, or drug therapy; cannot work for an extended period; and dies
No. 9 Patient is hospitalized for acute HUSb for 5 days in ICUc and 10 days in a regular room and dies after missing 32 days of work

aAdapted from Buzby et al (4). A patient is defined as a person infected with E. coli O157:H7 who has at least a gastrointestinal illness for more than 1 day.
bHUS, hemolytic uremic syndrome.
cICU, intensive care unit.

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