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Sample records for foodborne illness costs

  1. Component costs of foodborne illness: a scoping review

    PubMed Central

    2014-01-01

    Background Governments require high-quality scientific evidence to prioritize resource allocation and the cost-of-illness (COI) methodology is one technique used to estimate the economic burden of a disease. However, variable cost inventories make it difficult to interpret and compare costs across multiple studies. Methods A scoping review was conducted to identify the component costs and the respective data sources used for estimating the cost of foodborne illnesses in a population. This review was accomplished by: (1) identifying the research question and relevant literature, (2) selecting the literature, (3) charting, collating, and summarizing the results. All pertinent data were extracted at the level of detail reported in a study, and the component cost and source data were subsequently grouped into themes. Results Eighty-four studies were identified that described the cost of foodborne illness in humans. Most studies (80%) were published in the last two decades (1992–2012) in North America and Europe. The 10 most frequently estimated costs were due to illnesses caused by bacterial foodborne pathogens, with non-typhoidal Salmonella spp. being the most commonly studied. Forty studies described both individual (direct and indirect) and societal level costs. The direct individual level component costs most often included were hospital services, physician personnel, and drug costs. The most commonly reported indirect individual level component cost was productivity losses due to sick leave from work. Prior estimates published in the literature were the most commonly used source of component cost data. Data sources were not provided or specifically linked to component costs in several studies. Conclusions The results illustrated a highly variable depth and breadth of individual and societal level component costs, and a wide range of data sources being used. This scoping review can be used as evidence that there is a lack of standardization in cost inventories in

  2. Foodborne Illnesses

    MedlinePlus

    ... Some parasites and chemicals also cause foodborne illnesses. Bacteria Bacteria are tiny organisms that can cause infections of the GI tract. Not all bacteria are harmful to humans. Some harmful bacteria may ...

  3. Foodborne Illness

    MedlinePlus

    ... people in the U.S. get sick from contaminated food. Common culprits include bacteria, parasites and viruses. Symptoms ... are the most common cause of foodborne illness. Foods may have some bacteria on them when you ...

  4. The Per Case and Total Annual Costs of Foodborne Illness in the United States.

    PubMed

    Minor, Travis; Lasher, Angela; Klontz, Karl; Brown, Bradley; Nardinelli, Clark; Zorn, David

    2015-06-01

    We present an economic welfare-based method to estimate the health costs associated with foodborne illness caused by known viruses, bacteria, parasites, allergens, two marine biotoxins, and unspecified agents. The method generates health costs measured in both quality-adjusted life years and in dollars. We calculate the reduction in quality-adjusted life days caused by the illness and add reductions in quality-adjusted life years from any secondary effects that are estimated to occur. For fatal cases, we calculate the life years lost due to premature death. We add direct medical expenses to the monetary costs as derived from estimates of willingness to pay to reduce health risks. In total, we estimate that foodborne illness represents an annual burden to society of approximately $36 billion, with an average identified illness estimated to reduce quality-adjusted life days by 0.84, which is monetized and included in the average cost burden per illness of $3,630. PMID:25557397

  5. Foodborne illness and microbial agents

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne illnesses result from the consumption of food containing microbial agents such as bacteria, viruses, parasites or food contaminated by poisonous chemicals or bio-toxins. Pathogen proliferation is due to nutrient composition of foods, which are capable of supporting the growth of microorgan...

  6. Foodborne Illnesses: What You Need to Know

    MedlinePlus

    Foodborne Illness-Causing Organisms in the U.S. WHAT YOU NEED TO KNOW While the American food supply is among the safest in the ... deaths. The chart below includes foodborne disease-causing organisms that frequently cause illness in the United States. ...

  7. Diagnosis and Management of Foodborne Illness.

    PubMed

    Switaj, Timothy L; Winter, Kelly J; Christensen, Scott R

    2015-09-01

    The Centers for Disease Control and Prevention estimates that each year, one in six Americans will experience a foodborne illness. The most common causes in the United States are viruses, such as norovirus; bacteria, such as Salmonella, Escherichia coli, Campylobacter, and Listeria; and parasites, such as Toxoplasma gondii and Giardia. Resources are available to educate consumers on food recalls and proper handling, storage, and cooking of foods. Diagnosis and management of a foodborne illness are based on the history and physical examination. Common symptoms of foodborne illnesses include vomiting, diarrhea (with or without blood), fever, abdominal cramping, headache, dehydration, myalgia, and arthralgias. Definitive diagnosis can be made only through stool culture or more advanced laboratory testing. However, these results should not delay empiric treatment if a foodborne illness is suspected. Empiric treatment should focus on symptom management, rehydration if the patient is clinically dehydrated, and antibiotic therapy. Foodborne illnesses should be reported to local and state health agencies; reporting requirements vary among states. PMID:26371569

  8. CDC 2011 Estimates of Foodborne Illness in the United States

    MedlinePlus

    ... Total number of foodborne illnesses each year CDC estimated the number of illnesses, hospitalizations, and deaths caused by both known and unspecified agents. CDC estimated what proportion of each were foodborne. The first ...

  9. Food-borne illnesses during pregnancy

    PubMed Central

    Tam, Carolyn; Erebara, Aida; Einarson, Adrienne

    2010-01-01

    ABSTRACT QUESTION After hearing about outbreaks of illness resulting from Listeria and Salmonella, many of my patients are wondering about the risks of food-borne illnesses during pregnancy and what they can do to reduce their chances of contracting them. ANSWER Although heating or cooking food is the best way to inactivate food-borne pathogens, improved standards and surveillance have reduced the prevalence of contaminated foods at grocery stores. Therefore, it is no longer necessary for pregnant women to avoid foods like deli meats and soft cheeses (associated with Listeria); soft-cooked eggs (associated with Salmonella); or sushi and sashimi. Regardless of whether seafood is raw or cooked, pregnant women should choose low mercury seafood (eg, salmon and shrimp) over higher mercury varieties (eg, fresh tuna). Pregnant women should ensure that their food is obtained from reputable establishments; stored, handled, and cooked properly; and consumed within a couple of days of purchasing. PMID:20393091

  10. Health department use of social media to identify foodborne illness - Chicago, Illinois, 2013-2014.

    PubMed

    Harris, Jenine K; Mansour, Raed; Choucair, Bechara; Olson, Joe; Nissen, Cory; Bhatt, Jay

    2014-08-15

    An estimated 55 million to 105 million persons in the United States experience acute gastroenteritis caused by foodborne illness each year, resulting in costs of $2-$4 billion annually. Many persons do not seek treatment, resulting in underreporting of the actual number of cases and cost of the illnesses. To prevent foodborne illness, local health departments nationwide license and inspect restaurants and track and respond to foodborne illness complaints. New technology might allow health departments to engage with the public to improve foodborne illness surveillance. For example, the New York City Department of Health and Mental Hygiene examined restaurant reviews from an online review website to identify foodborne illness complaints. On March 23, 2013, the Chicago Department of Public Health (CDPH) and its civic partners launched FoodBorne Chicago, a website (https://www.foodbornechicago.org) aimed at improving food safety in Chicago by identifying and responding to complaints on Twitter about possible foodborne illnesses. In 10 months, project staff members responded to 270 Twitter messages (tweets) and provided links to the FoodBorne Chicago complaint form. A total of 193 complaints of possible foodborne illness were submitted through FoodBorne Chicago, and 133 restaurants in the city were inspected. Inspection reports indicated 21 (15.8%) restaurants failed inspection, and 33 (24.8%) passed with conditions indicating critical or serious violations. Eight tweets and 19 complaint forms to FoodBorne Chicago described seeking medical treatment. Collaboration between public health professionals and the public via social media might improve foodborne illness surveillance and response. CDPH is working to disseminate FoodBorne Chicago via freely available open source software. PMID:25121710

  11. A one-year study of foodborne illnesses in the municipality of Uppsala, Sweden.

    PubMed Central

    Lindqvist, R.; Andersson, Y.; Lindbäck, J.; Wegscheider, M.; Eriksson, Y.; Tideström, L.; Lagerqvist-Widh, A.; Hedlund, K. O.; Löfdahl, S.; Svensson, L.; Norinder, A.

    2001-01-01

    Surveillance was enhanced and a retrospective interview study performed in 1998-99 to determine incidence, causes, and costs of foodborne illnesses in Uppsala, Sweden. Sixty-eight percent of the detected foodborne illness incidents were single cases, and 32% were outbreaks. Most (85%) of the incidents came to the attention of the municipal authorities through telephone calls from affected persons. Calicivirus, Campylobacter spp., and Staphyloccocus aureus were the most common etiological agents; meat, meat products, and mixed dishes were the most implicated food categories. The incidence of foodborne illness was estimated to be 38 cases per 1,000 inhabitants per year. The estimated average costs per illness were 2,164 Swedish Krona (SEK) ($246) to society and 500 SEK ($57) to the patient. The annual cost of foodborne illnesses in Sweden was estimated to be 1,082 million SEK ($123 million). PMID:11485680

  12. Bacillus and relatives in foodborne illness.

    PubMed

    Logan, N A

    2012-03-01

    Species of Bacillus and related genera have long been troublesome to food producers on account of their resistant endospores. These organisms have undergone huge taxonomic changes in the last 30 years, with numbers of genera and species now standing at 56 and over 545, respectively. Despite this expansion, relatively few new species have been isolated from infections, few are associated with food and no important new agents of foodborne illness have been reported. What has changed is our knowledge of the established agents. Bacillus cereus is well known as a cause of food poisoning, and much more is now understood about its toxins and their involvement in infections and intoxications. Also, although B. licheniformis, B. subtilis and B. pumilus have occasionally been isolated from cases of food-associated illness, their roles were usually uncertain. Much more is now known about the toxins that strains of these species may produce, so that their significances in such episodes are clearer; however, it is still unclear why such cases are so rarely reported. Another important development is the use of aerobic endosporeformers as probiotics, as the potentials of such organisms to cause illness or to be sources of antibiotic resistance need to be borne in mind. PMID:22121830

  13. Reporting of foodborne illness by U.S. consumers and healthcare professionals.

    PubMed

    Arendt, Susan; Rajagopal, Lakshman; Strohbehn, Catherine; Stokes, Nathan; Meyer, Janell; Mandernach, Steven

    2013-08-01

    During 2009-2010, a total of 1,527 foodborne disease outbreaks were reported by the Centers for Disease Control and Prevention (CDC) (2013). However, in a 2011 CDC report, Scallan et al. estimated about 48 million people contract a foodborne illness annually in the United States. Public health officials are concerned with this under-reporting; thus, the purpose of this study was to identify why consumers and healthcare professionals don't report foodborne illness. Focus groups were conducted with 35 consumers who reported a previous experience with foodborne illness and with 16 healthcare professionals. Also, interviews with other healthcare professionals with responsibility of diagnosing foodborne illness were conducted. Not knowing who to contact, being too ill, being unsure of the cause, and believing reporting would not be beneficial were all identified by consumers as reasons for not reporting foodborne illness. Healthcare professionals that participated in the focus groups indicated the amount of time between patients' consumption of food and seeking treatment and lack of knowledge were barriers to diagnosing foodborne illness. Issues related to stool samples such as knowledge, access and cost were noted by both groups. Results suggest that barriers identified could be overcome with targeted education and improved access and information about the reporting process. PMID:23965924

  14. Reporting of Foodborne Illness by U.S. Consumers and Healthcare Professionals

    PubMed Central

    Arendt, Susan; Rajagopal, Lakshman; Strohbehn, Catherine; Stokes, Nathan; Meyer, Janell; Mandernach, Steven

    2013-01-01

    During 2009–2010, a total of 1,527 foodborne disease outbreaks were reported by the Centers for Disease Control and Prevention (CDC) (2013). However, in a 2011 CDC report, Scallan et al. estimated about 48 million people contract a foodborne illness annually in the United States. Public health officials are concerned with this under-reporting; thus, the purpose of this study was to identify why consumers and healthcare professionals don’t report foodborne illness. Focus groups were conducted with 35 consumers who reported a previous experience with foodborne illness and with 16 healthcare professionals. Also, interviews with other healthcare professionals with responsibility of diagnosing foodborne illness were conducted. Not knowing who to contact, being too ill, being unsure of the cause, and believing reporting would not be beneficial were all identified by consumers as reasons for not reporting foodborne illness. Healthcare professionals that participated in the focus groups indicated the amount of time between patients’ consumption of food and seeking treatment and lack of knowledge were barriers to diagnosing foodborne illness. Issues related to stool samples such as knowledge, access and cost were noted by both groups. Results suggest that barriers identified could be overcome with targeted education and improved access and information about the reporting process. PMID:23965924

  15. Whole Genome Sequencing: Cracking the Genetic Code for Foodborne Illness

    MedlinePlus

    ... Consumers Consumer Updates Whole Genome Sequencing: Cracking the Genetic Code for Foodborne Illness Share Tweet Linkedin Pin ... have millions of different genomes, or sequences of genetic code, each as unique as a fingerprint. Get ...

  16. Online Reports of Foodborne Illness Capture Foods Implicated in Official Foodborne Outbreak Reports

    PubMed Central

    Nsoesie, Elaine O.; Gordon, Sheryl A.; Brownstein, John S.

    2014-01-01

    Objective Traditional surveillance systems only capture a fraction of the estimated 48 million yearly cases of foodborne illness in the United States. We assessed whether foodservice reviews on Yelp.com (a business review site) can be used to support foodborne illness surveillance efforts. Methods We obtained reviews from 2005–2012 of 5824 foodservice businesses closest to 29 colleges. After extracting recent reviews describing episodes of foodborne illness, we compared implicated foods to foods in outbreak reports from the U.S. Centers for Disease Control and Prevention (CDC). Results Broadly, the distribution of implicated foods across five categories was as follows: aquatic (16% Yelp, 12% CDC), dairy-eggs (23% Yelp, 23% CDC), fruits-nuts (7% Yelp, 7% CDC), meat-poultry (32% Yelp, 33% CDC), and vegetables (22% Yelp, 25% CDC). The distribution of foods across 19 more specific food categories was also similar, with spearman correlations ranging from 0.60 to 0.85 for 2006–2011. The most implicated food categories in both Yelp and CDC were beef, dairy, grains-beans, poultry and vine-stalk. Conclusions Based on observations in this study and the increased usage of social media, we posit that online illness reports could complement traditional surveillance systems by providing near real-time information on foodborne illnesses, implicated foods and locations. PMID:25124281

  17. Chagas' disease as a foodborne illness.

    PubMed

    Pereira, Karen Signori; Schmidt, Flávio Luis; Guaraldo, Ana M A; Franco, Regina M B; Dias, Viviane L; Passos, Luiz A C

    2009-02-01

    Various researchers have studied the importance of the oral transmission of Chagas' disease since the mid-20th century. Only in recent years, due to an outbreak that occurred in the Brazilian State of Santa Catarina in 2005 and to various outbreaks occurring during the last 3 years in the Brazilian Amazon basin, mainly associated with the consumption of Amazonian palm berry or açaí (Euterpe oleracea Mart.) juice, has this transmission route aroused the attention of researchers. Nevertheless, reports published in the 1960s already indicated the possibility of Chagas' disease transmission via food in Brazil, mainly in the Amazonian region. Recently, in December 2007, an outbreak of Chagas' disease occurred in Caracas, Venezuela, related to ingestion of contaminated fruit juices. The objective of this article is to point out the importance of foodborne transmission in the etiology of Chagas' disease, on the basis of published research and Brazilian epidemiology data. PMID:19350996

  18. Cost of Hospitalization for Foodborne Diarrhea: A Case Study from Vietnam.

    PubMed

    Hoang, Van Minh; Tran, Tuan Anh; Ha, Anh Duc; Nguyen, Viet Hung

    2015-11-01

    Vietnam is undergoing a rapid social and economic developments resulting in speedy urbanization, changes in methods for animal production, food marketing systems, and food consumption habits. These changes will have major impacts on human exposures to food poisoning. The present case study aimed to estimate hospitalization costs of foodborne diarrhea cases in selected health facilities in Vietnam. This is a facility-based cost-of-illness study conducted in seven health facilities in Northern Vietnam. All suspect cases of foodborne diarrhea, as diagnosed by doctors, who admitted to the studied health facilities during June-August, 2013 were selected. Costs associated with hospitalization for foodborne diseases were estimated from societal perspective using retrospective approach. We included direct and indirect costs of hospitalization of foodborne diarrhea cases. During the study period, 87 foodborne diarrhea cases were included. On average, the costs per treatment episode and per hospitalization day for foodborne diarrhea case were US$ 106.9 and US$ 33.6 respectively. Indirect cost (costs of times to patient, their relatives due to the patient's illness) made up the largest share (51.3%). Direct medical costs accounted for 33.8%; direct non-medical costs (patient and their relatives) represented 14.9%. Cost levels and compositions varied by level of health facilities. More attentions should be paid on prevention, control of foodborne diarrhea cases in Vietnam. Ensuring safety of food depends on efforts of everyone involved in food chain continuum, from production, processing, and transport to consumption. PMID:26617452

  19. Foodborne Illness Acquired in the United States—Major Pathogens

    PubMed Central

    Hoekstra, Robert M.; Angulo, Frederick J.; Tauxe, Robert V.; Widdowson, Marc-Alain; Roy, Sharon L.; Jones, Jeffery L.; Griffin, Patricia M.

    2011-01-01

    Estimates of foodborne illness can be used to direct food safety policy and interventions. We used data from active and passive surveillance and other sources to estimate that each year 31 major pathogens acquired in the United States caused 9.4 million episodes of foodborne illness (90% credible interval [CrI] 6.6–12.7 million), 55,961 hospitalizations (90% CrI 39,534–75,741), and 1,351 deaths (90% CrI 712–2,268). Most (58%) illnesses were caused by norovirus, followed by nontyphoidal Salmonella spp. (11%), Clostridium perfringens (10%), and Campylobacter spp. (9%). Leading causes of hospitalization were nontyphoidal Salmonella spp. (35%), norovirus (26%), Campylobacter spp. (15%), and Toxoplasma gondii (8%). Leading causes of death were nontyphoidal Salmonella spp. (28%), T. gondii (24%), Listeria monocytogenes (19%), and norovirus (11%). These estimates cannot be compared with prior (1999) estimates to assess trends because different methods were used. Additional data and more refined methods can improve future estimates. PMID:21192848

  20. Food-borne bacteremic illnesses in febrile neutropenic children.

    PubMed

    Lee, Anselm Chi-Wai; Siao-Ping Ong, Nellie Dawn

    2011-08-31

    Bacteremia following febrile neutropenia is a serious complication in children with malignancies. Preventive measures are currently targeted at antimicrobial prophylaxis, amelioration of drug-induced neutropenia, and nosocomial spread of pathogens, with little attention to community-acquired infections. A retrospective study was conducted at a pediatric oncology center during a 3-year period to identify probable cases of food-borne infections with bacteremia. Twenty-one bacteremic illnesses affecting 15 children receiving chemotherapy or hematopoietic stem cell transplantation were reviewed. Three (14%) episodes were highly suspected of a food-borne origin: a 17-year-old boy with osteosarcoma contracted Sphingomonas paucimobilis septicemia after consuming nasi lemak bought from a street hawker; a 2-year-old boy with acute lymphoblastic leukemia developed Chryseobacterium meningosepticum septicemia after a sushi dinner; a 2-year-old girl was diagnosed with acute lymphoblastic leukemia and Lactobacillus bacteremia suspected to be of probiotic origin. All of them were neutropenic at the time of the infections and the bacteremias were cleared with antibiotic treatment. Food-borne sepsis may be an important, but readily preventable, cause of bloodstream infections in pediatric oncology patients, especially in tropical countries with an abundance of culinary outlets. PMID:22184532

  1. Food-borne bacteremic illnesses in febrile neutropenic children

    PubMed Central

    Lee, Anselm Chi-wai; Siao-ping Ong, Nellie Dawn

    2011-01-01

    Bacteremia following febrile neutropenia is a serious complication in children with malignancies. Preventive measures are currently targeted at antimicrobial prophylaxis, amelioration of drug-induced neutropenia, and nosocomial spread of pathogens, with little attention to community-acquired infections. A retrospective study was conducted at a pediatric oncology center during a 3-year period to identify probable cases of food-borne infections with bacteremia. Twenty-one bacteremic illnesses affecting 15 children receiving chemotherapy or hematopoietic stem cell transplantation were reviewed. Three (14%) episodes were highly suspected of a food-borne origin: a 17-year-old boy with osteosarcoma contracted Sphingomonas paucimobilis septicemia after consuming nasi lemak bought from a street hawker; a 2-year-old boy with acute lymphoblastic leukemia developed Chryseobacterium meningosepticum septicemia after a sushi dinner; a 2-year-old girl was diagnosed with acute lymphoblastic leukemia and Lactobacillus bacteremia suspected to be of probiotic origin. All of them were neutropenic at the time of the infections and the bacteremias were cleared with antibiotic treatment. Food-borne sepsis may be an important, but readily preventable, cause of bloodstream infections in pediatric oncology patients, especially in tropical countries with an abundance of culinary outlets. PMID:22184532

  2. The impact of socioeconomic status on foodborne illness in high-income countries: a systematic review.

    PubMed

    Newman, K L; Leon, J S; Rebolledo, P A; Scallan, E

    2015-09-01

    Foodborne illness is a major cause of morbidity and loss of productivity in developed nations. Although low socioeconomic status (SES) is generally associated with negative health outcomes, its impact on foodborne illness is poorly understood. We conducted a systematic review to examine the association between SES and laboratory-confirmed illness caused by eight important foodborne pathogens. We completed this systematic review using PubMed for all papers published between 1 January 1980 and 1 January 2013 that measured the association between foodborne illness and SES in highly developed countries and identified 16 studies covering four pathogens. The effect of SES varied across pathogens: the majority of identified studies for Campylobacter, salmonellosis, and E. coli infection showed an association between high SES and illness. The single study of listeriosis showed illness was associated with low SES. A reporting bias by SES could not be excluded. SES should be considered when targeting consumer-level public health interventions for foodborne pathogens. PMID:25600652

  3. The impact of socioeconomic status on foodborne illness in high income countries: A systematic review

    PubMed Central

    Newman, K. L.; Leon, J. S.; Rebolledo, P. A.; Scallan, E.

    2015-01-01

    SUMMARY Foodborne illness is a major cause of morbidity and loss of productivity in developed nations. Though low socioeconomic status (SES) is generally associated with negative health outcomes, its impact on foodborne illness is poorly understood. We conducted a systematic review to examine the association between SES and laboratory-confirmed illness caused by eight important foodborne pathogens. We completed this systematic review using PubMed for all papers published between 1 January 1980 and 1 January 2013 that measured the association between foodborne illness and SES in highly developed countries and identified 16 studies covering 4 pathogens. The effect of SES varied across pathogens: the majority of identified studies for Campylobacter, salmonellosis, and E. coli infection showed an association between high SES and illness. The single study of listeriosis showed illness was associated with low SES. A reporting bias by SES could not be excluded. SES should be considered when targeting consumer level public health interventions for foodborne pathogens. PMID:25600652

  4. Use of Internet Search Queries to Enhance Surveillance of Foodborne Illness.

    PubMed

    Bahk, Gyung Jin; Kim, Yong Soo; Park, Myoung Su

    2015-11-01

    As a supplement to or extension of methods used to determine trends in foodborne illness over time, we propose the use of Internet search metrics. We compared Internet query data for foodborne illness syndrome-related search terms from the most popular 5 Korean search engines using Health Insurance Review and Assessment Service inpatient stay data for 26 International Classification of Diseases, Tenth Revision, codes for foodborne illness in South Korea during 2010-2012. We used time-series analysis with Seasonal Autoregressive Integrated Moving Average (SARIMA) models. Internet search queries for "food poisoning" correlated most strongly with foodborne illness data (r=0.70, p<0.001); furthermore, "food poisoning" queries correlated most strongly with the total number of inpatient stays related to foodborne illness during the next month (β=0.069, SE 0.017, p<0.001). This approach, using the SARIMA model, could be used to effectively measure trends over time to enhance surveillance of foodborne illness in South Korea. PMID:26485066

  5. Use of Internet Search Queries to Enhance Surveillance of Foodborne Illness

    PubMed Central

    Kim, Yong Soo; Park, Myoung Su

    2015-01-01

    As a supplement to or extension of methods used to determine trends in foodborne illness over time, we propose the use of Internet search metrics. We compared Internet query data for foodborne illness syndrome–related search terms from the most popular 5 Korean search engines using Health Insurance Review and Assessment Service inpatient stay data for 26 International Classification of Diseases, Tenth Revision, codes for foodborne illness in South Korea during 2010–2012. We used time-series analysis with Seasonal Autoregressive Integrated Moving Average (SARIMA) models. Internet search queries for “food poisoning” correlated most strongly with foodborne illness data (r = 0.70, p<0.001); furthermore, “food poisoning” queries correlated most strongly with the total number of inpatient stays related to foodborne illness during the next month (β = 0.069, SE 0.017, p<0.001). This approach, using the SARIMA model, could be used to effectively measure trends over time to enhance surveillance of foodborne illness in South Korea. PMID:26485066

  6. Comparing Characteristics of Sporadic and Outbreak-Associated Foodborne Illnesses, United States, 2004–2011

    PubMed Central

    Ebel, Eric D.; Cole, Dana; Travis, Curtis C.; Klontz, Karl C.; Golden, Neal J.; Hoekstra, Robert M.

    2016-01-01

    Outbreak data have been used to estimate the proportion of illnesses attributable to different foods. Applying outbreak-based attribution estimates to nonoutbreak foodborne illnesses requires an assumption of similar exposure pathways for outbreak and sporadic illnesses. This assumption cannot be tested, but other comparisons can assess its veracity. Our study compares demographic, clinical, temporal, and geographic characteristics of outbreak and sporadic illnesses from Campylobacter, Escherichia coli O157, Listeria, and Salmonella bacteria ascertained by the Foodborne Diseases Active Surveillance Network (FoodNet). Differences among FoodNet sites in outbreak and sporadic illnesses might reflect differences in surveillance practices. For Campylobacter, Listeria, and Escherichia coli O157, outbreak and sporadic illnesses are similar for severity, sex, and age. For Salmonella, outbreak and sporadic illnesses are similar for severity and sex. Nevertheless, the percentage of outbreak illnesses in the youngest age category was lower. Therefore, we do not reject the assumption that outbreak and sporadic illnesses are similar. PMID:27314510

  7. Comparing Characteristics of Sporadic and Outbreak-Associated Foodborne Illnesses, United States, 2004-2011.

    PubMed

    Ebel, Eric D; Williams, Michael S; Cole, Dana; Travis, Curtis C; Klontz, Karl C; Golden, Neal J; Hoekstra, Robert M

    2016-07-01

    Outbreak data have been used to estimate the proportion of illnesses attributable to different foods. Applying outbreak-based attribution estimates to nonoutbreak foodborne illnesses requires an assumption of similar exposure pathways for outbreak and sporadic illnesses. This assumption cannot be tested, but other comparisons can assess its veracity. Our study compares demographic, clinical, temporal, and geographic characteristics of outbreak and sporadic illnesses from Campylobacter, Escherichia coli O157, Listeria, and Salmonella bacteria ascertained by the Foodborne Diseases Active Surveillance Network (FoodNet). Differences among FoodNet sites in outbreak and sporadic illnesses might reflect differences in surveillance practices. For Campylobacter, Listeria, and Escherichia coli O157, outbreak and sporadic illnesses are similar for severity, sex, and age. For Salmonella, outbreak and sporadic illnesses are similar for severity and sex. Nevertheless, the percentage of outbreak illnesses in the youngest age category was lower. Therefore, we do not reject the assumption that outbreak and sporadic illnesses are similar. PMID:27314510

  8. Complaint-based surveillance for foodborne illness in the United States: a survey of local health departments.

    PubMed

    Li, John; Shah, Gulzar H; Hedberg, Craig

    2011-03-01

    Foodborne illnesses are an important public health problem in the United States in terms of both the burden of illness and cost to the health care system. Strengthening foodborne illness surveillance helps address the growing issues of food safety in the United States. Very little is known about the use of consumer complaint surveillance systems for foodborne illness. This study evaluates the use of these surveillance systems by local health departments (LHDs) in the United States and their practices and policies for investigating complaints. Data for this study were collected through two Web-based surveys based on a representative sample of LHDs in the United States; 81% of LHDs use complaint-based surveillance. Of those that did not have a complaint system, 64% reported that the state health department or another agency ran their complaint system. Health departments collect a wide variety of information from callers through their complaint systems, including food intake history. Most of the LHDs, however, do not store the information in an electronic database. Outbreak rates and complaint rates were found to be positively correlated, with a Pearson's correlation coefficient of 0.38. Complaints were the most common outbreak detection mechanism reported by respondents, with a median of 69% of outbreaks during the previous year found through complaints. Complaint systems are commonly used in the United States. Increasing the rate at which illnesses are reported by the public and improving investigation practices could help increase the number of outbreaks detected through complaint surveillance. PMID:21375880

  9. Navigating the legal framework for state foodborne illness surveillance and outbreak response: observations and challenges.

    PubMed

    David, Stephanie D; Katz, Rebecca L

    2013-03-01

    Public health and food safety officials have long recognized the important role that state agencies play in protecting consumers from foodborne disease. With the increasing occurrence of multi-jurisdictional outbreaks, efforts have been underway to modernize and make more uniform the patchwork of state laws, protocols, and policies that exist across the U.S. for food-borne illness surveillance and outbreak response activities. To aid in this endeavor, and to better understand the role of law in a state's ability to carry out these functions effectively, we are creating a database of key legal authorities and provisions relating to foodborne illness surveillance and outbreak response across the 50 states and District of Columbia. There appears to be wide variation in the legal infrastructure for these activities, ranging from how certain terms are defined, to what and when foodborne illnesses must be reported, to which level of government has responsibility over investigation and response of foodborne outbreaks. As outbreaks become more widespread and involve multiple jurisdictions, it is important that public health and food safety stakeholders understand the legal authorities under which they operate, how such authorities may impede or promote efficient and effective surveillance and outbreak response, and use that knowledge to determine if state laws should be updated or strengthened. PMID:23590736

  10. The food industry's current and future role in preventing microbial foodborne illness within the United States.

    PubMed

    Doyle, Michael P; Erickson, Marilyn C; Alali, Walid; Cannon, Jennifer; Deng, Xiangyu; Ortega, Ynes; Smith, Mary Alice; Zhao, Tong

    2015-07-15

    During the past century, the microbiological safety of the US food supply has improved; however, many foodborne illnesses and outbreaks occur annually. Hence, opportunities for the food industry to improve the safety of both domestic and imported food exist through the adoption of risk-based preventive measures. Challenging food safety issues that are on the horizon include demographic changes to a population whose immune system is more susceptible to foodborne and opportunistic pathogens, climate changes that will shift where food is produced, and consumers' preferences for raw and minimally processed foods. Increased environmental and product testing and anonymous data sharing by the food industry with the public health community would aid in identifying system weaknesses and enabling more targeted corrective and preventive actions. Clinicians will continue to play a major role in reducing foodborne illnesses by diagnosing and reporting cases and in helping to educate the consumer about food safety practices. PMID:25824814

  11. Using Role-Play to Enhance Foodborne Illness Crisis Management Capacity in the Produce Industry

    ERIC Educational Resources Information Center

    Kreske, Audrey; Ducharme, Diane; Gunter, Chris; Phister, Trevor

    2013-01-01

    Foodborne illness outbreaks have measurable public health effects and often lead to negative produce industry impacts. Reducing loss following a crisis event requires a management plan, although many fresh produce industry members don't have one. Evidence-based workshops using a role-play simulated outbreak were delivered to impact crisis…

  12. Guidance for improving the federal response to foodborne illness outbreaks associated with fresh produce.

    PubMed

    Benson, Sara M

    2010-01-01

    Today, our nation's food supply flows through a complicated chain of farmers, processors, and distributors before reaching consumers. At some point during this process, food can become contaminated with pathogens and it can make people sick. The Food and Drug Administration, along with the Centers for Disease Control, are in charge of fighting an outbreak once it occurs. The CDC first identifies a specific food that is making people ill, and then the FDA steps in to find the source of that contaminated food. This process, however, does not always run smoothly. Historically, these federal agencies have been underfunded and have had few staff dedicated to fighting foodborne illness outbreaks. This means that an outbreak is not always handled effectively or efficiently, which can have devastating effects on innocent industry actors. This Note gives practical guidance to the FDA and CDC for improving its responses to foodborne illness outbreaks so that consumers, as well as innocent industry actors, are protected. PMID:24479238

  13. Diminishing willingness to pay per quality-adjusted life year: valuing acute foodborne illness.

    PubMed

    Haninger, Kevin; Hammitt, James K

    2011-09-01

    We design and conduct a stated-preference survey to estimate willingness to pay (WTP) to reduce foodborne risk of acute illness and to test whether WTP is proportional to the corresponding gain in expected quality-adjusted life years (QALYs). If QALYs measure utility for health, then economic theory requires WTP to be nearly proportional to changes in both health quality and duration of illness and WTP could be estimated by multiplying the expected change in QALYs by an appropriate monetary value. WTP is elicited using double-bounded, dichotomous-choice questions in which respondents (randomly selected from the U.S. general adult population, n = 2,858) decide whether to purchase a more expensive food to reduce the risk of foodborne illness. Health risks vary by baseline probability of illness, reduction in probability, duration and severity of illness, and conditional probability of mortality. The expected gain in QALYs is calculated using respondent-assessed decrements in health-related quality of life if ill combined with the duration of illness and reduction in probability specified in the survey. We find sharply diminishing marginal WTP for severity and duration of illness prevented. Our results suggest that individuals do not have a constant rate of WTP per QALY, which implies that WTP cannot be accurately estimated by multiplying the change in QALYs by an appropriate monetary value. PMID:21488924

  14. Attribution of Foodborne Illnesses, Hospitalizations, and Deaths to Food Commodities by using Outbreak Data, United States, 1998–2008

    PubMed Central

    Hoekstra, Robert M.; Ayers, Tracy; Tauxe, Robert V.; Braden, Christopher R.; Angulo, Frederick J.; Griffin, Patricia M.

    2013-01-01

    Each year, >9 million foodborne illnesses are estimated to be caused by major pathogens acquired in the United States. Preventing these illnesses is challenging because resources are limited and linking individual illnesses to a particular food is rarely possible except during an outbreak. We developed a method of attributing illnesses to food commodities that uses data from outbreaks associated with both simple and complex foods. Using data from outbreak-associated illnesses for 1998–2008, we estimated annual US foodborne illnesses, hospitalizations, and deaths attributable to each of 17 food commodities. We attributed 46% of illnesses to produce and found that more deaths were attributed to poultry than to any other commodity. To the extent that these estimates reflect the commodities causing all foodborne illness, they indicate that efforts are particularly needed to prevent contamination of produce and poultry. Methods to incorporate data from other sources are needed to improve attribution estimates for some commodities and agents. PMID:23622497

  15. Exploring the relationship between food access and foodborne illness by using spatial analysis.

    PubMed

    Newbold, Bruce; Watson, Susannah; Mackay, Kevin; Isaacs, Sandy

    2013-09-01

    There is some evidence that neighborhood deprivation increases residents' risk of foodborne illnesses. Because urban areas with the least available access to adequate amounts of nutritious or affordable food options (or "food deserts") also tend to be the most deprived areas within a city, it is hypothesized that food access and foodborne illness risk are linked. However, the complexity of tracking numbers and sources of gastrointestinal (GI) illnesses often leads researchers to speculate about reasons for disproportionate rates of pathogen outbreaks among demographic groups. This study explores the suitability of existing data to examine associations between food deserts and the spatial distribution of GI illnesses in Hamilton, Ontario, Canada. A spatial analysis by using GIS software methodology was used to identify and map food retail outlets and accessibility, as well as GI illness outbreaks and sales of antidiarrhea, antinausea, and rehydration products (used as a proxy for GI cases) within the city, based on available data. Statistical analysis of the maps shows no statistical relationship between location, access to food outlets, and rates of GI illness. The analysis points to shortfalls and gaps in the existing data, which leaves us unable to draw conclusions either supporting or refuting our hypothesis. This article includes recommendations to improve the current system of illness reporting and to continue to refine the definition and process of mapping food access issues. A more comprehensive set of data would enable municipalities to more easily identify groups most at risk, depending on exposures and the type of pathogen, and reduce the occurrence of foodborne disease. PMID:23992507

  16. Salmonellosis outbreak on transatlantic flights; foodborne illness on aircraft: 1947-1984.

    PubMed

    Tauxe, R V; Tormey, M P; Mascola, L; Hargrett-Bean, N T; Blake, P A

    1987-01-01

    In March 1984, 186 cases of gastroenteritis due to Salmonella enteritidis were reported after 29 flights to the United States on an international airline. An estimated 2,747 passengers on flights to the United States were affected. Illness was associated with flying supersonic or first class (odds ratio = 15, p less than 0.001). Eating food from the first-class menu was associated with illness (p = 0.09), and eating a tourist-class entree was protective (p less than 0.01). In 23 reported outbreaks of foodborne illness on aircraft, Salmonella has been the most common pathogen (seven outbreaks), followed by Staphylococcus (five outbreaks), and Vibrio species (five outbreaks). Outbreaks are most often the result of an improper temperature for preparation or for holding food in the flight kitchens. Serving the flight crew meals from one kitchen carries the risk that the entire crew will become ill. PMID:3788944

  17. [Asthma and cost of illness].

    PubMed

    Beyhun, N Ercüment; Cilingiroğlu, Nesrin

    2004-01-01

    The basic aim of the activities concerning health is to implement the initiatives for people to attain the best health status and sustain it. That's why these initiatives have to be chosen from the ones that consume minimum resource and affect life quality and duration in most beneficial way. Asthma is one of the most prevalent chronic disorders. Asthma brings significant direct and indirect costs to societies. To decrease the burden of asthma, it is necessary to emphasize its effects related to morbidity, mortality and material losses. Therefore, countries should give priority to cost of illness studies. PMID:15558364

  18. Parametric distributions of underdiagnosis parameters used to estimate annual burden of illness for five foodborne pathogens.

    PubMed

    Ebel, Eric D; Williams, Michael S; Schlosser, Wayne D

    2012-04-01

    Estimates of the burden of bacterial foodborne illness are used in applications ranging from determining economic losses due to a particular pathogenic organism to improving our understanding of the effects of antimicrobial resistance or changes in pathogen serotype. Estimates of the total number of illnesses can be derived by multiplying the number of observed illnesses, as reported by a specific active surveillance system, by an underdiagnosis factor that describes the relationship between observed and unobserved cases. The underdiagnosis factor can be a fixed value, but recent research efforts have focused on characterizing the inherent uncertainty in the surveillance system with a computer simulation. Although the inclusion of uncertainty is beneficial, re-creating the simulation results for every application can be burdensome. An alternative approach is to describe the underdiagnosis factor and its uncertainty with a parametric distribution. The use of such a distribution simplifies analyses by providing a closed-form definition of the underdiagnosis factor and allows this factor to be easily incorporated into Bayesian models. In this article, we propose and estimate parametric distributions for the underdiagnosis multipliers developed for the FoodNet surveillance systems in the United States. Distributions are provided for the five foodborne pathogens deemed most relevant to meat and poultry. PMID:22488071

  19. Foodborne Illnesses

    MedlinePlus

    ... problem for people traveling to developing countries in Africa, Asia, Latin America, and the Caribbean. Visitors to ... Get Email Updates Twitter Facebook Follow Us Privacy Policy | Freedom of Information Act | Accessibility | Disclaimers | Copyright | Sitemap | ...

  20. Epidemiology, prevention, and control of the number one foodborne illness: human norovirus.

    PubMed

    Dicaprio, Erin; Ma, Yuanmei; Hughes, John; Li, Jianrong

    2013-09-01

    Human norovirus (NoV) is the number one cause of foodborne illness. Despite tremendous research efforts, human NoV is still poorly understood and understudied. There is no effective measure to eliminate this virus from food and the environment. Future research efforts should focus on developing: (1) an efficient cell culture system and a robust animal model, (2) rapid and sensitive detection methods, (3) novel sanitizers and control interventions, and (4) vaccines and antiviral drugs. Furthermore, there is an urgent need to build multidisciplinary and multi-institutional teams to combat this important biodefense agent. PMID:24011835

  1. Fatal foodborne Clostridium perfringens illness at a state psychiatric hospital--Louisiana, 2010.

    PubMed

    2012-08-17

    Clostridium perfringens, the third most common cause of foodborne illness in the United States (1), most often causes a self-limited, diarrheal disease lasting 12-24 hours. Fatalities are very rare, occurring in <0.03% of cases (1). Death usually is caused by dehydration and occurs among the very young, the very old, and persons debilitated by illness (2). On May 7, 2010, 42 residents and 12 staff members at a Louisiana state psychiatric hospital experienced vomiting, abdominal cramps, and diarrhea. Within 24 hours, three patients had died. The three fatalities occurred among patients aged 41-61 years who were receiving medications that had anti-intestinal motility side effects. For two of three decedents, the cause of death found on postmortem examination was necrotizing colitis. Investigation by the Louisiana Office of Public Health (OPH) and CDC found that eating chicken served at dinner on May 6 was associated with illness. The chicken was cooked approximately 24 hours before serving and not cooled in accordance with hospital guidelines. C. perfringens enterotoxin (CPE) was detected in 20 of 23 stool specimens from ill residents and staff members. Genetic testing of C. perfringens toxins isolated from chicken and stool specimens was carried out to determine which of the two strains responsible for C. perfringens foodborne illness was present. The specimens tested negative for the beta-toxin gene, excluding C. perfringens type C as the etiologic agent and implicating C. perfringens type A. This outbreak underscores the need for strict food preparation guidelines at psychiatric inpatient facilities and the potential risk for adverse outcomes among any patients with impaired intestinal motility caused by medications, disease, and extremes of age when exposed to C. perfringens enterotoxin. PMID:22895383

  2. Risk factors for transmission of foodborne illness in restaurants and street vendors in Jakarta, Indonesia.

    PubMed Central

    Vollaard, A. M.; Ali, S.; van Asten, H. A. G. H.; Ismid, I. Suhariah; Widjaja, S.; Visser, L. G.; Surjadi, Ch; van Dissel, J. T.

    2004-01-01

    In a previous risk factor study in Jakarta we identified purchasing street food as an independent risk factor for paratyphoid. Eating from restaurants, however, was not associated with disease. To explain these findings we compared 128 street food-vendors with 74 food handlers from restaurants in a cross-sectional study in the same study area. Poor hand-washing hygiene and direct hand contact with foods, male sex and low educational level were independent characteristics of street vendors in a logistic regression analysis. Faecal contamination of drinking water (in 65 % of samples), dishwater (in 91 %) and ice cubes (in 100 %) was frequent. Directly transmittable pathogens including S. typhi (n = 1) and non-typhoidal Salmonella spp. (n = 6) were isolated in faecal samples in 13 (7 %) vendors; the groups did not differ, however, in contamination rates of drinking water and Salmonella isolation rates in stools. Poor hygiene of street vendors compared to restaurant vendors, in combination with faecal carriage of enteric pathogens including S. typhi, may help explain the association found between purchasing street food and foodborne illness, in particular Salmonella infections. Public health interventions to reduce transmission of foodborne illness should focus on general hygienic measures in street food trade, i.e. hand washing with soap, adequate food-handling hygiene, and frequent renewal of dishwater. PMID:15473149

  3. Examining the Prevalence of Self-Reported Foodborne Illnesses and Food Safety Risks among International College Students in the United States

    ERIC Educational Resources Information Center

    Lyonga, Agnes Ngale; Eighmy, Myron A.; Garden-Robinson, Julie

    2010-01-01

    Foodborne illness and food safety risks pose health threats to everyone, including international college students who live in the United States and encounter new or unfamiliar foods. This study assessed the prevalence of self-reported foodborne illness among international college students by cultural regions and length of time in the United…

  4. Potential of social media as a tool to combat foodborne illness.

    PubMed

    Chapman, Benjamin; Raymond, Benjamin; Powell, Douglas

    2014-07-01

    The use of social media platforms, such as Facebook and Twitter, has been increasing substantially in recent years and has affected the way that people access information online. Social media rely on high levels of interaction and user-generated context shared through established and evolving social networks. Health information providers must know how to successfully participate through social media in order to meet the needs of these online audiences. This article reviews the current research on the use of social media for public health communication and suggests potential frameworks for developing social media strategies. The extension to food safety risk communication is explored, considering the potential of social media as a tool to combat foodborne illness. PMID:24990140

  5. Using online reviews by restaurant patrons to identify unreported cases of foodborne illness - New York City, 2012-2013.

    PubMed

    Harrison, Cassandra; Jorder, Mohip; Stern, Henri; Stavinsky, Faina; Reddy, Vasudha; Hanson, Heather; Waechter, HaeNa; Lowe, Luther; Gravano, Luis; Balter, Sharon

    2014-05-23

    While investigating an outbreak of gastrointestinal disease associated with a restaurant, the New York City Department of Health and Mental Hygiene (DOHMH) noted that patrons had reported illnesses on the business review website Yelp (http://www.yelp.com) that had not been reported to DOHMH. To explore the potential of using Yelp to identify unreported outbreaks, DOHMH worked with Columbia University and Yelp on a pilot project to prospectively identify restaurant reviews on Yelp that referred to foodborne illness. During July 1, 2012-March 31, 2013, approximately 294,000 Yelp restaurant reviews were analyzed by a software program developed for the project. The program identified 893 reviews that required further evaluation by a foodborne disease epidemiologist. Of the 893 reviews, 499 (56%) described an event consistent with foodborne illness (e.g., patrons reported diarrhea or vomiting after their meal), and 468 of those described an illness within 4 weeks of the review or did not provide a period. Only 3% of the illnesses referred to in the 468 reviews had also been reported directly to DOHMH via telephone and online systems during the same period. Closer examination determined that 129 of the 468 reviews required further investigation, resulting in telephone interviews with 27 reviewers. From those 27 interviews, three previously unreported restaurant-related outbreaks linked to 16 illnesses met DOHMH outbreak investigation criteria; environmental investigation of the three restaurants identified multiple food-handling violations. The results suggest that online restaurant reviews might help to identify unreported outbreaks of foodborne illness and restaurants with deficiencies in food handling. However, investigating reports of illness in this manner might require considerable time and resources. PMID:24848215

  6. Control beliefs and engagement in hygienic and safety behaviours: the case of foodborne illness.

    PubMed

    Kouabenan, Dongo Rémi; Ngueutsa, Robert

    2016-08-01

    Foodborne illness is an ever-growing concern in public health. Studies found that conventional training is not enough to cause employees to apply the hygiene and safety measures. The present study explores control and fatalistic beliefs as potential factors for explaining engagement in preventive actions. Two-hundred and seventeen employees of a fast-food restaurant (75 % of all staff) answered a questionnaire assessing their control beliefs, fatalistic beliefs, risk perception, and engagement in hygienic and safety behaviours. The results validated our hypotheses. Control beliefs were positively related to engagement in hygienic and safety behaviours (b = 0.43, p < 0.001). The inverse relation was observed for fatalistic beliefs (b = - 0.24, p < 0.001). The perceived effectiveness of the prescribed measures seems to be the best predictor of engagement in preventive behaviours, followed by perceived self-efficacy. To increase adherence to preventive measures, it is recommended to enhance staff's self-efficacy and perceived effectiveness of these measures. PMID:26715283

  7. The Costs of Mental Illness

    ERIC Educational Resources Information Center

    Dickstein, Daniel

    2009-01-01

    Children with autism are likely to have unmet health care needs and live in families that have financial problems. Preschoolers with attention deficit hyperactivity disorder receive 2 to 4 times in health services than those without the disease. Cost effective treatments for childhood and adolescent depression are also discussed.

  8. Modeling uncertainty of estimated illnesses attributed to non-O157:H7 Shiga toxin-producing escherichia coli and its impact on illness cost.

    PubMed

    Marks, Harry M; Tohamy, Soumaya M; Tsui, Flora

    2013-06-01

    Because of numerous reported foodborne illness cases due to non-O157:H7 Shiga toxin-producing Escherichia coli (STEC) bacteria in the United States and elsewhere, interest in requiring better control of these pathogens in the food supply has increased. Successfully putting forth regulations depends upon cost-benefit analyses. Policy decisions often depend upon an evaluation of the uncertainty of the estimates used in such an analysis. This article presents an approach for estimating the uncertainties of estimated expected cost per illness and total annual costs of non-O157 STEC-related illnesses due to uncertainties associated with (i) recent FoodNet data and (ii) methodology proposed by Scallan et al. in 2011. The FoodNet data categorize illnesses regarding hospitalization and death. We obtained the illness-category costs from the foodborne illness cost calculator of the U.S. Department of Agriculture, Economic Research Service. Our approach for estimating attendant uncertainties differs from that of Scallan et al. because we used a classical bootstrap procedure for estimating uncertainty of an estimated parameter value (e.g., mean value), reflecting the design of the FoodNet database, whereas the other approach results in an uncertainty distribution that includes an extraneous contribution due to the underlying variability of the distribution of illnesses among different sites. For data covering 2005 through 2010, we estimate that the average cost per illness was about $450, with a 98% credible interval of $230 to $1,000. This estimate and range are based on estimations of about one death and 100 hospitalizations per 34,000 illnesses. Our estimate of the total annual cost is about $51 million, with a 98% credible interval of $19 million to $122 million. The uncertainty distribution for total annual cost is approximated well by a lognormal distribution, with mean and standard deviations for the log-transformed costs of 10.765 and 0.390, respectively. PMID:23726188

  9. Principles of risk assessment for illness caused by foodborne biological agents. National Advisory Committee on Microbiological Criteria for Foods.

    PubMed

    Buchanan, R

    1998-08-01

    The Risk Assessment Subcommittee of the National Advisory Committee on Microbiological Criteria in Foods has prepared a generic document on the principles of risk assessment as applied to biological agents that can cause human foodborne disease. Typical biological agents include bacteria, viruses, fungi, helminths, protozoa, algae, parasites, and the toxic products that these agents may produce. Basic principles elaborated to characterize food pathogen risks include the four broadly accepted components of risk assessment. The role of surveillance and investigational activities to link biological agents and their food sources to consumer illness is described as is the role of predictive modeling for food pathogens. PMID:9713775

  10. Genetic Characterization of Cronobacter sakazakii Recovered from the Environmental Surveillance Samples During a Sporadic Case Investigation of Foodborne Illness.

    PubMed

    Sulaiman, Irshad M; Jacobs, Emily; Segars, Katharine; Simpson, Steven; Kerdahi, Khalil

    2016-08-01

    Cronobacter sakazakii is an opportunistic human-pathogenic bacterium known to cause acute meningitis and necrotizing enterocolitis in neonates and immunocompromised individuals. This human-pathogenic microorganism has been isolated from a variety of food and environmental samples, and has been also linked to foodborne outbreaks associated with powdered infant formula (PIF). The U.S. Food and Drug Administration have a policy of zero tolerance of these organisms in PIF. Thus, this agency utilizes the presence of these microorganisms as one of the criteria in implementing regulatory actions and assessing adulteration of food products of public health importance. In this study, we recovered two isolates of Cronobacter from the 91 environmental swab samples during an investigation of sporadic case of foodborne illness following conventional microbiological protocols. The isolated typical colonies were identified using VITEK2 and real-time PCR protocols. The recovered Cronobacter isolates were then characterized for species identification by sequencing the 16S rRNA locus. Further, multilocus sequence typing (MLST) was accomplished characterizing seven known C. sakazakii-specific MLST loci (atpD, fusA, glnS, gltB, gyrB, infB, and pps). Results of this study confirmed all of the recovered Cronobacter isolates from the environmental swab samples to be C. sakazakii. The MLST profile matched with the published profile of the complex 31 of C. sakazakii. Thus, rRNA and 7-loci MLST-based sequencing protocols are robust techniques for rapid detection and differentiation of Cronobacter species, and these molecular diagnostic tools can be used in implementing successful surveillance program and in the control and prevention of foodborne illness. PMID:27155844

  11. Public Health Impact of Foodborne Illness: Impetus for an International Food Safety Effort

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In this book, the impact of foodborne pathogens–viral, bacterial, fungal and protozoan— at the global dinner table is explored. The Introduction provides brief statistical summaries of morbidity and mortality primarily based on data for the United States. The introductory chapter sketches each of ...

  12. The Role of Healthcare Providers and Caregivers in Educating Older Adults about Foodborne Illness Prevention

    ERIC Educational Resources Information Center

    Wohlgenant, Kelly C.; Cates, Sheryl C.; Godwin, Sandria L.; Speller-Henderson, Leslie

    2012-01-01

    Adults aged 60 or older are more likely than younger adults to experience severe complications or even death as a result of foodborne infections. This study investigated which specific groups of healthcare providers or other caregivers are most receptive to providing food safety information to older adults. Telephone-based focus groups were…

  13. School Meal Programs: Few Outbreaks of Foodborne Illness Reported. Report to the Ranking Minority Member, Committee on Agriculture, Nutrition, and Forestry, U.S. Senate.

    ERIC Educational Resources Information Center

    Robertson, Robert E.

    Twenty outbreaks of foodborne illness in schools were reported to the Centers for Disease Control and Prevention (CDC) during 1997; however, only 8 cases were associated with food served in the school meal programs. Preliminary findings identified nine outbreaks in 1998, affecting an estimated 1,609 individuals. CDC notes that such outbreaks are…

  14. Foodborne Illness Incidence Rates and Food Safety Risks for Populations of Low Socioeconomic Status and Minority Race/Ethnicity: A Review of the Literature

    PubMed Central

    Quinlan, Jennifer J.

    2013-01-01

    While foodborne illness is not traditionally tracked by race, ethnicity or income, analyses of reported cases have found increased rates of some foodborne illnesses among minority racial/ethnic populations. In some cases (Listeria, Yersinia) increased rates are due to unique food consumption patterns, in other cases (Salmonella, Shigella, Campylobacter) it is unclear why this health disparity exists. Research on safe food handling knowledge and behaviors among low income and minority consumers suggest that there may be a need to target safe food handling messages to these vulnerable populations. Another possibility is that these populations are receiving food that is less safe at the level of the retail outlet or foodservice facility. Research examining the quality and safety of food available at small markets in the food desert environment indicates that small corner markets face unique challenges which may affect the quality and potential safety of perishable food. Finally, a growing body of research has found that independent ethnic foodservice facilities may present increased risks for foodborne illness. This review of the literature will examine the current state of what is known about foodborne illness among, and food safety risks for, minority and low socioeconomic populations, with an emphasis on the United States and Europe. PMID:23955239

  15. Foodborne Disease Epidemiologist

    ERIC Educational Resources Information Center

    Sullivan, Megan

    2005-01-01

    The Centers for Disease Control and Prevention estimates that 76 million cases of foodborne illness occur in the U.S. each year; 5,000 are fatal. Most of these illnesses are caused by a variety of bacteria, viruses, and parasites and the remaining are poisonings triggered by harmful toxins or chemicals. To Jack Guzewich, a foodborne disease…

  16. A point-source foodborne listeriosis outbreak: documented incubation period and possible mild illness.

    PubMed

    Riedo, F X; Pinner, R W; Tosca, M L; Cartter, M L; Graves, L M; Reeves, M W; Weaver, R E; Plikaytis, B D; Broome, C V

    1994-09-01

    Listeria bacteremia occurred in 2 pregnant women whose only common exposure was attendance at a party. The incubation period, the possibility of mild disease due to Listeria infection, and foods associated with risk of disease were evaluated. Ten (28%) of 36 party attenders met a case definition, which included isolation of Listeria monocytogenes from blood or stool or two of the following: fever, musculoskeletal symptoms, nausea, vomiting, diarrhea. One of 25 stool cultures was positive. The 2 blood isolates and 1 stool isolate were serotype 4b and identical by enzyme typing. The incubation periods for illness in the 2 pregnant women were 19 and 23 days. Consumption of large amounts of shrimp, nonalcoholic beverages, Camembert cheese, and cauliflower was significantly associated with illness. Eating shrimp remained a significant risk factor for illness after controlling for consumption of other foods. This study suggests a milder illness may exist in healthy persons who consume foods contaminated with L. monocytogenes and demonstrates a prolonged incubation period for disease. PMID:8077731

  17. Trends in Reported Foodborne Illness in the United States; 1996-2013.

    PubMed

    Powell, Mark R

    2016-08-01

    Retrospective review is a key to designing effective food safety measures. The analysis examines trends in the reported incidence of illness due to bacterial pathogens commonly transmitted by food in the United States during 1996-2013 with and without specifying a model form for trend. The findings indicate early declines in reported incidence followed by a period of no significant trend for Campylobacter, Listeria, Shiga toxin-producing Escherichia coli O157, and Yersinia. The results are inconclusive about whether there is no trend or an increasing trend for Salmonella. While Shigella exhibits a continuous decline, Vibrio exhibits a continuous increase. Overall, the findings indicate a lack of evidence for continuous reduction in illness due to bacterial pathogens commonly transmitted by food in the United States during 1996-2013. PMID:26709453

  18. Household strategies to cope with the economic costs of illness.

    PubMed

    Sauerborn, R; Adams, A; Hien, M

    1996-08-01

    The authors examine the strategies rural households in Burkina Faso used to cope with the costs of illness in order to avert negative effects for household production and assets. They use information from 51 qualitative interviews, a household time allocation study and a household survey. Both surveys use the same sample of n = 566 households. The authors analyze these strategies along four dimensions: the type of behavior, the sequence in which strategies employed, the level at which strategies are negotiated, i.e. the household level, the non-household extended kin level or the community level, and finally the success of strategies in protecting household production and assets. A taxonomy of 11 distinct types of coping behavior is developed which have the effect of either avoiding costs by 'ignoring' disease, or of minimizing the impact of costs on the household once illness is perceived. Intra-household labor substitution was the main strategy to compensate for any labor lost to illness. However, labor substitution did not eliminate production losses in the majority of households struck with severe illness of a productive member. Only wealthy household were able to fully compensate labor losses by hiring labor or by investing in equipment to enhance productivity. Sales of livestock was the main strategy to cope with the financial costs of health care. None of the households studied fell into calamity. However, the households' ability to avert the loss of production and/or assets was very varied and depended on household size, composition and assets, on the type and duration of illness and on clustering of crises (e.g. several repetitive or simultaneous illnesses or concurrent seasonal stress). Coping with the costs of illness largely occurred at the level of the household. Inter-household transfers of resources played only a small role. The authors develop the concept of risk households and suggest several policies with the potential to strengthen the ability of

  19. Parasites and Foodborne Illness

    MedlinePlus

    ... addition, the eggs may remain viable in the environment for many months. These diseases are more prevalent in underdeveloped countries where sanitation practices may be substandard and in areas where ...

  20. Injury and Illness Costs in the Certified Safe Farm Study

    ERIC Educational Resources Information Center

    Donham, Kelley J.; Rautiainen, Risto H.; Lange, Jeffrey L.; Schneiders, Sara

    2007-01-01

    Context: The Certified Safe Farm (CSF) intervention program aims to reduce occupational injuries and illnesses, and promote wellness to reduce health care and related costs to farmers, insurers, and other stakeholders. Purpose: To evaluate the cost effectiveness of CSF. Methods: Farms (316) located in a 9-county area of northwestern Iowa were…

  1. Cost-of-illness studies: concepts, scopes, and methods.

    PubMed

    Jo, Changik

    2014-12-01

    Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis. PMID:25548737

  2. Cost-of-illness studies: concepts, scopes, and methods

    PubMed Central

    2014-01-01

    Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis. PMID:25548737

  3. The evaluation of cost-of-illness due to use of cost-of-illness-based chemicals

    PubMed Central

    Hong, Jiyeon; Lee, Yongjin; Lee, Geonwoo; Lee, Hanseul; Yang, Jiyeon

    2015-01-01

    Objectives This study is conducted to estimate the cost paid by the public suffering from disease possibly caused by chemical and to examine the effect on public health. Methods Cost-benefit analysis is an important factor in analysis and decision-making and is an important policy decision tool in many countries. Cost-of-illness (COI), a kind of scale-based analysis method, estimates the potential value lost as a result of illness as a monetary unit and calculates the cost in terms of direct, indirect and psychological costs. This study estimates direct medical costs, transportation fees for hospitalization and outpatient treatment, and nursing fees through a number of patients suffering from disease caused by chemicals in order to analyze COI, taking into account the cost of productivity loss as an indirect cost. Results The total yearly cost of the diseases studied in 2012 is calculated as 77 million Korean won (KRW) per person. The direct and indirect costs being 52 million KRW and 23 million KRW, respectively. Within the total cost of illness, mental and behavioral disability costs amounted to 16 million KRW, relevant blood immunological parameters costs were 7.4 million KRW, and disease of the nervous system costs were 6.7 million KRW. Conclusions This study reports on a survey conducted by experts regarding diseases possibly caused by chemicals and estimates the cost for the general public. The results can be used to formulate a basic report for a social-economic evaluation of the permitted use of chemicals and limits of usage. PMID:26206367

  4. Costs of occupational injury and illness across states.

    PubMed

    Waehrer, Geetha; Leigh, J Paul; Cassady, Diana; Miller, Ted R

    2004-10-01

    The objective of this study was to estimate occupational injury and illness costs per worker across states. Analysis was conducted on injury data from the Bureau of Labor Statistics and costs data from workers' compensation records. The following states were at the top of the list for average cost (cost per worker): West Virginia, Alaska, Wyoming, Kentucky, and Mississippi. The following states were at the bottom: South Carolina, Delaware, Minnesota, Massachusetts, and New Hampshire. The following variables (and signs on regression coefficients comparing this industry with manufacturing) were important in explaining the variation across states: employment in farming (+), agricultural service, forestry, fishing (+), mining (+), transportation and public utilities (+), wholesale trade (-), and finance, insurance, real estate (-). Southern and especially Western states were disproportionately represented in the high cost per worker list. A significant amount of the variation in cost per worker across states was explained by the composition of industries. PMID:15602183

  5. Osteoporosis in German men: a cost-of-illness study.

    PubMed

    Berghaus, Sabine; Müller, Dirk; Gandjour, Afschin; Civello, Daniele; Stock, Stephanie

    2015-06-01

    Costs of male osteoporosis may have increased due to population aging and change of treatment patterns. This cost-of-illness study provides a current estimate of the economic burden of male osteoporosis in Germany. Routine claims data from six German sickness funds were analyzed and extrapolated to the German statutory health insurance (SHI). For men above the age of 50 with at least one ICD-10 osteoporosis-related diagnosis or osteoporosis-related fracture in 2010, direct costs related to osteoporosis were considered based on a payer's perspective. Total direct costs attributable to osteoporosis amounted to €728 million in 2010. The majority of these costs (71%) resulted from inpatient treatment due to fractures. Patients aged 75 and older caused approximately 63% of costs. Male osteoporosis represents a non-negligible economic burden for the German health care system. Targeted prevention and promotion measures should be offered both to men and women. PMID:25495596

  6. Cost of treating mental illness from a managed care perspective.

    PubMed

    Docherty, J P

    1999-01-01

    The issue of cost-effectiveness in the pharmacoeconomics of mental illness is a new concept. As methodologies for exploring this subject unfold, the most fundamental objective for health care professionals and managed care officials is to find ways in which currently available resources can be used most effectively. The managed care perspective is highly cost-based within the market it serves. In addition to cost, other factors that influence the managed care perspective are a short-term focus, segmentation of budgets, and measurable indicators of outcome, cost, and quality of care. The cost of new psychopharmacology--especially antidepressants and antipsychotics--may be many times that of traditional drugs, and concern about increased drug costs is present in many managed care organizations. Several issues must be addressed to prevent restriction of pharmacotherapeutics in managed care settings. For example, a focus on both outcomes and practice guidelines is needed to help allocate limited resources fairly. This article suggests ways in which available resources can be used more effectively to treat mental illness within the present health care system. PMID:10073378

  7. Cost of Illness of Multiple Sclerosis - A Systematic Review

    PubMed Central

    Ernstsson, Olivia; Gyllensten, Hanna; Alexanderson, Kristina; Tinghög, Petter; Friberg, Emilie; Norlund, Anders

    2016-01-01

    Background Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices. Material and method A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used. Results The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups. Conclusion The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS. PMID:27411042

  8. Chronic sequelae of foodborne disease.

    PubMed Central

    Lindsay, J. A.

    1997-01-01

    In the past decade the complexity of foodborne pathogens, as well as their adaptability and ability to cause acute illness, and in some cases chronic (secondary) complications, have been newly appreciated. This overview examines long-term consequences of foodborne infections and intoxications to emphasize the need for more research and education. PMID:9366595

  9. Foodborne Parasites

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne infections are a significant cause of morbidity and mortality worldwide, and foodborne parasitic diseases, though not as widespread as bacterial and viral infections, are common on all continents and in most ecosystems, including arctic, temperate, and tropical regions. Certain foodborne ...

  10. Cost-of-illness studies : a review of current methods.

    PubMed

    Akobundu, Ebere; Ju, Jing; Blatt, Lisa; Mullins, C Daniel

    2006-01-01

    The number of cost-of-illness (COI) studies has expanded considerably over time. One outcome of this growth is that the reported COI estimates are inconsistent across studies, thereby raising concerns over the validity of the estimates and methods. Several factors have been identified in the literature as reasons for the observed variation in COI estimates. To date, the variation in the methods used to calculate costs has not been examined in great detail even though the variations in methods are a major driver of variation in COI estimates. The objective of this review was to document the variation in the methodologies employed in COI studies and to highlight the benefits and limitations of these methods. The review of COI studies was implemented following a four-step procedure: (i) a structured literature search of MEDLINE, JSTOR and EconLit; (ii) a review of abstracts using pre-defined inclusion and exclusion criteria; (iii) a full-text review using pre-defined inclusion and exclusion criteria; and (iv) classification of articles according to the methods used to calculate costs. This review identified four COI estimation methods (Sum_All Medical, Sum_Diagnosis Specific, Matched Control and Regression) that were used in categorising articles. Also, six components of direct medical costs and five components of indirect/non-medical costs were identified and used in categorising articles.365 full-length articles were reflected in the current review following the structured literature search. The top five cost components were emergency room/inpatient hospital costs, outpatient physician costs, drug costs, productivity losses and laboratory costs. The dominant method, Sum_Diagnosis Specific, was a total costing approach that restricted the summation of medical expenditures to those related to a diagnosis of the disease of interest. There was considerable variation in the methods used within disease subcategories. In several disease subcategories (e.g. asthma, dementia

  11. Food-Borne Noroviruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Noroviruses have emerged as the number one cause of food-borne illness in the United States. In this book chapter, the current molecular classification criteria are described as well as the current information regarding the molecular biology of the virus and its putative gene functions. Identifica...

  12. Eggs and Foodborne Disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Table eggs and eggshells may be contaminated with a variety of microorganisms, although the only significant threat to human health related to eggs in recent history has been from the bacterium Salmonella. Salmonella is currently the leading cause of bacterial foodborne illness in the U.S. with 16 ...

  13. OVERVIEW OF FOODBORNE PATHOGENS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the United States, an estimated 76 million cases of foodborne illness resulting in 325,000 hospitalizations and ~5,000 deaths occur annually. Of these the etiology or known cause is recognized for 14 million or ~20% of cases. In other words, the cause is unknown for 80% of these events. Viruse...

  14. Societal Burden of Clinically Anxious Youth Referred for Treatment: A Cost-of-Illness Study

    ERIC Educational Resources Information Center

    Bodden, Denise H. M.; Dirksen, Carmen D.; Bogels, Susan M.

    2008-01-01

    A prevalence-based cost-of-illness study using a societal perspective was conducted to investigate the cost-of-illness in clinically anxious youth aged 8-18 in The Netherlands. Discriminant validity of the cost diary used was obtained by comparing costs of families with an anxious child (n=118) to costs of families from the general population…

  15. A decision support tool to compare waterborne and foodborne infection and/or illness risks associated with climate change.

    PubMed

    Schijven, Jack; Bouwknegt, Martijn; de Roda Husman, Ana Maria; Rutjes, Saskia; Sudre, Bertrand; Suk, Jonathan E; Semenza, Jan C

    2013-12-01

    Climate change may impact waterborne and foodborne infectious disease, but to what extent is uncertain. Estimating climate-change-associated relative infection risks from exposure to viruses, bacteria, or parasites in water or food is critical for guiding adaptation measures. We present a computational tool for strategic decision making that describes the behavior of pathogens using location-specific input data under current and projected climate conditions. Pathogen-pathway combinations are available for exposure to norovirus, Campylobacter, Cryptosporidium, and noncholera Vibrio species via drinking water, bathing water, oysters, or chicken fillets. Infection risk outcomes generated by the tool under current climate conditions correspond with those published in the literature. The tool demonstrates that increasing temperatures lead to increasing risks for infection with Campylobacter from consuming raw/undercooked chicken fillet and for Vibrio from water exposure. Increasing frequencies of drought generally lead to an elevated infection risk of exposure to persistent pathogens such as norovirus and Cryptosporidium, but decreasing risk of exposure to rapidly inactivating pathogens, like Campylobacter. The opposite is the case with increasing annual precipitation; an upsurge of heavy rainfall events leads to more peaks in infection risks in all cases. The interdisciplinary tool presented here can be used to guide climate change adaptation strategies focused on infectious diseases. PMID:23781944

  16. Is glycemic control of the critically ill cost-effective?

    PubMed

    Krinsley, James S

    2014-10-01

    Intensive monitoring of blood glucose levels and treatment of hyperglycemia have been associated with significant improvements in morbidity and mortality in the critically ill. In contrast to the large prospective and observational body of data relating glycemic control and clinical outcomes, the financial impact of glycemic control implementation has not been as well described. This article details data from interventional trials of intensive insulin therapy; investigations that relate dysglycemia to morbidity, particularly intensive care unit (ICU)-acquired infections and increased ICU length of stay; and evaluations of the attributable cost of nosocomial infection in order to construct a sensitivity analysis of the net economic impact of glycemic control. It concludes that glycemic control is associated with positive financial outcomes, even using very conservative assumptions, and provides the reader with an automated spreadsheet to estimate the financial implications of glycemic control using assumptions based on locally derived data. PMID:25502129

  17. Peripheral arterial obliterative disease. Cost of illness in France.

    PubMed

    Montron, A; Guignard, E; Pelc, A; Comte, S

    1998-01-01

    The main purpose of this study, carried out in 1995, was to determine, using available sources, the cost of peripheral arterial obliterative disease (PAOD) in France over a 1-year period. This cost-of-illness study was based on a retrospective analysis of the available literature and databases. It involved a description of epidemiological data and a cost estimate of the different medical resources consumed over 1 year. For this latter purpose, a payer perspective was chosen. Data were extracted from national representative surveys and databases with respect to morbidity and mortality [from the National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale; INSERM) and the National Sickness Insurance Fund for Salaried People (Caisse Nationale d'Assurance Maladie des Travailleurs Salariés; CNAMTS)], consultations, examination tests and drug prescriptions [from the French Medical Audit conducted by Intercontinental Medical Statistics (IMS)], hospitalisations [from the Statistical Unit of the Department of Health-Service des Statistiques, des Etudes et des Systemes d'Information (SESI) and the National Public Research Centre in Health Economics (Centre de Recherche d'Etude et de Documentation en Economie de la Santé; CREDES)] and related health expenditure from CNAMTS. In France, the prevalence of stage II PAOD (Leriche and Fontaine classification) in 1992 was estimated to be 675,000; 53% of these patients had undergone vascular or bypass surgery. The total annual cost of healthcare (including consultations, drugs, laboratory tests, hospitalisation and hydrotherapy) for the management of patients with PAOD ranged from 3.9 billion French francs (F) to F4.6 billion (1995 values), depending on the type of hospital considered. 50% of this cost was related to hospitalisations and 75% was covered by the CNAMTS. Although this study was only a partial evaluation and did not take into account indirect costs or nonmedical direct

  18. An Improved Multiplex Real-Time SYBR Green PCR Assay for Analysis of 24 Target Genes from 16 Bacterial Species in Fecal DNA Samples from Patients with Foodborne Illnesses.

    PubMed

    Kawase, Jun; Etoh, Yoshiki; Ikeda, Tetsuya; Yamaguchi, Keiji; Watahiki, Masanori; Shima, Tomoko; Kameyama, Mitsuhiro; Horikawa, Kazumi; Fukushima, Hiroshi; Goto, Ryoichi; Shirabe, Komei

    2016-05-20

    Here, we developed a new version of our original screening system (Rapid Foodborne Bacterial Screening 24; RFBS24), which can simultaneously detect 24 genes of foodborne pathogens in fecal DNA samples. This new version (RFBS24 ver. 5) detected all known stx2 subtypes, enterotoxigenic Escherichia coli (STh genotype), and Vibrio parahaemolyticus (trh2), which were not detected by the original RFBS24 assay. The detection limits of RFBS24 ver. 5 were approximately 5.6 × 10(-2)-5.6 × 10(-5) (ng DNA)/reaction, significantly lower (10- to 100-fold) than those of the original RFBS24 for the 22 target genes analyzed here. We also tested the new assay on fecal DNA samples from patients infected with Salmonella, Campylobacter, or enterohemorrhagic E. coli. The number of bacterial target genes detected by RFBS24 ver. 5 was greater than that detected by RFBS24. RFBS24 ver. 5 combined with an Ultra Clean Fecal DNA Isolation Kit showed adequate performance (sensitivity and specificity 89% and 100%, respectively, for Salmonella spp. and 100% and 83%, respectively, for Campylobacter jejuni) in terms of rapid detection of a causative pathogen during foodborne-illness outbreaks. Thus, RFBS24 ver. 5 is more useful than the previous assay system for detection of foodborne pathogens and offers quick simultaneous analysis of many targets and thus facilitates rapid dissemination of information to public health officials. PMID:26166499

  19. Detection of food-borne pathogens by nanoparticle technology coupled to a low-cost cell reader

    NASA Astrophysics Data System (ADS)

    Noiseux, Isabelle; Bouchard, Jean-Pierre; Gallant, Pascal; Bourqui, Pascal; Cao, Honghe; Vernon, Marci; Johnson, Roger; Chen, Shu; Mermut, Ozzy

    2010-02-01

    The detection, identification and quantification of pathogenic microorganisms at low cost are of great interest to the agro-food industry. We have developed a simple, rapid, sensitive, and specific method for detection of food-borne pathogens based on use of nanoparticles alongside a low cost fluorescence cell reader for the bioassay. The nanoparticles are coupled with antibodies that allow specific recognition of the targeted Listeria in either a liquid or food matrix. The bioconjugated nanoparticles (FNP) contain thousands of dye molecules enabling significant amplification of the fluorescent signal emitted from each bacterium. The developed fluorescence Cell Reader is an LED-based reader coupled with suitable optics and a camera that acquires high resolution images. The dedicated algorithm allowed the counting of each individual nanoparticles-fluorescent bacterial cells thus enabling highly sensitive reading. The system allows, within 1 hour, the recovery and counting of 104 to 108 cfu/mL of Listeria in pure culture. However, neither the Cell Reader nor the algorithm can differentiate between the FNPs specifically-bound to the target and the residual unbound FNPs limiting sensitivity of the system. Since FNPs are too small to be washed in the bioassay, a dual tagging approach was implemented to allow online optical separation of the fluorescent background caused by free FNPs.

  20. Cost-of-Illness Trends Associated with Thyroid Disease in Korea

    PubMed Central

    Hyun, Kyung-Rae; Kang, Sungwook

    2014-01-01

    Background The purpose of this study is to analyze the scale of and trends associated with the cost-of-illness of thyroid disease in Korea at 2-year intervals during the last 10 years for which data are available. Methods Cost-of-illness was estimated in terms of direct and indirect costs. Direct costs include direct medical costs due to hospitalization, outpatient and pharmacy sectors, transportation, and care-giver costs. Indirect costs include future income loss due to premature death and loss of productivity as a result of absence from work. Results The cost-of-illness of thyroid disease in Korea was estimated at 224.2 billion won in 2002, 303.4 billion won in 2004, 400.3 billion won in 2006, 570.4 billion won in 2008, and 762.2 billion won in 2010. For example, the cost-of-illness of thyroid disease in 2010 was 3.4 times greater compared to 2002. The direct cost of the total cost-of-illness was 69.7%, which accounted for the highest proportion of costs. Cost-of-illness for individuals between the ages of 30 and 50 accounted for the greatest share of costs. Conclusion The cost-of-illness of thyroid disease was relatively large in economically active age groups, and demonstrated a very rapid growth rate compared to other major diseases in Korea. Therefore, we suggest nationwide recognition of the importance of prevention and management of thyroid disease and prioritization of the management of thyroid disease among current and future health promotion policies in Korea. PMID:25309784

  1. Systematic review of cost-of-illness studies in hand eczema.

    PubMed

    Politiek, Klaziena; Oosterhaven, Jart A F; Vermeulen, Karin M; Schuttelaar, Marie-Louise A

    2016-08-01

    The individual burden of disease in hand eczema patients is considerable. However, little is known about the socio-economic impact of this disease. The aims of this review were to evaluate the literature on cost-of-illness in hand eczema, and to compose a checklist for future use. The literature was retrieved from the MEDLINE and EMBASE databases up to October 2015. Quality evaluation was based on seven relevant items in cost-of-illness studies. Cost data (direct and indirect) were extracted and converted into euros (2014 price level) by use of the Dutch Consumer Price Index. Six articles were included. The mean annual total cost per patient ranged from €1712 to €9792 (direct cost per patient, €521 to €3829; and indirect cost per patient, €100 to €6846). Occupational hand eczema patients showed indirect costs up to 70% of total costs, mainly because of absenteeism. A large diversity in hand eczema severity was found between studies. The socio-economic burden of hand eczema is considerable, especially for more severe and/or occupational hand eczema. Absenteeism from paid work leads to a high total cost-of-illness, although disregard of presenteeism often leads to underestimation of indirect costs. Differences in included cost components, the occupational status of patients and hand eczema severity make international comparison difficult. A checklist was added to standardize the approach to cost-of-illness studies in hand eczema. PMID:27218305

  2. Modern approaches in probiotics research to control foodborne pathogens.

    PubMed

    Amalaradjou, Mary Anne Roshni; Bhunia, Arun K

    2012-01-01

    Foodborne illness is a serious public health concern. There are over 200 known microbial, chemical, and physical agents that are known to cause foodborne illness. Efforts are made for improved detection, control and prevention of foodborne pathogen in food, and pathogen associated diseases in the host. Several commonly used approaches to control foodborne pathogens include antibiotics, natural antimicrobials, bacteriophages, bacteriocins, ionizing radiations, and heat. In addition, probiotics offer a potential intervention strategy for the prevention and control of foodborne infections. This review focuses on the use of probiotics and bioengineered probiotics to control foodborne pathogens, their antimicrobial actions, and their delivery strategies. Although probiotics have been demonstrated to be effective in antagonizing foodborne pathogens, challenges exist in the characterization and elucidation of underlying molecular mechanisms of action and in the development of potential delivery strategies that could maintain the viability and functionality of the probiotic in the target organ. PMID:23034117

  3. How much does it cost to identify a critically ill child experiencing electrographic seizures?

    PubMed Central

    Abend, Nicholas S.; Topjian, Alexis A; Williams, Sankey

    2015-01-01

    Objectives Electrographic seizures in critically ill children may be identified by continuous electroencephalographic (EEG) monitoring. We evaluated the cost-effectiveness of four electrographic seizure identification strategies (no EEG monitoring and EEG monitoring for 1 hour, 24 hours, or 48 hours). Methods We created a decision tree to model the relationships among variables from a societal perspective. To provide input for the model, we estimated variable costs directly related to EEG monitoring from their component parts, and we reviewed the literature to estimate the probabilities of outcomes. We calculated incremental cost-effectiveness ratios to identify the tradeoff between cost and effectiveness at different willingness-to-pay values. Results Our analysis found that the preferred strategy was EEG monitoring for 1 hour, 24 hours, and 48 hours if the decision maker was willing to pay <$1,666, $1,666–$22,648, and >$22,648 per critically ill child identified with electrographic seizures, respectively. The 48 hour strategy only identified 4% more children with electrographic seizures at substantially higher cost. Sensitivity analyses found that all three strategies were acceptable at lower willingness-to-pay values when children with higher electrographic seizure risk were monitored. Conclusions Our results support monitoring of critically ill children for 24 hours because the cost to identify a critically ill child with electrographic seizures is modest. Further study is needed to predict better which children may benefit from 48 hours of EEG monitoring since the costs are much higher. PMID:25626776

  4. The Cost of Illness Associated with Stepped Care for Obsessive-Compulsive Disorder

    PubMed Central

    Diefenbach, Gretchen J.; Tolin, David F.

    2013-01-01

    Stepped care for obsessive-compulsive disorders (OCD) is a promising approach for improving the accessibility and cost-effectiveness of exposure and response prevention (ERP). Previous research has shown that stepped care is less costly compared with standard, therapist-directed ERP, owing largely to the roughly one-third of patients who respond to lower intensity guided self-help (GSH). The aim of this study was to recalculate the costs of treatment in stepped versus standard care when also including the cost of illness; defined as costs related to functional disability in work, school, and home functioning attributed to OCD symptoms. It was found that the cost savings of stepped care was reduced to a moderate effect (d = 0.66) when the cost of illness was included. Data also indicated substantial potential cost savings if patient-to-treatment matching variables are identified. Exploratory analyses suggested that problems with attention may be an important variable to investigate as a potential treatment moderator in future GSH treatment outcome research. These data highlight the importance of including the cost of illness in cost-effectiveness analyses, and of identifying predictors that will facilitate matched care and prevent unnecessary treatment delay for the roughly two-thirds of patients who will not respond to GSH for OCD. PMID:23525502

  5. A Cost-Benefit Analysis of a Family Systems Intervention for Managing Pediatric Chronic Illness.

    PubMed

    Distelberg, Brian J; Emerson, Natacha D; Gavaza, Paul; Tapanes, Daniel; Brown, Whitney N; Shah, Huma; Williams-Reade, Jacqueline; Montgomery, Susanne

    2016-07-01

    Despite recent increases of psychosocial programs for pediatric chronic illness, few studies have explored their economic benefits. This study investigated the costs-benefits of a family systems-based, psychosocial intervention for pediatric chronic illness (MEND: Mastering Each New Direction). A quasi-prospective study compared the 12-month pre-post direct and indirect costs of 20 families. The total cost for program was estimated to $5,320. Families incurred $15,249 less in direct and $15,627 less in indirect costs after MEND. On average, medical expenses reduced by 86% in direct and indirect costs, for a cost-benefit ratio of 0.17. Therefore, for every dollar spent on the program, families and their third payers saved approximately $5.74. Implications for healthcare policy and reimbursements are discussed. PMID:27282311

  6. Troubleshooting Costs

    NASA Astrophysics Data System (ADS)

    Kornacki, Jeffrey L.

    Seventy-six million cases of foodborne disease occur each year in the United States alone. Medical and lost productivity costs of the most common pathogens are estimated to be 5.6-9.4 billion. Product recalls, whether from foodborne illness or spoilage, result in added costs to manufacturers in a variety of ways. These may include expenses associated with lawsuits from real or allegedly stricken individuals and lawsuits from shorted customers. Other costs include those associated with efforts involved in finding the source of the contamination and eliminating it and include time when lines are shut down and therefore non-productive, additional non-routine testing, consultant fees, time and personnel required to overhaul the entire food safety system, lost market share to competitors, and the cost associated with redesign of the factory and redesign or acquisition of more hygienic equipment. The cost associated with an effective quality assurance plan is well worth the effort to prevent the situations described.

  7. Real Time Detection of Foodborne Pathogens

    NASA Astrophysics Data System (ADS)

    Velusamy, V.; Arshak, K.; Korostynka, O.; Vaseashta, Ashok; Adley, C.

    Contamination of foods by harmful bacteria by natural events or malicious intent poses a serious threat to public health and safety. This review introduces current technologies in detecting pathogens in food and foodborne illnesses. Causes of foodborne diseases and trends impacting foodborne diseases such as globalization and changes in micro-organisms, human populations, lifestyles, and climates are addressed. In addition, a review of the limitations in detecting pathogens with conventional technologies is presented. Finally, a review of nanostructured and nanomaterials based sensing technologies by pathogen, detection limits, and advantages is described.

  8. The high cost of diarrhoeal illness for urban slum households–a cost-recovery approach: a cohort study

    PubMed Central

    Patel, Ronak B; Stoklosa, Hanni; Shitole, Shrutika; Shitole, Tejal; Sawant, Kiran; Nanarkar, Mahesh; Subbaraman, Ramnath; Ridpath, Alison; Patil-Deshmuk, Anita

    2013-01-01

    Objectives Rapid urbanisation has often meant that public infrastructure has not kept pace with growth leading to urban slums with poor access to water and sanitation and high rates of diarrhoea with greater household costs due to illness. This study sought to determine the monetary cost of diarrhoea to urban slum households in Kaula Bandar slum in Mumbai, India. The study also tested the hypotheses that the cost of water and sanitation infrastructure may be surpassed by the cumulative costs of diarrhoea for households in an urban slum community. Design A cohort study using a baseline survey of a random sample followed by a systematic longitudinal household survey. The baseline survey was administered to a random sample of households. The systematic longitudinal survey was administered to every available household in the community with a case of diarrhoea for a period of 5 weeks. Participants Every household in Kaula Bandar was approached for the longitudinal survey and all available and consenting adults were included. Results The direct cost of medical care for having at least one person in the household with diarrhoea was 205 rupees. Other direct costs brought total expenses to 291 rupees. Adding an average loss of 55 rupees per household from lost wages and monetising lost productivity from homemakers gave a total loss of 409 rupees per household. During the 5-week study period, this community lost an estimated 163 600 rupees or 3635 US dollars due to diarrhoeal illness. Conclusions The lack of basic water and sanitation infrastructure is expensive for urban slum households in this community. Financing approaches that transfer that cost to infrastructure development to prevent illness may be feasible. These findings along with the myriad of unmeasured benefits of preventing diarrhoeal illness add to pressing arguments for investment in basic water and sanitation infrastructure. PMID:23558731

  9. The Costs of Respiratory Illnesses Arising from Florida Gulf Coast Karenia brevis Blooms

    PubMed Central

    Hoagland, Porter; Jin, Di; Polansky, Lara Y.; Kirkpatrick, Barbara; Kirkpatrick, Gary; Fleming, Lora E.; Reich, Andrew; Watkins, Sharon M.; Ullmann, Steven G.; Backer, Lorraine C.

    2009-01-01

    Background Algal blooms of Karenia brevis, a harmful marine algae, occur almost annually off the west coast of Florida. At high concentrations, K. brevis blooms can cause harm through the release of potent toxins, known as brevetoxins, to the atmosphere. Epidemiologic studies suggest that aerosolized brevetoxins are linked to respiratory illnesses in humans. Objectives We hypothesized a relationship between K. brevis blooms and respiratory illness visits to hospital emergency departments (EDs) while controlling for environmental factors, disease, and tourism. We sought to use this relationship to estimate the costs of illness associated with aerosolized brevetoxins. Methods We developed a statistical exposure–response model to express hypotheses about the relationship between respiratory illnesses and bloom events. We estimated the model with data on ED visits, K. brevis cell densities, and measures of pollen, pollutants, respiratory disease, and intra-annual population changes. Results We found that lagged K. brevis cell counts, low air temperatures, influenza outbreaks, high pollen counts, and tourist visits helped explain the number of respiratory-specific ED diagnoses. The capitalized estimated marginal costs of illness for ED respiratory illnesses associated with K. brevis blooms in Sarasota County, Florida, alone ranged from $0.5 to $4 million, depending on bloom severity. Conclusions Blooms of K. brevis lead to significant economic impacts. The costs of illness of ED visits are a conservative estimate of the total economic impacts. It will become increasingly necessary to understand the scale of the economic losses associated with K. brevis blooms to make rational choices about appropriate mitigation. PMID:19672403

  10. Using Common Themes: Cost-Effectiveness of Permanent Supported Housing for People with Mental Illness

    ERIC Educational Resources Information Center

    McLaughlin, Thomas Chalmers

    2011-01-01

    This article examines the cost-effectiveness of providing permanent supported housing to homeless people with mental illness. Through the use of billing records and frequency of use charts, researchers were able to map the service usage of a cohort of 268 homeless individuals from both urban and rural communities. The results suggest that…

  11. Socio-economic burden of rare diseases: A systematic review of cost of illness evidence.

    PubMed

    Angelis, Aris; Tordrup, David; Kanavos, Panos

    2015-07-01

    Cost-of-illness studies, the systematic quantification of the economic burden of diseases on the individual and on society, help illustrate direct budgetary consequences of diseases in the health system and indirect costs associated with patient or carer productivity losses. In the context of the BURQOL-RD project ("Social Economic Burden and Health-Related Quality of Life in patients with Rare Diseases in Europe") we studied the evidence on direct and indirect costs for 10 rare diseases (Cystic Fibrosis [CF], Duchenne Muscular Dystrophy [DMD], Fragile X Syndrome [FXS], Haemophilia, Juvenile Idiopathic Arthritis [JIA], Mucopolysaccharidosis [MPS], Scleroderma [SCL], Prader-Willi Syndrome [PWS], Histiocytosis [HIS] and Epidermolysis Bullosa [EB]). A systematic literature review of cost of illness studies was conducted using a keyword strategy in combination with the names of the 10 selected rare diseases. Available disease prevalence in Europe was found to range between 1 and 2 per 100,000 population (PWS, a sub-type of Histiocytosis, and EB) up to 42 per 100,000 population (Scleroderma). Overall, cost evidence on rare diseases appears to be very scarce (a total of 77 studies were identified across all diseases), with CF (n=29) and Haemophilia (n=22) being relatively well studied, compared to the other conditions, where very limited cost of illness information was available. In terms of data availability, total lifetime cost figures were found only across four diseases, and total annual costs (including indirect costs) across five diseases. Overall, data availability was found to correlate with the existence of a pharmaceutical treatment and indirect costs tended to account for a significant proportion of total costs. Although methodological variations prevent any detailed comparison between conditions and based on the evidence available, most of the rare diseases examined are associated with significant economic burden, both direct and indirect. PMID:25661982

  12. Cost Effectiveness of Implementing Integrated Management of Neonatal and Childhood Illnesses Program in District Faridabad, India

    PubMed Central

    Prinja, Shankar; Bahuguna, Pankaj; Mohan, Pavitra; Mazumder, Sarmila; Taneja, Sunita; Bhandari, Nita; van den Hombergh, Henri; Kumar, Rajesh

    2016-01-01

    Introduction Despite the evidence for preventing childhood morbidity and mortality, financial resources are cited as a constraint for Governments to scale up the key health interventions in some countries. We evaluate the cost effectiveness of implementing IMNCI program in India from a health system and societal perspective. Methods We parameterized a decision analytic model to assess incremental cost effectiveness of IMNCI program as against routine child health services for infant population at district level in India. Using a 15-years time horizon from 2007 to 2022, we populated the model using data on costs and effects as found from a cluster-randomized trial to assess effectiveness of IMNCI program in Haryana state. Effectiveness was estimated as reduction in infant illness episodes, deaths and disability adjusted life years (DALY). Incremental cost per DALY averted was used to estimate cost effectiveness of IMNCI. Future costs and effects were discounted at a rate of 3%. Probabilistic sensitivity analysis was undertaken to estimate the probability of IMNCI to be cost effective at varying willingness to pay thresholds. Results Implementation of IMNCI results in a cumulative reduction of 57384 illness episodes, 2369 deaths and 76158 DALYs among infants at district level from 2007 to 2022. Overall, from a health system perspective, IMNCI program incurs an incremental cost of USD 34.5 (INR 1554) per DALY averted, USD 34.5 (INR 1554) per life year gained, USD 1110 (INR 49963) per infant death averted. There is 90% probability for ICER to be cost effective at INR 2300 willingness to pay, which is 5.5% of India’s GDP per capita. From a societal perspective, IMNCI program incurs an additional cost of USD 24.1 (INR 1082) per DALY averted, USD 773 (INR 34799) per infant death averted and USD 26.3 (INR 1183) per illness averted in during infancy. Conclusion IMNCI program in Indian context is very cost effective and should be scaled-up as a major child survival

  13. Cost-of-illness and disease burden of food-related pathogens in the Netherlands, 2011.

    PubMed

    Mangen, Marie-Josée J; Bouwknegt, Martijn; Friesema, Ingrid H M; Haagsma, Juanita A; Kortbeek, Laetitia M; Tariq, Luqman; Wilson, Margaret; van Pelt, Wilfrid; Havelaar, Arie H

    2015-03-01

    To inform risk management decisions on control and prevention of food-related disease, both the disease burden expressed in Disability Adjusted Life Years (DALY) and the cost-of-illness of food-related pathogens are estimated and presented. Disease burden of fourteen pathogens that can be transmitted by food, the environment, animals and humans was previously estimated by Havelaar et al. (2012). In this paper we complement these by cost-of-illness estimates. Together, these present a complete picture of the societal burden of food-related diseases. Using incidence estimates for 2011, community-acquired non-consulting cases, patients consulting their general practitioner, hospitalized patients and the incidence of sequelae and fatal cases, estimates were obtained for DALYs, direct healthcare costs (e.g. costs for doctor's fees, hospitalizations and medicines), direct non-healthcare costs (e.g. travel costs to and from the doctor), indirect non-healthcare costs (e.g. productivity loss, special education) and total costs. The updated disease burden for 2011 was equal to 13,940 DALY/year (undiscounted) or 12,650 DALY/year (discounted at 1.5%), and was of the same magnitude as previous estimates. At the population-level thermophilic Campylobacter spp., Toxoplasma gondii and rotavirus were associated with the highest disease burden. Perinatal listeriosis infection was associated with the highest DALY per symptomatic case. The total cost-of-illness in 2011 of fourteen food-related pathogens and associated sequelae was estimated at € 468 million/year, if undiscounted, and at € 416 million/year if discounted by 4%. Direct healthcare costs accounted for 24% of total costs, direct non-healthcare costs for 2% and indirect non-healthcare costs for 74% of total costs. At the population-level, norovirus had the highest total cost-of-illness in 2011 with € 106 million/year, followed by thermophilic Campylobacter spp. (€ 76 million/year) and rotavirus (€ 73 million

  14. Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore

    PubMed Central

    Carrasco, Luis R.; Lee, Linda K.; Lee, Vernon J.; Ooi, Eng Eong; Shepard, Donald S.; Thein, Tun L.; Gan, Victor; Cook, Alex R.; Lye, David; Ng, Lee Ching; Leo, Yee Sin

    2011-01-01

    Background Dengue illness causes 50–100 million infections worldwide and threatens 2.5 billion people in the tropical and subtropical regions. Little is known about the disease burden and economic impact of dengue in higher resourced countries or the cost-effectiveness of potential dengue vaccines in such settings. Methods and Findings We estimate the direct and indirect costs of dengue from hospitalized and ambulatory cases in Singapore. We consider inter alia the impacts of dengue on the economy using the human-capital and the friction cost methods. Disease burden was estimated using disability-adjusted life years (DALYs) and the cost-effectiveness of a potential vaccine program was evaluated. The average economic impact of dengue illness in Singapore from 2000 to 2009 in constant 2010 US$ ranged between $0.85 billion and $1.15 billion, of which control costs constitute 42%–59%. Using empirically derived disability weights, we estimated an annual average disease burden of 9–14 DALYs per 100 000 habitants, making it comparable to diseases such as hepatitis B or syphilis. The proportion of symptomatic dengue cases detected by the national surveillance system was estimated to be low, and to decrease with age. Under population projections by the United Nations, the price per dose threshold for which vaccines stop being more cost-effective than the current vector control program ranged from $50 for mass vaccination requiring 3 doses and only conferring 10 years of immunity to $300 for vaccination requiring 2 doses and conferring lifetime immunity. The thresholds for these vaccine programs to not be cost-effective for Singapore were $100 and $500 per dose respectively. Conclusions Dengue illness presents a serious economic and disease burden in Singapore. Dengue vaccines are expected to be cost-effective if reasonably low prices are adopted and will help to reduce the economic and disease burden of dengue in Singapore substantially. PMID:22206028

  15. Comparison of hydrostatic and hydrodynamic pressure to inactivate foodborne viruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Viruses cause the majority of cases of foodborne illness in the United States. The lack of culturability of some foodborne viruses requires the use of alternate models, like non-pathogenic surrogates or bacteriophage, for inactivation studies. High pressure technology is currently being implemented ...

  16. An Economic Evaluation of PulseNet: A Network for Foodborne Disease Surveillance.

    PubMed

    Scharff, Robert L; Besser, John; Sharp, Donald J; Jones, Timothy F; Peter, Gerner-Smidt; Hedberg, Craig W

    2016-05-01

    The PulseNet surveillance system is a molecular subtyping network of public health and food regulatory agency laboratories designed to identify and facilitate investigation of foodborne illness outbreaks. This study estimates health and economic impacts associated with PulseNet. The staggered adoption of PulseNet across the states offers a natural experiment to evaluate its effectiveness, which is measured as reduction of reported illnesses due to improved information, enhanced industry accountability, and more-rapid recalls. Economic impacts attributable to PulseNet include medical costs and productivity losses averted due to reduced illness. Program costs are also reported. Better information and accountability from enhanced surveillance is associated with large reductions of reported illnesses. Data collected between 1994 and 2009 were assembled and analyzed between 2010 and 2015. Conservatively, accounting for underreporting and underdiagnosis, 266,522 illnesses from Salmonella, 9,489 illnesses from Escherichia coli (E. coli), and 56 illnesses due to Listeria monocytogenes are avoided annually. This reduces medical and productivity costs by $507 million. Additionally, direct effects from improved recalls reduce illnesses from E. coli by 2,819 and Salmonella by 16,994, leading to $37 million in costs averted. Annual costs to public health agencies are $7.3 million. The PulseNet system makes possible the identification of food safety risks by detecting widespread or non-focal outbreaks. This gives stakeholders information for informed decision making and provides a powerful incentive for industry. Furthermore, PulseNet enhances the focus of regulatory agencies and limits the impact of outbreaks. The health and economic benefits from PulseNet and the foodborne disease surveillance system are substantial. PMID:26993535

  17. The Economic Burden of Liver Cirrhosis in Iran: a Cost of Illness Study

    PubMed Central

    AKBARI SARI, Ali; KAZEMI KARYANI, Ali; ALAVIAN, Seyed Moayed; ARAB, Mohamad; ROSTAMI GHOLMOHAMADI, Fateme; REZAEI, Satar

    2015-01-01

    Background: According to importance of cirrhosis of the liver and the lack of information about the economic burden of the disease, we performed this study to estimate the economic burden of liver Cirrhosis in Iran in 2011. Methods: The cost-of-illness method, based on the human capital theory, has been used. Both direct and indirect costs have been estimated using a prevalence approach and bottom-up method. The inpatient and outpatient records were investigated for obtaining the medical costs. Also, a questionnaire was used for collection the other data such as transportation costs, out of pocket payment and times of inpatients, etc. Costs consisted of expenditures which happened during March 2011 to February 2012 and the perspective of the study was Iranian society. Results: The total cost of the disease was 2014.5 billion Rials (USD164.32 million). Direct and indirect costs were 1384.16 and 630.4 billion Rials (86.7% and 11.3% of the total cost), respectively. Cost due to premature death was USD 38.66 million, included 23.52% of the total cost and 75% of indirect cost. Conclusion: Liver Cirrhosis impose enormous economic burden on Iranian society. Policymakers should therefore take this into consideration and according to available health resources provide services and facilities for the prevention and treatment of the disease. PMID:26056670

  18. Depression in Working Adults: Comparing the Costs and Health Outcomes of Working When Ill

    PubMed Central

    Cocker, Fiona; Nicholson, Jan M.; Graves, Nicholas; Oldenburg, Brian; Palmer, Andrew J.; Martin, Angela; Scott, Jenn; Venn, Alison; Sanderson, Kristy

    2014-01-01

    Objective Working through a depressive illness can improve mental health but also carries risks and costs from reduced concentration, fatigue, and poor on-the-job performance. However, evidence-based recommendations for managing work attendance decisions, which benefit individuals and employers, are lacking. Therefore, this study has compared the costs and health outcomes of short-term absenteeism versus working while ill (“presenteeism”) amongst employed Australians reporting lifetime major depression. Methods Cohort simulation using state-transition Markov models simulated movement of a hypothetical cohort of workers, reporting lifetime major depression, between health states over one- and five-years according to probabilities derived from a quality epidemiological data source and existing clinical literature. Model outcomes were health service and employment-related costs, and quality-adjusted-life-years (QALYs), captured for absenteeism relative to presenteeism, and stratified by occupation (blue versus white-collar). Results Per employee with depression, absenteeism produced higher mean costs than presenteeism over one- and five-years ($42,573/5-years for absenteeism, $37,791/5-years for presenteeism). However, overlapping confidence intervals rendered differences non-significant. Employment-related costs (lost productive time, job turnover), and antidepressant medication and service use costs of absenteeism and presenteeism were significantly higher for white-collar workers. Health outcomes differed for absenteeism versus presenteeism amongst white-collar workers only. Conclusions Costs and health outcomes for absenteeism and presenteeism were not significantly different; service use costs excepted. Significant variation by occupation type was identified. These findings provide the first occupation-specific cost evidence which can be used by clinicians, employees, and employers to review their management of depression-related work attendance, and may

  19. Novel methods for detection of foodborne viruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Enteric viruses such as norovirus are the number one cause of foodborne illness. Bivalve shellfish such as oysters efficiently bioconcentrate and retain theses pathogens, making raw shellfish consumption a significant risk factor for acquisition of these viruses. Recent ARS research indicates...

  20. Foodborne Campylobacter: Infections, metabolism, pathogenesis and resorvoirs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Campylobacter species are a leading cause of bacterial-derived foodborne illness worldwide. The emergence of this bacterial group as a significant causative agent of human disease and their propensity to carry antibiotic resistance elements that allows them to resist antibacterial therapy make them...

  1. Cost-of-Illness in Psoriasis: Comparing Inpatient and Outpatient Therapy

    PubMed Central

    Steinke, Sabine I. B.; Peitsch, Wiebke K.; Ludwig, Alexander; Goebeler, Matthias

    2013-01-01

    Treatment modalities of chronic plaque psoriasis have dramatically changed over the past ten years with a still continuing shift from inpatient to outpatient treatment. This development is mainly caused by outpatient availability of highly efficient and relatively well-tolerated systemic treatments, in particular BioLogicals. In addition, inpatient treatment is time- and cost-intense, conflicting with the actual burst of health expenses and with patient preferences. Nevertheless, inpatient treatment with dithranol and UV light still is a major mainstay of psoriasis treatment in Germany. The current study aims at comparing the total costs of inpatient treatment and outpatient follow-up to mere outpatient therapy with different modalities (topical treatment, phototherapy, classic systemic therapy or BioLogicals) over a period of 12 months. To this end, a retrospective cost-of-illness study was conducted on 120 patients treated at the University Medical Centre Mannheim between 2005 and 2006. Inpatient therapy caused significantly higher direct medical, indirect and total annual costs than outpatient treatment (13,042 € versus 2,984 €). Its strong influence on cost levels was confirmed by regression analysis, with total costs rising by 104.3% in case of inpatient treatment. Patients receiving BioLogicals produced the overall highest costs, whereas outpatient treatment with classic systemic antipsoriatic medications was less cost-intense than other alternatives. PMID:24194911

  2. Foodborne listeriosis acquired in hospitals.

    PubMed

    Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M

    2014-08-15

    Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods. PMID:24846635

  3. Oseltamivir Treatment for Children with Influenza-Like Illness in China: A Cost-Effectiveness Analysis

    PubMed Central

    Shen, Kunling; Xiong, Tengbin; Tan, Seng Chuen; Wu, Jiuhong

    2016-01-01

    Background Influenza is a common viral respiratory infection that causes epidemics and pandemics in the human population. Oseltamivir is a neuraminidase inhibitor—a new class of antiviral therapy for influenza. Although its efficacy and safety have been established, there is uncertainty regarding whether influenza-like illness (ILI) in children is best managed by oseltamivir at the onset of illness, and its cost-effectiveness in children has not been studied in China. Objective To evaluate the cost-effectiveness of post rapid influenza diagnostic test (RIDT) treatment with oseltamivir and empiric treatment with oseltamivir comparing with no antiviral therapy against influenza for children with ILI. Methods We developed a decision-analytic model based on previously published evidence to simulate and evaluate 1-year potential clinical and economic outcomes associated with three managing strategies for children presenting with symptoms of influenza. Model inputs were derived from literature and expert opinion of clinical practice and research in China. Outcome measures included costs and quality-adjusted life year (QALY). All the interventions were compared with incremental cost-effectiveness ratios (ICER). Results In base case analysis, empiric treatment with oseltamivir consistently produced the greatest gains in QALY. When compared with no antiviral therapy, the empiric treatment with oseltamivir strategy is very cost effective with an ICER of RMB 4,438. When compared with the post RIDT treatment with oseltamivir, the empiric treatment with oseltamivir strategy is dominant. Probabilistic sensitivity analysis projected that there is a 100% probability that empiric oseltamivir treatment would be considered as a very cost-effective strategy compared to the no antiviral therapy, according to the WHO recommendations for cost-effectiveness thresholds. The same was concluded with 99% probability for empiric oseltamivir treatment being a very cost-effective strategy

  4. An introduction to on-farm strategies to control foodborne pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne illnesses affect more than 48 million Americans each year. The economic impact of these foodborne illnesses caused by bacteria associated with food animals ranges from $10 to 40 billion (USD) per year, and effects across the EU are similar in scale. Because of the large drain on the GDP,...

  5. Infantile gastroenteritis in the community:a cost-of-illness study

    PubMed Central

    LORGELLY, P. K.; JOSHI, D.; ITURRIZA GÓMARA, M.; FLOOD, C.; HUGHES, C. A.; DALRYMPLE, J.; GRAY, J.; MUGFORD, M.

    2008-01-01

    SUMMARY Rotavirus infections are the main cause of gastroenteritis in infants and children and it is expected that by the age of 5 years, nearly every child will have experienced at least one episode of rotavirus gastroenteritis. While severe cases are hospitalized, milder disease is either treated at home or by the GP, and as such the true prevalence of rotavirus infection in the community, and the burden of disease, is unknown. This paper reports the results of a cost-of-illness study which was conducted alongside a structured community surveillance study. Forty-eight percent of our sample was found to have rotavirus acute gastroenteritis; and the average total cost of a child presenting with rotavirus gastroenteritis ranged between £59 and £143 per episode, depending on the perspective. Given the prevalence and severity of the disease, the estimated burden of rotavirus gastroenteritis to society is £11.5 million per year. PMID:17338837

  6. Infantile gastroenteritis in the community: a cost-of-illness study.

    PubMed

    Lorgelly, P K; Joshi, D; Iturriza Gómara, M; Flood, C; Hughes, C A; Dalrymple, J; Gray, J; Mugford, M

    2008-01-01

    Rotavirus infections are the main cause of gastroenteritis in infants and children and it is expected that by the age of 5 years, nearly every child will have experienced at least one episode of rotavirus gastroenteritis. While severe cases are hospitalized, milder disease is either treated at home or by the GP, and as such the true prevalence of rotavirus infection in the community, and the burden of disease, is unknown. This paper reports the results of a cost-of-illness study which was conducted alongside a structured community surveillance study. Forty-eight percent of our sample was found to have rotavirus acute gastroenteritis; and the average total cost of a child presenting with rotavirus gastroenteritis ranged between pound sterling 59 and pound sterling 143 per episode, depending on the perspective. Given the prevalence and severity of the disease, the estimated burden of rotavirus gastroenteritis to society is pound sterling 11.5 million per year. PMID:17338837

  7. Emerging foodborne pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The emergence of new foodborne pathogens is due to a number of factors. An important factor is the globalization of the food supply with the possibility of the introduction of foodborne pathogens from other countries. Animal husbandry, food production, food processing, and food distribution system...

  8. The cost of quality improvements due to integrated management of childhood illness (IMCI) in Uganda.

    PubMed

    Bishai, David; Mirchandani, Gita; Pariyo, George; Burnham, Gilbert; Black, Robert

    2008-01-01

    The goal of this paper is to measure the marginal change in facility-level costs of medical care for children under five due to an increase in service quality achieved through the integrated management of childhood illness (IMCI) strategy. Since the beneficial effects of IMCI training on child health outcomes are due to IMCI's effects on service quality, costs of IMCI are regressed against measures of service quality in this paper. Our model shows that quality, as measured by a WHO-index of integrated child assessment is 44% higher in facilities with at least one health worker trained in IMCI as compared to facilities with no health workers trained in IMCI, adjusting for facility utilization as well as type of facility ownership. Our marginal analysis that tied IMCI training to quality and quality to costs shows that on the margin, investing in IMCI training at a primary facility level can yield a significant 44.3% improvement in service quality for a modest 13.5% increase in annual facility costs. PMID:17387710

  9. Emerging Foodborne Trematodiasis

    PubMed Central

    Utzinger, Jürg

    2005-01-01

    Foodborne trematodiasis is an emerging public health problem, particularly in Southeast Asia and the Western Pacific region. We summarize the complex life cycle of foodborne trematodes and discuss its contextual determinants. Currently, 601.0, 293.8, 91.1, and 79.8 million people are at risk for infection with Clonorchis sinensis, Paragonimus spp., Fasciola spp., and Opisthorchis spp., respectively. The relationship between diseases caused by trematodes and proximity of human habitation to suitable freshwater bodies is examined. Residents living near freshwater bodies have a 2.15-fold higher risk (95% confidence interval 1.38–3.36) for infections than persons living farther from the water. Exponential growth of aquaculture may be the most important risk factor for the emergence of foodborne trematodiasis. This is supported by reviewing aquaculture development in countries endemic for foodborne trematodiasis over the past 10–50 years. Future and sustainable control of foodborne trematodiasis is discussed. PMID:16318688

  10. Palliative care for the terminally ill in America: the consideration of QALYs, costs, and ethical issues.

    PubMed

    Yang, Y Tony; Mahon, Margaret M

    2012-11-01

    The drive for cost-effective use of medical interventions has advantages, but can also be challenging in the context of end-of-life palliative treatments. A quality-adjusted life-year (QALY) provides a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health-related quality of life and survival for the patient. However, since it is in the nature of end-of-life palliative care that the benefits it brings to its patients are of short duration, it fares poorly under a policy of QALY-maximization. Nevertheless, we argue that the goals of palliative care and QALY are not incompatible, and optimal integration of palliative care into the calculation of QALY may reveal a mechanism to modify considerations of how optimal quality of life can be achieved, even in the face of terminal illness. The use of QALYs in resource allocation means that palliative care will always compete with alternative uses of the same money. More research should be conducted to evaluate choices between palliative care and more aggressive therapies for the terminally ill. However, current limited data show that investing in palliative care makes more sense not only ethically, but also financially. PMID:22071573

  11. How to Report a Foodborne Illness

    MedlinePlus

    ... and Environmental Diseases Salmonella Homepage E. coli Homepage Listeria Homepage Foodsafety.gov U.S. Food and Drug Administration ( ... and Environmental Diseases Salmonella Homepage E. coli Homepage Listeria Homepage Foodsafety.gov U.S. Food and Drug Administration ( ...

  12. Household costs of illness during different phases of tuberculosis treatment in Central Asia: a patient survey in Tajikistan

    PubMed Central

    2010-01-01

    Background Illness-related costs incurred by patients constitute a severe economic burden for households especially in low-income countries. High household costs of illness lead to impoverishment; they impair affordability and equitable access to health care and consequently hamper tuberculosis (TB) control. So far, no study has investigated patient costs of TB in the former Soviet Union. Methods All adult new pulmonary TB cases enrolled into the DOTS program in 12 study districts during the study period were enrolled. Medical and non-medical expenditure as well as loss of income were quantified in two interviews covering separate time periods. Costs of different items were summed up to calculate total costs. For missing values, multiple imputation was applied. Results A cohort of 204 patients under DOTS, 114 men and 90 women, participated in the questionnaire survey. Total illness costs of a TB episode averaged $1053 (c. $4900 purchasing power parity, PPP), of which $292, $338 and $422 were encountered before the start of treatment, during intensive phase and in continuation phase, respectively. Costs per month were highest before the start of treatment ($145) and during intensive phase ($153) and lower during continuation phase ($95). These differences were highly significant (paired t-test, p < 0.0005 for both comparisons). Conclusions The illness-related costs of an episode of TB exceed the per capita GDP of $1600 PPP about two-and-a-half times. Hence, these costs are catastrophic for concerned households and suggest a high risk for impoverishment. Costs are not equally spread over time, but peak in early stages of treatment, exacerbating the problem of affordability. Mitigation strategies are needed in order to control TB in Tajikistan and may include social support to the patients as well as changes in the management of TB cases. These mitigation strategies should be timed early in treatment when the cost burden is highest. PMID:20078897

  13. Cost effectiveness of intensive care in a low resource setting: A prospective cohort of medical critically ill patients

    PubMed Central

    Cubro, Hajrunisa; Somun-Kapetanovic, Rabija; Thiery, Guillaume; Talmor, Daniel; Gajic, Ognjen

    2016-01-01

    AIM: To calculate cost effectiveness of the treatment of critically ill patients in a medical intensive care unit (ICU) of a middle income country with limited access to ICU resources. METHODS: A prospective cohort study and economic evaluation of consecutive patients treated in a recently established medical ICU in Sarajevo, Bosnia and Herzegovina. A cost utility analysis of the intensive care of critically ill patients compared to the hospital ward treatment from the perspective of the health care system was subsequently performed. Incremental cost effectiveness was calculated using estimates of ICU vs non-ICU treatment effectiveness based on a formal systematic review of published studies. Decision analytic modeling was used to compare treatment alternatives. Sensitivity analyses of the key model parameters were performed. RESULTS: Out of 148 patients, seventy patients (47.2%) survived to one year after critical illness with a median quality of life index 0.64 [interquartile range(IQR) 0.49-0.76]. Median number of life years gained per patient was 30 (IQR 16-40) or 18 quality adjusted life years (QALYs) (IQR 7-28). The cost of treatment of critically ill patients varied between 1820 dollar and 20109 dollar per hospital survivor and between 100 dollar and 2514 dollar per QALY saved. Mean factors that influenced costs were: Age, diagnostic category, ICU and hospital length of stay and number and type of diagnostic and therapeutic interventions. The incremental cost effectiveness ratio for ICU treatment was estimated at 3254 dollar per QALY corresponding to 35% of per capita GDP or a Very Cost Effective category according to World Health Organization criteria. CONCLUSION: The ICU treatment of critically ill medical patients in a resource poor country is cost effective and compares favorably with other medical interventions. Public health authorities in low and middle income countries should encourage development of critical care services. PMID:27152258

  14. Coping with the cost burdens of illness: Combining qualitative and quantitative methods in longitudinal, household research1

    PubMed Central

    GOUDGE, JANE; GUMEDE, TEBOGO; GILSON, LUCY; RUSSELL, STEVE; TOLLMAN, STEPHEN M.; MILLS, ANNE

    2010-01-01

    Over the last 10–15 years, poor African households have had to cope with the burden of increased levels of chronic illness such as HIV/AIDS. How do these households cope with the cost burdens of ill health and healthcare, and has this burden further impoverished them? What policy responses might better support these households? This is a report from the field of the South African Costs and Coping study (SACOCO) – a longitudinal investigation of household experiences in the Agincourt health and demographic surveillance site. PMID:17676521

  15. Medication cost problems among chronically ill adults in the US: did the financial crisis make a bad situation even worse?

    PubMed

    Piette, John D; Rosland, Ann Marie; Silveira, Maria J; Hayward, Rodney; McHorney, Colleen A

    2011-01-01

    A national internet survey was conducted between March and April 2009 among 27,302 US participants in the Harris Interactive Chronic Illness Panel. Respondents reported behaviors related to cost-related medication non-adherence (CRN) and the impacts of medication costs on other aspects of their daily lives. Among respondents aged 40-64 and looking for work, 66% reported CRN in 2008, and 41% did not fill a prescription due to cost pressures. More than half of respondents aged 40-64 and nearly two-thirds of those in this group who were looking for work or disabled reported other impacts of medication costs, such as cutting back on basic needs or increasing credit card debt. More than one-third of respondents aged 65+ who were working or looking for work reported CRN. Regardless of age or employment status, roughly half of respondents reporting medication cost hardship said that these problems had become more frequent in 2008 than before the economic recession. These data show that many chronically ill patients, particularly those looking for work or disabled, reported greater medication cost problems since the economic crisis began. Given links between CRN and worse health, the financial downturn may have had significant health consequences for adults with chronic illness. PMID:21573050

  16. Food-Borne Trematodiases

    PubMed Central

    Keiser, Jennifer; Utzinger, Jürg

    2009-01-01

    Summary: An estimated 750 million people are at risk of infections with food-borne trematodes, which comprise liver flukes (Clonorchis sinensis, Fasciola gigantica, Fasciola hepatica, Opisthorchis felineus, and Opisthorchis viverrini), lung flukes (Paragonimus spp.), and intestinal flukes (e.g., Echinostoma spp., Fasciolopsis buski, and the heterophyids). Food-borne trematodiases pose a significant public health and economic problem, yet these diseases are often neglected. In this review, we summarize the taxonomy, morphology, and life cycle of food-borne trematodes. Estimates of the at-risk population and number of infections, geographic distribution, history, and ecological features of the major food-borne trematodes are reviewed. We summarize clinical manifestations, patterns of infection, and current means of diagnosis, treatment, and other control options. The changing epidemiological pattern and the rapid growth of aquaculture and food distribution networks are highlighted, as these developments might be associated with an elevated risk of transmission of food-borne trematodiases. Current research needs are emphasized. PMID:19597009

  17. Determining the Cost-Savings Threshold for HIV Adherence Intervention Studies for Persons with Serious Mental Illness and HIV.

    PubMed

    Wu, Evan S; Rothbard, Aileen; Holtgrave, David R; Blank, Michael B

    2016-05-01

    Persons with serious mental illnesses are at increased risk for contracting and transmitting HIV and often have poor adherence to medication regimens. Determining the economic feasibility of different HIV adherence interventions among individuals with HIV and serious mental illness is important for program planners who must make resource allocation decisions. The goal of this study was to provide a methodology to estimate potential cost savings from an HIV medication adherence intervention program for a new study population, using data from prior published studies. The novelty of this approach is the way CD4 count data was used as a biological marker to estimate costs averted by greater adherence to anti-retroviral treatment. Our approach is meant to be used in other adherence intervention studies requiring cost modeling. PMID:25535041

  18. The cost of implementing a jail diversion program for people with mental illness in San Antonio, Texas.

    PubMed

    Cowell, Alexander J; Hinde, Jesse M; Broner, Nahama; Aldridge, Arnie P

    2015-02-01

    Jail diversion programs for people with mental illness are designed to redirect offenders with mental illness into community treatment. Although much has been published about program models and their successes, little detail is available to policy makers and community stakeholders on the resources required to start and implement a jail diversion program and which agencies bear how much of the burden. The current study used data on a model jail diversion program in San Antonio, Texas, to address this research gap. Data on staff costs, client contacts, planning, and implementation were collected for three types of diversion: pre-booking police, post-booking bond, and post-booking docket. An activity-based costing algorithm was developed to which parameter values were applied. The start-up cost for the program was $556,638.69. Pre-booking diversion cost $370 per person; 90% of costs were incurred by community mental health agencies for short-term monitoring and screening (>80% of activities). Post-booking bond and docket diversion cost $238 and $205 per person, respectively; the majority of costs were incurred by the courts for court decisions. Developing a multiple-intercept jail diversion program requires significant up-front investment. The share of costs varies greatly depending on the type of diversion. PMID:25463013

  19. "How Much Will It Cost?" Predictable Pricing of ILL Services: An Investigation and a Proposal.

    ERIC Educational Resources Information Center

    Budd, John M.; And Others

    1991-01-01

    Examines interlibrary loan (ILL) charges for photocopied material at two academic libraries, the University of Arizona and the University of Nevada, Reno. Statistics were reported for separate academic units to determine which were the most active users and which were charged the most, and recommendations are made for dealing with ILL charges.…

  20. Emerging foodborne diseases.

    PubMed

    Altekruse, S F; Cohen, M L; Swerdlow, D L

    1997-01-01

    The epidemiology of foodborne diseases is rapidly changing. Recently described pathogens, such as Escherichia coli O157:H7 and the epidemic strain of Salmonella serotype Typhimurium Definitive Type 104 (which is resistant to at least five antimicrobial drugs), have become important public health problems. Well-recognized pathogens, such as Salmonella serotype Enteritidis, have increased in prevalence or become associated with new vehicles. Emergence in foodborne diseases is driven by the same forces as emergence in other infectious diseases: changes in demographic characteristics, human behavior, industry, and technology; the shift toward a global economy; microbial adaptation; and the breakdown in the public health infrastructure. Addressing emerging foodborne diseases will require more sensitive and rapid surveillance, enhanced methods of laboratory identification and subtyping, and effective prevention and control. PMID:9284372

  1. Human H5N1 influenza infections in Cambodia 2005–2011: case series and cost-of-illness

    PubMed Central

    2013-01-01

    Background Southeast Asia has been identified as a potential epicentre of emerging diseases with pandemic capacity, including highly pathogenic influenza. Cambodia in particular has the potential for high rates of avoidable deaths from pandemic influenza due to large gaps in health system resources. This study seeks to better understand the course and cost-of-illness for cases of highly pathogenic avian influenza in Cambodia. Methods We studied the 18 laboratory-confirmed cases of avian influenza subtype H5N1 identified in Cambodia between January 2005 and August 2011. Medical records for all patients were reviewed to extract information on patient characteristics, travel to hospital, time to admission, diagnostic testing, treatment and disease outcomes. Further data related to costs was collected through interviews with key informants at district and provincial hospitals, the Ministry of Health and non-governmental organisations. An ingredient-based approach was used to estimate the total economic cost for each study patient. Costing was conducted from a societal perspective and included both financial and opportunity costs to the patient or carer. Sensitivity analysis was undertaken to evaluate potential change or variation in the cost-of-illness. Results Of the 18 patients studied, 11 (61%) were under the age of 18 years. The majority of patients (16, 89%) died, eight (44%) within 24 hours of hospital admission. There was an average delay of seven days between symptom onset and hospitalisation with patients travelling an average of 148 kilometres (8-476 km) to the admitting hospital. Five patients were treated with oseltamivir of whom two received the recommended dose. For the 16 patients who received all their treatment in Cambodia the average per patient cost of H5N1 influenza illness was US$300 of which 85.0% comprised direct medical provider costs, including diagnostic testing (41.2%), pharmaceuticals (28.4%), hospitalisation (10.4%), oxygen (4.4%) and

  2. Techniques for rapid detection and quantification of active foodborne Staphylococcus Enterotoxin(Abstract)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Staphylococcus aureus is an important bacterial pathogen and causative agent of foodborne illnesses.Staphylococcal enterotoxins(SEs)produced by this organism act upon the gastrointestinal tract and generate a superantigen immune response in low concentrations. Recent S. aureus foodborne ...

  3. Costs of a Public Health Model to Increase Receipt of Hepatitis-Related Services for Persons with Mental Illness

    PubMed Central

    Slade, Eric P.; Rosenberg, Stanley D.; Dixon, Lisa B.; Goldberg, Richard W.; Wolford, George; Himelhoch, Seth; Tapscott, Stephanie

    2013-01-01

    Objective The objective was to contextualize the costs associated with implementation of a specialized HIV/hepatitis preventive services model designed to reach persons with serious mental illness and co-occurring disorders, an underserved population. Methods Between 2006 and 2008, a random sample of 236 non-elderly, predominantly African American, male participants with serious mental illness and a co-occurring substance use disorder were recruited at four community mental health outpatient programs in a large metropolitan area. All participants had been diagnosed with a psychotic or major depressive disorder. Participants were randomized within site to receive either the experimental intervention Screen, Test, Immunize, Reduce risk, and Refer (STIRR) or enhanced treatment as usual, which consisted of education and referral to medical testing. We estimated STIRR’s standardized costs, the costs of STIRR per person who received hepatitis testing, HIV testing, and/or hepatitis A/B vaccination during the 6-months post-randomization. Results The average cost of delivering the STIRR intervention was $423 (SD±$90) per participant (in 2008 dollars) and the average cost of delivering the eTAU intervention was $24 (SD±$22) per participant (test of difference t=52.9, P<.001). The standardized costs per person who received hepatitis C testing, hepatitis B testing, HIV testing, and hepatitis A/B vaccination were $706 (SD±$165), $776 (SD±$181), $3,630 (SD±$846), and $561 (SD±131). Conclusions The STIRR model’s standardized costs suggest that hepatitis and HIV prevention services delivered in outpatient mental health settings to persons with serious mental illness can be at least as cost-effective as similar interventions designed for other at-risk populations. PMID:23475451

  4. Effectiveness of community health financing in meeting the cost of illness.

    PubMed Central

    Preker, Alexander S.; Carrin, Guy; Dror, David; Jakab, Melitta; Hsiao, William; Arhin-Tenkorang, Dyna

    2002-01-01

    How to finance and provide health care for the more than 1.3 billion rural poor and informal sector workers in low- and middle-income countries is one of the greatest challenges facing the international development community. This article presents the main findings from an extensive survey of the literature of community financing arrangements, and selected experiences from the Asia and Africa regions. Most community financing schemes have evolved in the context of severe economic constraints, political instability, and lack of good governance. Micro-level household data analysis indicates that community financing improves access by rural and informal sector workers to needed heath care and provides them with some financial protection against the cost of illness. Macro-level cross-country analysis gives empirical support to the hypothesis that risk-sharing in health financing matters in terms of its impact on both the level and distribution of health, financial fairness and responsiveness indicators. The background research done for this article points to five key policies available to governments to improve the effectiveness and sustainability of existing community financing schemes. This includes: (a) increased and well-targeted subsidies to pay for the premiums of low-income populations; (b) insurance to protect against expenditure fluctuations and re-insurance to enlarge the effective size of small risk pools; (c) effective prevention and case management techniques to limit expenditure fluctuations; (d) technical support to strengthen the management capacity of local schemes; and (e) establishment and strengthening of links with the formal financing and provider networks. PMID:11953793

  5. Development of an oligonucleotide-based microarray to detect multiple foodborne pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Escherichia coli O157:H7, Salmonella enterica, Listeria monocytogenes and Campylobacter jejuni are considered important human pathogens causing the most food-related human illnesses worldwide. Current methods for pathogen detection have limitations in effectively identifying multiple foodborne patho...

  6. Development of an oligonucleotide-based microarray to detect multiple foodborne pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Escherichia coli O157:H7, Salmonella spp., Listeria monocytogenes and Campylobacter jejuni are considered important foodborne bacterial pathogens causing the most food-related human illnesses worldwide. Current methods for pathogen detection have limitations in effectively identifying multiple foodb...

  7. DIETARY STRATEGIES TO REDUCE FOODBORNE PATHOGENS IN PIGS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Swine can carry foodborne pathogenic bacteria that cause human illness, most notably Salmonella. Slaughter facilities in the U.S. and EU reduce the horizontal and vertical spread of pathogens on carcasses and finished products. However, we can enhance the effectiveness of the post-slaughter treatm...

  8. Novel method to identify probiotic isolates against enteric foodborne pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Campylobacter is the leading cause of foodborne illness worldwide, primarily caused by consumption of contaminated poultry products. One potential strategy to reduce Campylobacter colonization in poultry is by the use of oral probiotics, but this produces variable results, possibly due to destructio...

  9. Outbreaks of food-borne and waterborne viral gastroenteritis.

    PubMed Central

    Hedberg, C W; Osterholm, M T

    1993-01-01

    Norwalk virus infection is the epidemiologic prototype for outbreaks of food-borne and waterborne gastroenteritis. Around the world, Norwalk virus and Norwalk-like viruses appear to be major causes of food-borne and waterborne illness. Assessment of the overall significance of viral agents to the epidemiology of food-borne and waterborne illness is hampered by the lack of surveillance throughout much of the world. In areas where food-borne and waterborne illness surveillance is conducted, outbreaks of viral gastroenteritis are underreported because of the lack of availability of routine laboratory services to confirm the viral etiology. Routine use of epidemiologic criteria as an alternative to laboratory confirmation will allow better assessments of the importance of viral gastroenteritis until effective laboratory methods can be widely implemented. Outbreaks of viral gastroenteritis have been propagated by contamination of water supplies, raw foods, and ill food handlers. Controlling an outbreak depends on identifying and removing the source of contamination. The demonstrated occurrence of person-to-person transmission and the likely occurrence of transmission of Norwalk-like viruses by aerosol make it necessary to evaluate the potential for transmission by food handlers and servers in every outbreak, regardless of primary source. PMID:8395330

  10. Norovirus: Human Health and Food-borne Implications

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Norovirus (NV) infection is a significant human health issue. The CDC estimates that there are approximately 22 million cases of NV illness per annum in the United States. Of these, approximately 40% are acquired via a food-borne route. Common foods that are consumed uncooked such as raw vegetabl...

  11. Influence of Criminal Justice Involvement and Psychiatric Diagnoses on Treatment Costs Among Adults With Serious Mental Illness

    PubMed Central

    Robertson, Allison G.; Swanson, Jeffrey W.; Lin, Hsiuju; Easter, Michele M.; Frisman, Linda K.; Swartz, Marvin S.

    2015-01-01

    The impact of criminal justice involvement and clinical characteristics on the cost of public treatment services for adults with serious mental illnesses is unknown. The authors examined differential effects of justice involvement on behavioral health treatment costs by primary psychiatric diagnosis (schizophrenia or bipolar disorder) and also by substance use diagnosis among 25,133 adult clients of Connecticut’s public behavioral health system in fiscal years 2006 and 2007. Justice-involved adults with schizophrenia had the highest costs, strongly driven by forensic hospitalizations. Addressing the cross-system burdens of forensic hospitalizations may be a sensible starting point in the effort to reduce costs in both the public behavioral health and justice systems. PMID:25975893

  12. Influence of Criminal Justice Involvement and Psychiatric Diagnoses on Treatment Costs Among Adults With Serious Mental Illness.

    PubMed

    Robertson, Allison G; Swanson, Jeffrey W; Lin, Hsiuju; Easter, Michele M; Frisman, Linda K; Swartz, Marvin S

    2015-09-01

    The impact of criminal justice involvement and clinical characteristics on the cost of public treatment services for adults with serious mental illnesses is unknown. The authors examined differential effects of justice involvement on behavioral health treatment costs by primary psychiatric diagnosis (schizophrenia or bipolar disorder) and also by substance use diagnosis among 25,133 adult clients of Connecticut's public behavioral health system in fiscal years 2006 and 2007. Justice-involved adults with schizophrenia had the highest costs, strongly driven by forensic hospitalizations. Addressing the cross-system burdens of forensic hospitalizations may be a sensible starting point in the effort to reduce costs in both the public behavioral health and justice systems. PMID:25975893

  13. Violence and the Costs of Caring for a Family Member with Severe Mental Illness

    ERIC Educational Resources Information Center

    Thompson, Maxine Seaborn

    2007-01-01

    Drawing on the stress paradigm and using data from the Duke Mental Health Study, this paper investigates the links between violence by and against persons with severe mental illness and their caregivers' financial burden (e.g., number of financial contributions and perceived financial strain). In addition to violence, substance use and medication…

  14. A randomized trial of the cost effectiveness of VA hospital-based home care for the terminally ill.

    PubMed

    Hughes, S L; Cummings, J; Weaver, F; Manheim, L; Braun, B; Conrad, K

    1992-02-01

    All admissions to a 1,100-bed Department of Veterans Affairs (VA) hospital were screened to identify 171 terminally ill patients with informal caregivers who were then randomly assigned to VA hospital-based team home care (HBHC, N = 85) or customary care (N = 86). Patient functioning, and patient and caregiver morale and satisfaction with care were measured at baseline, one month, and six months. Health services utilization was monitored over the six-month study period and converted to cost. Findings included no differences in patient survival, activities of daily living (ADL), cognitive functioning, or morale, but a significant increase in patient (p = .02) and caregiver (p = .005) satisfaction with care at one month. A substitution effect of HBHC was seen. Those in the experimental group used 5.9 fewer VA hospital days (p = .03), resulting in a $1,639 or 47 percent per capita saving in VA hospital costs (p = .02). As a result, total per capita health care costs, including HBHC, were $769 or 18 percent (n.s.) lower in the HBHC sample, indicating that expansion of VA HBHC to serve terminally ill veterans would increase satisfaction with care at no additional cost. PMID:1737710

  15. [The health economics of attention deficit hyperactivity disorder in Germany. Part 1: Health care utilization and cost of illness].

    PubMed

    Schlander, M; Trott, G-E; Schwarz, O

    2010-03-01

    In the German region of Nordbaden, 5% of children (aged 7-12 years) and 1.3% of adolescents (aged 13-19 years) were diagnosed with attention deficit hyperactivity disorder (ADHD) in 2003. About two thirds of these patients were not seen by a physician specialized in psychiatry. Now the National Association of Statutory Health Insurance Physicians in Germany (Kassenaerztliche Bundesvereinigung, KBV) has developed a proposal for the integrated provision of care for these patients, combining a guidelines-oriented multidisciplinary approach with a system of quality assurance. Against this background, currently available ADHD-related data are presented, covering epidemiology, comorbidity and differential diagnosis, health care utilization, and cost of illness. According to administrative data analyses from Nordbaden, direct medical costs for patients with ADHD, from the perspective of statutory health insurance (SHI), exceed those of matched controls by a factor of >2.5. On this basis, ADHD-related expenditures of the German SHI may be estimated at around EUR 260 million in 2003, and almost certainly will have continued to grow further since. In addition to this, a diagnosis of ADHD is associated with substantial indirect cost. Although the literature on the burden of ADHD is incomplete, it seems plausible that the cost of illness might be comparable to that reported for alcohol and addiction disorders. Thus we anticipate an increasing relevance of formal health economic evaluations of health care programs offered to patients with ADHD. PMID:20232510

  16. European Union-28: An annualised cost-of-illness model for venous thromboembolism.

    PubMed

    Barco, Stefano; Woersching, Alex L; Spyropoulos, Alex C; Piovella, Franco; Mahan, Charles E

    2016-04-01

    Annual costs for venous thromboembolism (VTE) have been defined within the United States (US) demonstrating a large opportunity for cost savings. Costs for the European Union-28 (EU-28) have never been defined. A literature search was conducted to evaluate EU-28 cost sources. Median costs were defined for each cost input and costs were inflated to 2014 Euros (€) in the study country and adjusted for Purchasing Power Parity between EU countries. Adjusted costs were used to populate previously published cost-models based on adult incidence-based events. In the base model, annual expenditures for total, hospital-associated, preventable, and indirect costs were €1.5-2.2 billion, €1.0-1.5 billion, €0.5-1.1 billion and €0.2-0.3 billion, respectively (indirect costs: 12 % of expenditures). In the long-term attack rate model, total, hospital-associated, preventable, and indirect costs were €1.8-3.3 billion, €1.2-2.4 billion, €0.6-1.8 billion and €0.2-0.7 billion (indirect costs: 13 % of expenditures). In the multiway sensitivity analysis, annual expenditures for total, hospital-associated, preventable, and indirect costs were €3.0-8.5 billion, €2.2-6.2 billion, €1.1-4.6 billion and €0.5-1.4 billion (indirect costs: 22 % of expenditures). When the value of a premature life-lost increased slightly, aggregate costs rose considerably since these costs are higher than the direct medical costs. When evaluating the models aggregately for costs, the results suggests total, hospital-associated, preventable, and indirect costs ranging from €1.5-13.2 billion, €1.0-9.7 billion, €0.5-7.3 billion and €0.2-6.1 billion, respectively. Our study demonstrates that VTE costs have a large financial impact upon the EU-28's healthcare systems and that significant savings could be realised if better preventive measures are applied. PMID:26607486

  17. Costs and benefits of automatization in category learning of ill-defined rules.

    PubMed

    Raijmakers, Maartje E J; Schmittmann, Verena D; Visser, Ingmar

    2014-03-01

    Learning ill-defined categories (such as the structure of Medin & Schaffer, 1978) involves multiple learning systems and different corresponding category representations, which are difficult to detect. Application of latent Markov analysis allows detection and investigation of such multiple latent category representations in a statistically robust way, isolating low performers and quantifying shifts between latent strategies. We reanalyzed data from three experiments presented in Johansen and Palmeri (2002), which comprised prolonged training of ill-defined categories, with the aim of studying the changing interactions between underlying learning systems. Our results broadly confirm the original conclusion that, in most participants, learning involved a shift from a rule-based to an exemplar-based strategy. Separate analyses of latent strategies revealed that (a) shifts from a rule-based to an exemplar-based strategy resulted in an initial decrease of speed and an increase of accuracy; (b) exemplar-based strategies followed a power law of learning, indicating automatization once an exemplar-based strategy was used; (c) rule-based strategies changed from using pure rules to rules-plus-exceptions, which appeared as a dual processes as indicated by the accuracy and response-time profiles. Results suggest an additional pathway of learning ill-defined categories, namely involving a shift from a simple rule to a complex rule after which this complex rule is automatized as an exemplar-based strategy. PMID:24418795

  18. The effect of severity of illness on total joint arthroplasty costs across New York state hospitals: an analysis of 172,738 cases.

    PubMed

    Adrados, Murillo; Lajam, Claudette; Hutzler, Lorraine; Slover, James; Bosco, Joseph

    2015-01-01

    We explored the average cost of 94,197 total knee and 78,541 total hip arthroplasties (TKA and THA) using the New York State Hospital Inpatient Cost Transparency database to evaluate the effect of beneficiary health status on hospital reported cost for the two operations. Using the 3M APR-DRG severity of illness index as a measure of patient's health status, we found a significant increase in cost for both TKA and THA for patients with higher severity of illness index. This study confirms the greater cost and variability of TKA and THA for patients with increased severity of illness and illustrates the inherent unpredictability in cost forecasting and budgeting for these same patients. PMID:25269683

  19. A Novel Training Program for Police Officers that Improves Interactions with Mentally Ill Individuals and is Cost-Effective

    PubMed Central

    Krameddine, Yasmeen I.; DeMarco, David; Hassel, Robert; Silverstone, Peter H.

    2013-01-01

    Police and law enforcement providers frequently come into contact with individuals who have psychiatric disorders, sometimes with tragic results. Repeated studies suggest that greater understanding of psychiatric conditions by police officers would be beneficial. Here we present a novel approach to training police officers to improve their interactions with those who might have a mental illness. This approach involved developing a carefully scripted role-play training, which involved police officers (n = 663) interacting with highly trained actors during six realistic scenarios. The primary goal of the training was to improve empathy, communication skills, and the ability of officers to de-escalate potentially difficult situations. Uniquely, feedback was given to officers after each scenario by several individuals including experienced police officers, a mental health professional, and by the actors involved (with insights such as “this is how you made me feel”). Results showed that there were no changes in attitudes of the police toward the mentally ill comparing data at baseline and at 6 months after the training in those who completed both ratings (n = 170). In contrast, there were significant improvements in directly measured behaviors (n = 142) as well as in indirect measurements of behavior throughout the police force. Thus, compared to previous years, there was a significant increase in the recognition of mental health issues as a reason for a call (40%), improved efficiency in dealing with mental health issues, and a decrease in weapon or physical interactions with mentally ill individuals. The training cost was $120 per officer but led to significant cost savings (more than $80,000) in the following 6 months. In conclusion, this novel 1-day training course significantly changed behavior of police officers in meaningful ways and also led to cost savings. We propose that this training model could be adopted by other police agencies. PMID

  20. Can the Direct Medical Cost of Chronic Disease Be Transferred across Different Countries? Using Cost-of-Illness Studies on Type 2 Diabetes, Epilepsy and Schizophrenia as Examples

    PubMed Central

    Gao, Lan; Hu, Hao; Zhao, Fei-Li; Li, Shu-Chuen

    2016-01-01

    Objectives To systematically review cost of illness studies for schizophrenia (SC), epilepsy (EP) and type 2 diabetes mellitus (T2DM) and explore the transferability of direct medical cost across countries. Methods A comprehensive literature search was performed to yield studies that estimated direct medical costs. A generalized linear model (GLM) with gamma distribution and log link was utilized to explore the variation in costs that accounted by the included factors. Both parametric (Random-effects model) and non-parametric (Boot-strapping) meta-analyses were performed to pool the converted raw cost data (expressed as percentage of GDP/capita of the country where the study was conducted). Results In total, 93 articles were included (40 studies were for T2DM, 34 studies for EP and 19 studies for SC). Significant variances were detected inter- and intra-disease classes for the direct medical costs. Multivariate analysis identified that GDP/capita (p<0.05) was a significant factor contributing to the large variance in the cost results. Bootstrapping meta-analysis generated more conservative estimations with slightly wider 95% confidence intervals (CI) than the parametric meta-analysis, yielding a mean (95%CI) of 16.43% (11.32, 21.54) for T2DM, 36.17% (22.34, 50.00) for SC and 10.49% (7.86, 13.41) for EP. Conclusions Converting the raw cost data into percentage of GDP/capita of individual country was demonstrated to be a feasible approach to transfer the direct medical cost across countries. The approach from our study to obtain an estimated direct cost value along with the size of specific disease population from each jurisdiction could be used for a quick check on the economic burden of particular disease for countries without such data. PMID:26814959

  1. Use of Extract of Citrus sinensis as an antimicrobial agent for foodborne zoonotic pathogens and spoilage bacteria

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne pathogens remain global health problems despite concerted efforts to control the transmission of these microorganisms through food. The resurgence of drug resistant bacteria has renewed interest in developing and testing new sources of antimicrobial agents to control foodborne illness. Thi...

  2. Proteomics of Foodborne Bacterial Pathogens

    NASA Astrophysics Data System (ADS)

    Fagerquist, Clifton K.

    This chapter is intended to be a relatively brief overview of proteomic techniques currently in use for the identification and analysis of microorganisms with a special emphasis on foodborne pathogens. The chapter is organized as follows. First, proteomic techniques are introduced and discussed. Second, proteomic applications are presented specifically as they relate to the identification and qualitative/quantitative analysis of foodborne pathogens.

  3. The Evolution of Foodborne Pathogens

    NASA Astrophysics Data System (ADS)

    Abu-Ali, Galeb S.; Manning, Shannon D.

    Despite continuous advances in food safety and disease surveillance, control, and prevention, foodborne bacterial infections remain a major public health concern. Because foodborne pathogens are commonly exposed to multiple environmental stressors, such as low pH and antibiotics, most have evolved specific mechanisms to facilitate survival in adverse environments.

  4. The cost and outcomes of community-based care for the seriously mentally ill.

    PubMed Central

    Dickey, B; Fisher, W; Siegel, C; Altaffer, F; Azeni, H

    1997-01-01

    OBJECTIVE: To examine the cost-effectiveness of community-based mental health care. DATA SOURCES/STUDY SETTING: Administrative data from Medicaid and the Massachusetts Department of Mental Health; primary data from 144 psychiatrically disabled adult Medicaid beneficiaries who lived in Boston, central Massachusetts, and western Massachusetts. STUDY DESIGN: A cross-sectional observational study compared the costs and outcomes of treatment in three different types of public mental health service systems. DATA COLLECTION/EXTRACTION METHODS: Beneficiaries, randomly sampled from outpatient mental health programs, were interviewed about their mental health status. All their acute treatment and long-term continuing care for the preceding year were abstracted from Medicaid and Department of Mental Health files. Costs were extracted from Medicaid paid claims and from Department of Mental Health contracts and other financial documents. PRINCIPAL FINDINGS: Clients in the region allocating a greater proportion of its Department of Mental Health budget to community support services used far fewer hospital days, resulting in lower per person treatment expenditures. Outcomes, however, were not significantly different from outcomes of clients in the other regions. For all regions, substance abuse comorbidity increased hospitalization and total treatment costs. An individual-level cost-effectiveness analysis identified western Massachusetts (community-based care) as significantly more cost effective than the other two regions. CONCLUSIONS: Systems with stronger community-based orientation are more cost effective. PMID:9402903

  5. Social living mitigates the costs of a chronic illness in a cooperative carnivore

    USGS Publications Warehouse

    Almberg, Emily S.; Cross, Paul C.; Dobson, Andrew P.; Smith, Douglas W.; Metz, Matthew C; Stahler, Daniel R.; Hudson, Peter J.

    2015-01-01

    Infection risk is assumed to increase with social group size, and thus be a cost of group living. We assess infection risk and costs with respect to group size using data from an epidemic of sarcoptic mange (Sarcoptes scabiei) among grey wolves (Canis lupus). We demonstrate that group size does not predict infection risk and that individual costs of infection, in terms of reduced survival, can be entirely offset by having sufficient numbers of pack-mates. Infected individuals experience increased mortality hazards with increasing proportions of infected pack-mates, but healthy individuals remain unaffected. The social support of group hunting and territory defence are two possible mechanisms mediating infection costs. This is likely a common phenomenon among other social species and chronic infections, but difficult to detect in systems where infection status cannot be measured continuously over time.

  6. Social living mitigates the costs of a chronic illness in a cooperative carnivore

    PubMed Central

    Almberg, E S; Cross, P C; Dobson, A P; Smith, D W; Metz, M C; Stahler, D R; Hudson, P J; Festa-Bianchet, Marco

    2015-01-01

    Infection risk is assumed to increase with social group size, and thus be a cost of group living. We assess infection risk and costs with respect to group size using data from an epidemic of sarcoptic mange (Sarcoptes scabiei) among grey wolves (Canis lupus). We demonstrate that group size does not predict infection risk and that individual costs of infection, in terms of reduced survival, can be entirely offset by having sufficient numbers of pack-mates. Infected individuals experience increased mortality hazards with increasing proportions of infected pack-mates, but healthy individuals remain unaffected. The social support of group hunting and territory defence are two possible mechanisms mediating infection costs. This is likely a common phenomenon among other social species and chronic infections, but difficult to detect in systems where infection status cannot be measured continuously over time. PMID:25983011

  7. Social living mitigates the costs of a chronic illness in a cooperative carnivore.

    PubMed

    Almberg, E S; Cross, P C; Dobson, A P; Smith, D W; Metz, M C; Stahler, D R; Hudson, P J

    2015-07-01

    Infection risk is assumed to increase with social group size, and thus be a cost of group living. We assess infection risk and costs with respect to group size using data from an epidemic of sarcoptic mange (Sarcoptes scabiei) among grey wolves (Canis lupus). We demonstrate that group size does not predict infection risk and that individual costs of infection, in terms of reduced survival, can be entirely offset by having sufficient numbers of pack-mates. Infected individuals experience increased mortality hazards with increasing proportions of infected pack-mates, but healthy individuals remain unaffected. The social support of group hunting and territory defence are two possible mechanisms mediating infection costs. This is likely a common phenomenon among other social species and chronic infections, but difficult to detect in systems where infection status cannot be measured continuously over time. PMID:25983011

  8. Intervention strategies for control of foodborne pathogens

    NASA Astrophysics Data System (ADS)

    Juneja, Vijay K.

    2004-03-01

    The increasing numbers of illnesses associated with foodborne pathogens such as Listeria monocytogenes and Escherichia coli O157:H7, has renewed concerns about food safety because of consumer preferences for minimally processed foods that offer convenience in availability and preparation. Accordingly, the need for better control of foodborne pathogens has been paramount in recent years. Mechanical removal of microorganisms from food can be accomplished by centrifugation, filtration, trimming and washing. Cleaning and sanitation strategies can be used for minimizing the access of microorganisms in foods from various sources. Other strategies for control of foodborne pathogens include established physical microbiocidal treatments such as ionizing radiation and heating. Research has continued to demonstrate that food irradiation is a suitable process to control and possibly eliminate foodborne pathogens, for example Listeria monocytogenes and Escherichia coli O157:H7, from a number of raw and cooked meat and poultry products. Heat treatment is the most common method in use today for the inactivation of microorganisms. Microorganisms can also be destroyed by nonthermal treatments, such as application of high hydrostatic pressure, pulsed electric fields, oscillating magnetic fields or a combination of physical processes such as heat-irradiation, or heat-high hydrostatic pressure, etc. Each of the non-thermal technologies has specific applications in terms of the types of food that can be processed. Both conventional and newly developed physical treatments can be used in combination for controlling foodborne pathogens and enhancing the safety and shelf life of foods. Recent research has focused on combining traditional preservation factors with emerging intervention technologies. However, many key issues still need to be addressed for combination preservation factors or technologies to be useful in the food industry to meet public demands for foods with enhanced safety

  9. Cost-of-illness studies based on massive data: a prevalence-based, top-down regression approach.

    PubMed

    Stollenwerk, Björn; Welchowski, Thomas; Vogl, Matthias; Stock, Stephanie

    2016-04-01

    Despite the increasing availability of routine data, no analysis method has yet been presented for cost-of-illness (COI) studies based on massive data. We aim, first, to present such a method and, second, to assess the relevance of the associated gain in numerical efficiency. We propose a prevalence-based, top-down regression approach consisting of five steps: aggregating the data; fitting a generalized additive model (GAM); predicting costs via the fitted GAM; comparing predicted costs between prevalent and non-prevalent subjects; and quantifying the stochastic uncertainty via error propagation. To demonstrate the method, it was applied to aggregated data in the context of chronic lung disease to German sickness funds data (from 1999), covering over 7.3 million insured. To assess the gain in numerical efficiency, the computational time of the innovative approach has been compared with corresponding GAMs applied to simulated individual-level data. Furthermore, the probability of model failure was modeled via logistic regression. Applying the innovative method was reasonably fast (19 min). In contrast, regarding patient-level data, computational time increased disproportionately by sample size. Furthermore, using patient-level data was accompanied by a substantial risk of model failure (about 80 % for 6 million subjects). The gain in computational efficiency of the innovative COI method seems to be of practical relevance. Furthermore, it may yield more precise cost estimates. PMID:25648977

  10. Decreased competiveness of the foodborne pathogen, Campylobacter jejuni, co-culture with the hyper-ammonia anaerobe, Clostridium aminophilum

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Campylobacter spp. are a leading bacterial cause of human foodborne illness. When co-cultured in anaerobic Bolton broth with the hyper-ammonia-producing bacterium, Clostridium aminophilum, ammonia accumulation was greater (P 1...

  11. Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

    PubMed Central

    Gomes, Barbara; Calanzani, Natalia; Curiale, Vito; McCrone, Paul; Higginson, Irene J

    2013-01-01

    Background Extensive evidence shows that well over 50% of people prefer to be cared for and to die at home provided circumstances allow choice. Despite best efforts and policies, one-third or less of all deaths take place at home in many countries of the world. Objectives 1. To quantify the effect of home palliative care services for adult patients with advanced illness and their family caregivers on patients' odds of dying at home; 2. to examine the clinical effectiveness of home palliative care services on other outcomes for patients and their caregivers such as symptom control, quality of life, caregiver distress and satisfaction with care; 3. to compare the resource use and costs associated with these services; 4. to critically appraise and summarise the current evidence on cost-effectiveness. Search methods We searched 12 electronic databases up to November 2012. We checked the reference lists of all included studies, 49 relevant systematic reviews, four key textbooks and recent conference abstracts. We contacted 17 experts and researchers for unpublished data. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series (ITSs) evaluating the impact of home palliative care services on outcomes for adults with advanced illness or their family caregivers, or both. Data collection and analysis One review author assessed the identified titles and abstracts. Two independent reviewers performed assessment of all potentially relevant studies, data extraction and assessment of methodological quality. We carried out meta-analysis where appropriate and calculated numbers needed to treat to benefit (NNTBs) for the primary outcome (death at home). Main results We identified 23 studies (16 RCTs, 6 of high quality), including 37,561 participants and 4042 family caregivers, largely with advanced cancer but also congestive heart failure (CHF), chronic obstructive

  12. Foodborne anisakiasis and allergy.

    PubMed

    Baird, Fiona J; Gasser, Robin B; Jabbar, Abdul; Lopata, Andreas L

    2014-08-01

    Human anisakiasis, a disease caused by Anisakis spp. (Nematoda), is often associated with clinical signs that are similar to those associated with bacterial or viral gastroenteritis. With the globalisation of the seafood industry, the risk of humans acquiring anisakiasis in developed countries appears to be underestimated. The importance of this disease is not only in its initial manifestation, which can often become chronic if the immune response does not eliminate the worm, but, importantly, in its subsequent sensitisation of the human patient. This sensitisation to Anisakis-derived allergens can put the patient at risk of an allergic exacerbation upon secondary exposure. This article reviews some aspects of this food-borne disease and explains its link to chronic, allergic conditions in humans. PMID:24583228

  13. Resource Sharing or Cost Shifting?--The Unequal Burden of Cooperative Cataloging and ILL in Network.

    ERIC Educational Resources Information Center

    Lowry, Charles B.

    1990-01-01

    Examines the dilemmas of participation in resource sharing library networks and proposes solutions based on shifting inducements toward contribution by remunerating the contributing library for the unit cost of original cataloging. A "contribution pricing" model recently announced by OCLC is also evaluated as a possible solution. (21 references)…

  14. Comparison of cost-of-illness with willingness-to-pay estimates to avoid shigellosis: evidence from China.

    PubMed

    Guh, Soyeon; Xingbao, Chen; Poulos, Christine; Qi, Zhang; Jianwen, Cao; von Seidlein, Lorenz; Jichao, Chen; Wang, XuanYi; Zhanchun, Xing; Nyamete, Andrew; Clemens, John; Whittington, Dale

    2008-03-01

    Previous studies have shown that cost of illness (COI) measures are lower than the conceptually correct willingness-to-pay (WTP) measure of the economic benefits of disease prevention. We compare COI with stated preference estimates of WTP associated with shigellosis in a rural area of China. COI data were collected through face-to-face interviews at 7 and 14 days after culture-confirmed diagnosis. WTP to avoid an episode similar to the one the respondent just experienced was elicited using a sliding-scale payment card. In contrast to previous studies' findings, average COI estimates (2002 PPP adjusted US dollars 28.2) approximate an upper bound estimate of WTP, rather than a lower bound. One explanation for the similarity between COI and WTP is that preventive expenditures and disutility due to pain and suffering are low for shigellosis. WTP to avoid additional cases in children aged 0-5 years is higher than in adults. Also, average COI (2002 PPP adjusted US dollars 28.4) for children is similar to a lower bound estimate of WTP (2002 PPP adjusted US dollars 16.4) and lies within the WTP range. Because the monetary loss associated with another episode in children is small, caregivers' higher WTP may be attributable to the disutility of illness due to the children's pain and suffering. These findings suggest that for some diseases, COI may approximate more comprehensive measures of economic benefits. PMID:18234703

  15. Estimates of Foodborne Illness–Related Hospitalizations and Deaths in Canada for 30 Specified Pathogens and Unspecified Agents

    PubMed Central

    Murray, Regan; Flockhart, Logan; Pintar, Katarina; Fazil, Aamir; Nesbitt, Andrea; Marshall, Barbara; Tataryn, Joanne; Pollari, Frank

    2015-01-01

    Abstract Foodborne illness estimates help to set food safety priorities and create public health policies. The Public Health Agency of Canada estimates that 4 million episodes of foodborne illness occur each year in Canada due to 30 known pathogens and unspecified agents. The main objective of this study was to estimate the number of domestically acquired foodborne illness–related hospitalizations and deaths. Using the estimates of foodborne illness for Canada along with data from the Canadian Hospitalization Morbidity Database (for years 2000–2010) and relevant international literature, the number of hospitalizations and deaths for 30 pathogens and unspecified agents were calculated. Analysis accounted for under-reporting and underdiagnosis. Estimates of the proportion foodborne and the proportion travel-related were incorporated for each pathogen. Monte Carlo simulations were performed to account for uncertainty generating mean estimates and 90% probability intervals. It is estimated that each year there are 4000 hospitalizations (range 3200–4800) and 105 (range 75–139) deaths associated with domestically acquired foodborne illness related to 30 known pathogens and 7600 (range 5900–9650) hospitalizations and 133 (range 77–192) deaths associated with unspecified agents, for a total estimate of 11,600 (range 9250–14,150) hospitalizations and 238 (range 155–323) deaths associated with domestically acquired foodborne illness in Canada. Key pathogens associated with these hospitalizations or deaths include norovirus, nontyphoidal Salmonella spp., Campylobacter spp., VTEC O157 and Listeria monocytogenes. This is the first time Canada has established pathogen-specific estimates of domestically acquired foodborne illness–related hospitalizations and deaths. This information illustrates the substantial burden of foodborne illness in Canada. PMID:26259128

  16. Too Costly To Be Ill: Health Care Access and Health Seeking Behaviors among Rural-to-urban Migrants in China

    PubMed Central

    Hong, Yan; Li, Xiaoming; Stanton, Bonita; Lin, Danhua; Fang, Xiaoyi; Rong, Mao; Wang, Jing

    2007-01-01

    Of the 114 million rural-to-urban migrants in China, most have only temporary employment in the cities. Because of their non-urban residence, they are not entitled to many benefits and services accorded to most urban dwellers. Only limited research has been conducted on the health care access and health seeking behaviors of this population. This study, based on qualitative data from in-depth interviews with 90 rural-to-urban migrants, found that migrants had limited access to regular medical services. Lack of insurance coverage, high cost, and exacting work schedules have resulted in use of unsupervised self-treatment or substandard care. Their health seeking behaviors have led to suboptimal health consequences including delayed treatment of illnesses. Findings from this study underscore the importance of reducing institutional barriers to health services and providing affordable health care to this population. PMID:18277099

  17. Dietary fibre intakes and reduction in functional constipation rates among Canadian adults: a cost-of-illness analysis

    PubMed Central

    Abdullah, Mohammad M. H.; Gyles, Collin L.; Marinangeli, Christopher P. F.; Carlberg, Jared G.; Jones, Peter J. H.

    2015-01-01

    Background Evidence-based research highlights beneficial impacts of dietary fibre on several aspects of the gut pathophysiology that are accompanied by a considerable financial burden in healthcare services. Recommended intakes of dietary fibre may thus associate with financial benefits at a population level. Objective We sought to systematically assess the potential annual savings in healthcare costs that would follow the reduction in rates of functional constipation and irregularity with increased dietary fibre intakes among Canadian adults. Design A cost-of-illness analysis was developed on the basis of current and recommended levels of fibre intake in Canada, constipation reduction per 1 g fibre intake, proportion of adults who are likely to consume fibre-rich diets, and population expected to respond to fibre intake. Sensitivity analyses covering a range of assumptions were further implemented within the economic simulation. Results Our literature searches assumed a 1.8% reduction in constipation rates with each 1 g/day increase in fibre intake. With intakes corresponding to the Institute of Medicine's adequate levels of 38 g/day for men and 25 g/day for women, among 5 and 100% of the adult populations, anywhere between CAD$1.5 and CAD$31.9 million could be saved on constipation-related healthcare costs annually. Each 1 g/day increase in dietary fibre was estimated to result in total annual healthcare cost savings that ranged between CAD$0.1 and CAD$2.5 million. Conclusions The present research suggests an economic value of increasing dietary fibre intake beyond its well-known health benefits. Healthy-eating behaviours consistent with the recommended intakes of dietary fibre by the general public should hence be advocated as a practical approach for reducing costs associated with the management of constipation in Canada. PMID:26652739

  18. Cost of illness of patient-reported adverse drug events: a population-based cross-sectional survey

    PubMed Central

    Gyllensten, Hanna; Rehnberg, Clas; Jönsson, Anna K; Petzold, Max; Carlsten, Anders; Andersson Sundell, Karolina

    2013-01-01

    Objectives To estimate the cost of illness (COI) of individuals with self-reported adverse drug events (ADEs) from a societal perspective and to compare these estimates with the COI for individuals without ADE. Furthermore, to estimate the direct costs resulting from two ADE categories, adverse drug reactions (ADRs) and subtherapeutic effects of medication therapy (STE). Design Cross-sectional study. Setting The adult Swedish general population. Participants The survey was distributed to a random sample of 14 000 Swedish residents aged 18 years and older, of which 7099 responded, 1377 reported at least one ADE and 943 reported an ADR or STE. Main outcome measures Societal COI, including direct and indirect costs, for individuals with at least one self-reported ADE, and the direct costs for prescription drugs and healthcare use resulting from self-reported ADRs and STEs were estimated during 30 days using a bottom-up approach. Results The economic burden for individuals with ADEs were (95% CI) 442.7 to 599.8 international dollars (Int$), of which direct costs were Int$ 279.6 to 420.0 (67.1%) and indirect costs were Int$ 143.0 to 199.8 (32.9%). The average COI was higher among those reporting ADEs compared with other respondents (COI: Int$ 442.7 to 599.8 versus Int$ 185.8 to 231.2). The COI of respondents reporting at least one ADR or STE was Int$ 468.9 to 652.9. Direct costs resulting from ADRs or STEs were Int$ 15.0 to 48.4. The reported resource use occurred both in hospitals and outside in primary care. Conclusions Self-reported ADRs and STEs cause resource use both in hospitals and in primary care. Moreover, ADEs seem to be associated with high overall COI from a societal perspective when comparing respondents with and without ADEs. There is a need to further examine this relationship and to study the indirect costs resulting from ADEs. PMID:23794552

  19. Food-borne Zoonoses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: The awareness of food borne illness has shifted over the years as international agribusiness and transportation have steadily increased. At least 30 food borne agents have been identified, with one-third emerging in the last 3 decades. Despite an increased emphasis on control measures, t...

  20. [New foodborne infections].

    PubMed

    Rottman, Martin; Gaillard, Jean-Louis

    2003-05-15

    The last 20 years have witnessed a profound reshaping of the spectrum of foodborne infections in industrialized countries. Food products are overall very safe, but the industrial scale and standardisation of food production have spawned spectacular epidemics, bringing into the light previously little known microorganisms such as Listeria or Escherichia coli O157:H7, the causative agent of the "hamburger disease". The recent "mad cow disease" crisis is another illustration of a food industry gone astray under the pressure of underlying economic stakes. Through unprecedented efforts from the countries involved--epitomized in France by the creation of the Agence française de sécurité sannitaire des aliments in 1999--these diseases are about to be curtailed in their epidemic form. But new dangers emerge yet with Campylobacter infections, Norovirus gastroenteritis or the spread of multi-resistant bacteria. Issues mostly unknown to the general public that are likely to be strongly publicized in the future. PMID:12846023

  1. Microarrays for foodborne virus detection and typing(Abstract)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Human noroviruses (HuNoV) cause up to 21 million cases of foodborne disease in the United States annually and are considered to be the most common cause of acute gastroenteritis in industrialized countries. To implement the use of simpler, rapid and cost-effective method for the simultaneous detecti...

  2. Prevention of bacterial foodborne disease using nanobiotechnology

    PubMed Central

    Billington, Craig; Hudson, J Andrew; D’Sa, Elaine

    2014-01-01

    Foodborne disease is an important source of expense, morbidity, and mortality for society. Detection and control constitute significant components of the overall management of foodborne bacterial pathogens, and this review focuses on the use of nanosized biological entities and molecules to achieve these goals. There is an emphasis on the use of organisms called bacteriophages (phages: viruses that infect bacteria), which are increasingly being used in pathogen detection and biocontrol applications. Detection of pathogens in foods by conventional techniques is time-consuming and expensive, although it can also be sensitive and accurate. Nanobiotechnology is being used to decrease detection times and cost through the development of biosensors, exploiting specific cell-recognition properties of antibodies and phage proteins. Although sensitivity per test can be excellent (eg, the detection of one cell), the very small volumes tested mean that sensitivity per sample is less compelling. An ideal detection method needs to be inexpensive, sensitive, and accurate, but no approach yet achieves all three. For nanobiotechnology to displace existing methods (culture-based, antibody-based rapid methods, or those that detect amplified nucleic acid) it will need to focus on improving sensitivity. Although manufactured nonbiological nanoparticles have been used to kill bacterial cells, nanosized organisms called phages are increasingly finding favor in food safety applications. Phages are amenable to protein and nucleic acid labeling, and can be very specific, and the typical large “burst size” resulting from phage amplification can be harnessed to produce a rapid increase in signal to facilitate detection. There are now several commercially available phages for pathogen control, and many reports in the literature demonstrate efficacy against a number of foodborne pathogens on diverse foods. As a method for control of pathogens, nanobiotechnology is therefore flourishing

  3. Proteomics of foodborne bacterial pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This chapter focuses on recent research on foodborne bacterial pathogens that use mass spectrometry-based proteomic techniques as well as protein microarrays. Mass spectrometry ionization techniques (e.g. electrospray ionization and matrix-assisted laser desorption/ionization), analyzers (e.g. ion ...

  4. Zoonotic foodborne parasites and their surveillance.

    PubMed

    Murrell, K D

    2013-08-01

    Humans suffer from several foodborne helminth zoonotic diseases, some of which can be deadly (e.g., trichinellosis, cerebral cysticercosis) while others are chronic and cause only mild illness (e.g., intestinal taeniosis). The route of infection is normally consumption of the parasite's natural host as a human food item (e.g., meat). The risk for infection with these parasites is highest wherever people have an inadequate knowledge of infection and hygiene, poor animal husbandry practices, and unsafe management and disposal of human and animal waste products. The design of surveillance and control strategies for the various foodborne parasite species, and the involvement of veterinary and public health agencies, vary considerably because of the different life cycles of these parasites, and epidemiological features. Trichinella spiralis, which causes most human trichinellosis, is acquired from the consumption of pork, although increasingly cases occur from eating wild game. For cysticercosis, however, the only sources for human infection are pork (Taenia solium) or beef (T. saginata). The chief risk factor for infection of humans with these parasites is the consumption of meat that has been inadequately prepared. For the pig or cow, however, the risk factors are quite different between Trichinella and Taenia. For T. spiralis the major source of infection of pigs is exposure to infected animal meat (which carries the infective larval stage), while for both Taenia species it is human faecal material contaminated with parasite eggs shed by the adult intestinal stage of the tapeworm. Consequently, the means for preventing exposure of pigs and cattle to infective stages of T. spiralis, T. solium, and T. saginata vary markedly, especially the requirements for ensuring the biosecurity of these animals at the farm. The surveillance strategies and methods required for these parasites in livestock are discussed, including the required policy-level actions and the necessary

  5. Inactivation of foodborne pathogens on frankfurters using ultraviolet light and GRAS antimicrobials

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Listeria monocytogenes is an occasional contaminant of ready-to-eat meats such as frankfurters and sausages and is responsible for foodborne illness outbreaks and recalls of the subsequently adulterated food products. Salmonellae and Staphylococus aureus are prevalent among pathogens which cause foo...

  6. Ecological concepts to reduce colonization of cattle by food-borne pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Annually, food-borne pathogenic bacteria sicken millions across North America. Many of these illnesses are caused by consumption of animal-produced foods, especially those from cattle. Post slaughter intervention strategies effectively reduce bacterial contamination levels that reach consumers fro...

  7. Potential of predatory bacteria as biocontrol agents for foodborne and plant pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne pathogens such as Escherichia coli O157:H7, Salmonella spp., Listeria monocytogenes, Shigella are responsible for frequent occurrences of illnesses and mortality in humans and produce losses. Pre-harvest yield losses and post-harvest decay on minimally processed produce (fruits, vegetables...

  8. CLOSTRIDIUM PERFRINGENS: STATUS OF A FOOD-BORNE SPORE-FORMER

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Clostridium perfringens is responsible for the third most common cause of food-borne illness in the U.S. today, resulting in an estimated 0.25 million cases annually and an associated economic loss of 12.5 billion dollars. The increased production of minimally-processed, extended shelf-life, refrig...

  9. Inactivation of foodborne pathogens on frankfurters using ultraviolet light (254 nm) and GRAS antimicrobials

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Listeria monocytogenes is an occasional contaminant of ready-to-eat meats such as frankfurters and sausages and is responsible for foodborne illness outbreaks and recalls of the subsequently adulterated food products. Salmonella and Staphylococus aureus are prevalent among pathogens which cause food...

  10. Inactivation of foodborne pathogens on crawfish tail meat using cryogenic freezing and gamma radiation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne illness outbreaks occasionally occur as a result of microbiologically contaminated crustaceans, including crawfish. Cryogenic freezing and gamma radiation are two technologies which can be used to improve the microbiological safety and shelf-life of foods. In the U.S. the majority of non-c...

  11. Announcement: 20th Anniversary of PulseNet: the National Molecular Subtyping Network for Foodborne Disease Surveillance - United States, 2016.

    PubMed

    2016-01-01

    PulseNet is celebrating 20 years of public health achievements in transforming the way foodborne disease outbreaks are detected and investigated. PulseNet is a national surveillance network of federal, state, and local public health laboratories that work together to detect foodborne disease outbreaks by connecting DNA fingerprints of bacteria that cause illness (1). The network facilitates the early identification of common sources of foodborne outbreaks and helps regulatory agencies identify areas where implementation of new measures are likely to improve the safety of the food supply. PMID:27337605

  12. Influenza-Like-Illness and Clinically Diagnosed Flu: Disease Burden, Costs and Quality of Life for Patients Seeking Ambulatory Care or No Professional Care at All

    PubMed Central

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011–2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5–6 symptoms over a 6-day period; required 1.6 physician visits and 86–91% took medication. An average episode amounted to €51–€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries. PMID:25032688

  13. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    PubMed

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries. PMID:25032688

  14. An assessment of the human health impact of seven leading foodborne pathogens in the United States using disability adjusted life years.

    PubMed

    Scallan, E; Hoekstra, R M; Mahon, B E; Jones, T F; Griffin, P M

    2015-10-01

    We explored the overall impact of foodborne disease caused by seven leading foodborne pathogens in the United States using the disability adjusted life year (DALY). We defined health states for each pathogen (acute illness and sequelae) and estimated the average annual incidence of each health state using data from public health surveillance and previously published estimates from studies in the United States, Canada and Europe. These pathogens caused about 112 000 DALYs annually due to foodborne illnesses acquired in the United States. Non-typhoidal Salmonella (32 900) and Toxoplasma (32 700) caused the most DALYs, followed by Campylobacter (22 500), norovirus (9900), Listeria monocytogenes (8800), Clostridium perfringens (4000), and Escherichia coli O157 (1200). These estimates can be used to prioritize food safety interventions. Future estimates of the burden of foodborne disease in DALYs would be improved by addressing important data gaps and by the development and validation of US-specific disability weights for foodborne diseases. PMID:25633631

  15. A systematic review to assess the policy-making relevance of dementia cost-of-illness studies in the US and Canada.

    PubMed

    Oremus, Mark; Aguilar, S Carolina

    2011-02-01

    A systematic review of dementia cost-of-illness (COI) studies in the US and Canada was conducted to explore the policy-making relevance of these studies. MEDLINE, CINAHL, EconLit, AMED and the Cochrane Library were searched from inception to March 2010 for English-language COI articles. Content analysis was used to extract common themes about dementia cost from the conclusions of articles that passed title, abstract and full-text screening. These themes informed our exploration of the policy-making relevance of COI studies in dementia. The literature search retrieved 961 articles and data were extracted from 46 articles. All except three articles reported data from the US; 27 articles included Alzheimer's dementia only. Common themes pertained to general observations about dementia cost, cost drivers in dementia, caregiver cost, items that may lower dementia cost, social service cost, Medicare and Medicaid cost, and cost comparisons with other diseases. The common themes suggest policy-oriented research for the future. However, the extracted COI studies were typically not conducted for policy-making purposes and they did not commonly provide prescriptive policy options. Researchers and policy makers need to consider whether the optimal research focus in dementia should be on programme evaluations instead of more COI studies. PMID:21090840

  16. Radiation inactivation of foodborne pathogens on frozen seafood products.

    PubMed

    Sommers, Christopher H; Rajkowski, Kathleen T

    2011-04-01

    Foodborne illness due to consumption of contaminated seafood is, unfortunately, a regular occurrence in the United States. Ionizing (gamma) radiation can effectively inactivate microorganisms and extend the shelf life of seafood. In this study, the ability of gamma irradiation to inactivate foodborne pathogens surface inoculated onto frozen seafood (scallops, lobster meat, blue crab, swordfish, octopus, and squid) was investigated. The radiation D(10)-values (the radiation dose needed to inactivate 1 log unit of a microorganism) for Listeria monocytogenes, Staphylococcus aureus, and Salmonella inoculated onto seafood samples that were then frozen and irradiated in the frozen state (-20°C) were 0.43 to 0.66, 0.48 to 0.71, and 0.47 to 0.70 kGy, respectively. In contrast, the radiation D(10)-value for the same pathogens suspended on frozen pork were 1.26, 0.98, and 1.18 kGy for L. monocytogenes, S. aureus, and Salmonella, respectively. The radiation dose needed to inactivate these foodborne pathogens on frozen seafood is significantly lower than that for frozen meat or frozen vegetables. PMID:21477481

  17. Foodborne gastroenteritis due to Norwalk virus in a Winnipeg hotel.

    PubMed Central

    Sekla, L; Stackiw, W; Dzogan, S; Sargeant, D

    1989-01-01

    Within 1 week four separate incidents of gastroenteritis presumed to be foodborne were reported by guests of a Winnipeg hotel. Investigation revealed poor food-handling practices and illness among the kitchen staff. Elevated bacterial counts and Escherichia coli were found in 15 of 24 samples of food tested, and Staphylococcus aureus was isolated from 2 pastry samples. Culture of 14 stool samples for bacteria yielded Clostridium perfringens in 1 sample from a staff member and coagulase-positive S. aureus in 2 samples from staff members and 3 from guests. All of the S. aureus isolates were nonenterotoxigenic and had three different phage patterns. Electron microscopy and immunoelectron microscopy revealed the prototype Norwalk virus in five (56%) of nine stool samples; four samples were from guests, and one was from a kitchen employee. The employee had had diarrhea 24 hours before the first outbreak and was thus believed to be the source of the virus infection, possibly through food handling. This is the first report of Norwalk virus isolation and the first of foodborne Norwalk virus transmission in Canada. A review of foodborne Norwalk virus infections is presented. Images Fig. 1 Fig. 2 PMID:2541881

  18. Foodborne gastroenteritis due to Norwalk virus in a Winnipeg hotel.

    PubMed

    Sekla, L; Stackiw, W; Dzogan, S; Sargeant, D

    1989-06-15

    Within 1 week four separate incidents of gastroenteritis presumed to be foodborne were reported by guests of a Winnipeg hotel. Investigation revealed poor food-handling practices and illness among the kitchen staff. Elevated bacterial counts and Escherichia coli were found in 15 of 24 samples of food tested, and Staphylococcus aureus was isolated from 2 pastry samples. Culture of 14 stool samples for bacteria yielded Clostridium perfringens in 1 sample from a staff member and coagulase-positive S. aureus in 2 samples from staff members and 3 from guests. All of the S. aureus isolates were nonenterotoxigenic and had three different phage patterns. Electron microscopy and immunoelectron microscopy revealed the prototype Norwalk virus in five (56%) of nine stool samples; four samples were from guests, and one was from a kitchen employee. The employee had had diarrhea 24 hours before the first outbreak and was thus believed to be the source of the virus infection, possibly through food handling. This is the first report of Norwalk virus isolation and the first of foodborne Norwalk virus transmission in Canada. A review of foodborne Norwalk virus infections is presented. PMID:2541881

  19. Emerging foodborne diseases: an evolving public health challenge.

    PubMed Central

    Tauxe, R. V.

    1997-01-01

    The epidemiology of foodborne disease is changing. New pathogens have emerged, and some have spread worldwide. Many, including Salmonella, Escherichia coli O157:H7, Campylobacter, and Yersinia enterocolitica, have reservoirs in healthy food animals, from which they spread to an increasing variety of foods. These pathogens cause millions of cases of sporadic illness and chronic complications, as well as large and challenging outbreaks over many states and nations. Improved surveillance that combines rapid subtyping methods, cluster identification, and collaborative epidemiologic investigation can identify and halt large, dispersed outbreaks. Outbreak investigations and case-control studies of sporadic cases can identify sources of infection and guide the development of specific prevention strategies. Better understanding of how pathogens persist in animal reservoirs is also critical to successful long-term prevention. In the past, the central challenge of foodborne disease lay in preventing the contamination of human food with sewage or animal manure. In the future, prevention of foodborne disease will increasingly depend on controlling contamination of feed and water consumed by the animals themselves. PMID:9366593

  20. Treatment in Kenyan rural health facilities: projected drug costs using the WHO-UNICEF integrated management of childhood illness (IMCI) guidelines.

    PubMed Central

    Boulanger, L. L.; Lee, L. A.; Odhacha, A.

    1999-01-01

    Guidelines for the integrated management of childhood illness (IMCI) in peripheral health facilities have been developed by WHO and UNICEF to improve the recognition and treatment of common causes of childhood death. To evaluate the impact of the guidelines on treatment costs, we compared the cost of drugs actually prescribed to a sample of 747 sick children aged 2-59 months in rural health facilities in western Kenya with the cost of drugs had the children been managed using the IMCI guidelines. The average cost of drugs actually prescribed per child was US$ 0.44 (1996 US$). Antibiotics were the most costly component, with phenoxymethylpenicillin syrup accounting for 59% of the cost of all the drugs prescribed. Of the 295 prescriptions for phenoxymethylpenicillin syrup, 223 (76%) were for treatment of colds or cough. The cost of drugs that would have been prescribed had the same children been managed with the IMCI guidelines ranged from US$ 0.16 per patient (based on a formulary of larger-dose tablets and a home remedy for cough) to US$ 0.39 per patient (based on a formulary of syrups or paediatric-dose tablets and a commercial cough preparation). Treatment of coughs and colds with antibiotics is not recommended in the Kenyan or in the IMCI guidelines. Compliance with existing treatment guidelines for the management of acute respiratory infections would have halved the cost of the drugs prescribed. The estimated cost of the drugs needed to treat children using the IMCI guidelines was less than the cost of the drugs actually prescribed, but varied considerably depending on the dosage forms and whether a commercial cough preparation was used. PMID:10593034

  1. Estimate of Illnesses from Salmonella Enteritidis in Eggs, United States, 2000

    PubMed Central

    Naugle, Alecia Larew; Schlosser, Wayne D.; Hogue, Allan T.; Angulo, Frederick J.; Rose, Jonathon S.; Ebel, Eric D.; Disney, W. Terry; Holt, Kristin G.; Goldman, David P.

    2005-01-01

    Results from our model suggest that eating Salmonella enterica serovar Enteritidis–contaminated shell eggs caused 182,060 illnesses in the United States during 2000. Uncertainty about the estimate ranged from 81,535 (5th percentile) to 276,500 illnesses (95th percentile). Our model provides 1 approach for estimating foodborne illness and quantifying estimate uncertainty. PMID:15705332

  2. How big is the financial burden of hepatitis B to society? A cost-of-illness study of hepatitis B infection in Singapore.

    PubMed

    Ong, S C; Lim, S G; Li, S C

    2009-01-01

    Hepatitis B virus (HBV) infection is the most common cause of chronic viral liver disease in Singapore. Nevertheless, very little data exist on the financial burden of HBV infection to the society as a whole. The aim of this study was therefore to assess the direct and indirect cost of HBV infection in a cost-of-illness analysis. The combined data from the direct and indirect cost with the estimated prevalence for different disease stages of HBV infection would represent the annual financial burden of HBV infection to the Singaporean society as a whole. The estimated total annual cost of chronic HBV infection and its associated complications in Singapore was US$279 million (range US$34-941 million when allowing various assumptions as tested by the sensitivity analyses), with 58% or US$161 million attributable to direct cost. Based on the base-case estimation, total direct cost alone is equivalent to 12% of the national healthcare expenditure for 2003. The total cost incurred by chronic hepatitis B patients represents the biggest cost component, followed by decompensated cirrhosis (DC) patients. The ratio of direct to indirect costs based on the base-case estimation increased with disease severity, with the highest ratio obtained for the post-liver transplants (40.2:1), followed by hepatocellular carcinoma (7.4:1) and DC patients (2.7:1). The results of this study suggest that the management of HBV infection poses more than a medical challenge as it is a sizeable economic burden from both the payer and societal perspectives. PMID:19192158

  3. Nonpeptidic mimics of host defense proteins as antimicrobial agents for E. coli O104:H4, campylobacter spp. and other foodborne pathogens

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Foodborne illness is a serious public health problem. According to the U.S. Food and Drug Administration Campylobacter jejuni is the leading cause of bacterial diarrheal illness in the United States, causing more disease than Shigella spp. and Salmonella spp. combined. The CDC estima...

  4. Approaches to the Surveillance of Foodborne Disease: A Review of the Evidence.

    PubMed

    Ford, Laura; Miller, Megge; Cawthorne, Amy; Fearnley, Emily; Kirk, Martyn

    2015-12-01

    Foodborne disease surveillance aims to reduce the burden of illness due to contaminated food. There are several different types of surveillance systems, including event-based surveillance, indicator-based surveillance, and integrated food chain surveillance. These approaches are not mutually exclusive, have overlapping data sources, require distinct capacities and resources, and can be considered a hierarchy, with each level being more complex and resulting in a greater ability to detect and control foodborne disease. Event-based surveillance is generally the least resource-intensive system and makes use of informal data sources. Indicator-based surveillance is seen as traditional notifiable disease surveillance and consists of routinely collected data. Integrated food chain surveillance is viewed as the optimal practice for conducting continuous risk analysis for foodborne diseases, but also requires significant ongoing resources and greater multisectoral collaboration compared to the other systems. Each country must determine the most appropriate structure for their surveillance system for foodborne diseases based on their available resources. This review explores the evidence on the principles, minimum capabilities, and minimum requirements of each type of surveillance and discusses examples from a range of countries. This review forms the evidence base for the Strengthening the Surveillance and Response for Foodborne Diseases: A Practical Manual. PMID:26554434

  5. The economic impact of chronic pain: a nationwide population-based cost-of-illness study in Portugal.

    PubMed

    Azevedo, Luís Filipe; Costa-Pereira, Altamiro; Mendonça, Liliane; Dias, Cláudia Camila; Castro-Lopes, José M

    2016-01-01

    In addition to its high frequency and relevant individual and social impact, chronic pain (CP) has been shown to be a major contributor to increased healthcare utilisation, reduced labour productivity, and consequently large direct and indirect costs. In the context of a larger nationwide study, we aimed to assess the total annual direct and indirect costs associated with CP in Portugal. A population-based study was conducted in a representative sample of the Portuguese adult population. The 5,094 participants were selected using random digit dialling and contacted by computer-assisted telephone interviews. Questionnaires included the brief pain inventory and pain disability index. Estimates were adequately weighted for the population. From all CP subjects identified, a subsample (n = 562) accepted to participate in this economic study. Mean total annualised costs per CP subject of €1,883.30 were observed, amounting to €4,611.69 million nationally, with 42.7% direct and 57.3% indirect costs, and corresponding to 2.71% of the Portuguese annual GDP in 2010. Only socio-demographic variables were significantly and independently associated with CP costs, and not CP severity, raising the possibility of existing inequalities in the distribution of healthcare in Portugal. The high economic impact of CP in Portugal was comprehensively demonstrated. Given the high indirect costs observed, restricting healthcare services is not a rational response to these high societal costs; instead improving the quality of CP prevention and management is recommended. PMID:25416319

  6. A scoping study on the costs of indoor air quality illnesses:an insurance loss reduction perspective

    SciTech Connect

    Chen, Allan; Vine, Edward L.

    1998-08-31

    The incidence of commercial buildings with poor indoor air quality (IAQ), and the frequency of litigation over the effects of poor IAQ is increasing. If so, these increases have ramifications for insurance carriers, which pay for many of the costs of health care and general commercial liability. However, little is known about the actual costs to insurance companies from poor IAQ in buildings. This paper reports on the results of a literature search of buildings-related, business and legal databases, and interviews with insurance and risk management representatives aimed at finding information on the direct costs to the insurance industry of poor building IAQ, as well as the costs of litigation. The literature search and discussions with insurance and risk management professionals reported in this paper turned up little specific information about the costs of IAQ-related problems to insurance companies. However, those discussions and certain articles in the insurance industry press indicate that there is a strong awareness and growing concern over the "silent crisis" of IAQ and its potential to cause large industry losses, and that a few companies are taking steps to address this issue. The source of these losses include both direct costs to insurers from paying health insurance and professional liability claims, as weIl as the cost of litigation. In spite of the lack of data on how IAQ-related health problems affect their business, the insurance industry has taken the anecdotal evidence about their reality seriously enough to alter their policies in ways that have lessened their exposure. We conclude by briefly discussing four activities that need to be addressed in the near future: (1) quantifying IAQ-related insurance costs by sector, (2) educating the insurance industry about the importance of IAQ issues, (3) examining IAQ impacts on the insurance industry in the residential sector, and (4) evaluating the relationship between IAQ improvements and their impact on

  7. Bacteriophage biocontrol of foodborne pathogens.

    PubMed

    Kazi, Mustafa; Annapure, Uday S

    2016-03-01

    Bacteriophages are viruses that only infect bacterial cells. Phages are categorized based on the type of their life cycle, the lytic cycle cause lysis of the bacterium with the release of multiple phage particles where as in lysogenic phase the phage DNA is incorporated into the bacterial genome. Lysogeny does not result in lysis of the host. Lytic phages have several potential applications in the food industry as biocontrol agents, biopreservatives and as tools for detecting pathogens. They have also been proposed as alternatives to antibiotics in animal health. Two unique features of phage relevant for food safety are that they are harmless to mammalian cells and high host specificity, keeping the natural microbiota undisturbed. However, the recent approval of bacteriophages as food additives has opened the discussion about 'edible viruses'. This article reviews in detail the application of phages for the control of foodborne pathogens in a process known as "biocontrol". PMID:27570260

  8. APPLICATIONS OF THE POLYMERASE CHAIN REACTION (PCR) FOR DETECTION, IDENTIFICATION, AND TYPING OF FOOD-BORNE MICROORGANISMS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Public awareness of microorganisms transmitted by food, which pose a severe threat to human health, has increased dramatically in recent years. Some of the agents, which have been responsible for numerous cases and outbreaks of food-borne illness and also many deaths, are Salmonella spp., Listeria ...

  9. Molecular Epidemiology, Gastrointestinal Ecology and Development of Antibiotic Alternative Interventions for Commensal Human Food-Borne Bacterial Pathogens in Poultry

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Campylobacter spp., Salmonella spp., and Clostridium perfringens, the three leading causes of human bacterial food-borne illness, are commonly associated with normal poultry gastrointestinal flora. Our research unit correlated rep-PCR analysis to serological typing of Salmonella spp. and source-tra...

  10. Immunological biosensing of foodborne pathogenic bacteria using electrochemical and light-addressable potentiometric sensor (LAPS) detection platforms

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The US Centers for Disease Control and Prevention estimates that contaminated foods account for 48 million illnesses, 128,000 hospitalizations, and 3000 deaths per year in the United States alone. Of these cases,9.4 million have been attributed to 31 major foodborne pathogens. Microbial culture-bas...

  11. Impact of changing consumer lifestyles on the emergence/reemergence of foodborne pathogens.

    PubMed Central

    Collins, J. E.

    1997-01-01

    Foodborne illness of microbial origin is the most serious food safety problem in the United States. The Centers for Disease Control and Prevention reports that 79% of outbreaks between 1987 and 1992 were bacterial; improper holding temperature and poor personal hygiene of food handlers contributed most to disease incidence. Some microbes have demonstrated resistance to standard methods of preparation and storage of foods. Nonetheless, food safety and public health officials attribute a rise in incidence of foodborne illness to changes in demographics and consumer lifestyles that affect the way food is prepared and stored. Food editors report that fewer than 50% of consumers are concerned about food safety. An American Meat Institute (1996) study details lifestyle changes affecting food behavior, including an increasing number of women in the workforce, limited commitment to food preparation, and a greater number of single heads of households. Consumers appear to be more interested in convenience and saving time than in proper food handling and preparation. PMID:9366599

  12. Cost-effectiveness of assertive community treatment versus standard case management for persons with co-occurring severe mental illness and substance use disorders.

    PubMed Central

    Clark, R E; Teague, G B; Ricketts, S K; Bush, P W; Xie, H; McGuire, T G; Drake, R E; McHugo, G J; Keller, A M; Zubkoff, M

    1998-01-01

    OBJECTIVE: To determine the cost-effectiveness of Assertive Community Treatment (ACT) in comparison to Standard Case Management (SCM) for persons with severe mental illness and substance use disorders. DATA SOURCES AND STUDY SETTING: Original data on the effectiveness and social costs of ACT and SCM that were collected between 1989 and 1995. Seven community mental health centers in New Hampshire provided both types of treatment. STUDY DESIGN: Persons with schizophrenia, schizoaffective disorder, or bipolar disorder and a concurrent substance use disorder were randomly assigned to ACT or SCM and followed for three years. The primary variables assessed were substance use, psychiatric symptoms, functioning, quality of life, and social costs. DATA COLLECTION METHODS: Effectiveness data were obtained from interviews at six-month intervals with persons enrolled in treatment and with their service providers. Social cost and service utilization data came from client reports; interviews with informal caregivers; provider information systems and Medicaid claims; law enforcement agencies; courts; and community service providers. PRINCIPAL FINDINGS: Participants in both groups showed significant reductions in substance use over time. Focusing on quality of life and substance use outcomes, ACT and SCM were not significantly different in cost-effectiveness over the entire three-year study period. Longitudinal analyses showed that SCM tended to be more efficient during the first two years but that ACT was significantly more efficient than SCM during the final year of the study. CONCLUSIONS: In an adequately funded system, ACT is not more cost-effective than SCM. However, ACT efficiency appears to improve over time. PMID:9865221

  13. Foodborne and waterborne zoonotic sarcocystosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The ingestion of raw beef or pork infected with Sarcocystis can cause illness in humans. Allergic/toxic type symptoms (nausea, vomiting) can occur within three days of consuming infected meat; these symptoms are considered due to toxic substances in sarcocysts or to other factors in raw meat. Diarrh...

  14. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada

    PubMed Central

    Abdullah, Mohammad M. H.; Gyles, Collin L.; Marinangeli, Christopher P. F.; Carlberg, Jared G.; Jones, Peter J. H.

    2015-01-01

    Background: Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with reductions in T2D and CVD rates, separately, following increased intakes of dietary fiber by adults. Methods: A three-step cost-of-illness analysis was conducted to identify the percentage of individuals expected to consume fiber-rich diets in Canada, estimate increased fiber intakes in relation to T2D and CVD reduction rates, and independently assess the potential annual savings in healthcare costs associated with the reductions in rates of these two epidemics. The economic model employed a sensitivity analysis of four scenarios (universal, optimistic, pessimistic, and very pessimistic) to cover a range of assumptions within each step. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8 million–$1.3 billion in CVD costs were calculated under a scenario where cereal fiber was used to increase current intakes of dietary fiber to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fiber consumption resulted in annual CAD$2.6 to $51.1 million savings for T2D and $4.6 to $92.1 million savings for CVD. Conclusion: Findings of this analysis shed light on the economic value of optimal dietary fiber intakes. Strategies to increase consumers’ general knowledge of the recommended intakes of dietary fiber, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of healthcare and related costs associated with T2D and CVD in Canada. PMID

  15. BACTERIAL FOODBORNE INFECTIONS AFTER HEMATOPOIETIC CELL TRANSPLANTATION

    PubMed Central

    Boyle, Nicole; Podczervinski, Sara; Jordan, Kim; Stednick, Zach; Butler-Wu, Susan; McMillen, Kerry; Pergam, Steven A.

    2014-01-01

    Background Diarrhea, abdominal pain and fever are common among patients undergoing hematopoietic cell transplant (HCT), but such symptoms are also typical with foodborne infections. The burden of disease caused by foodborne infections in patients undergoing HCT is unknown. We sought to describe bacterial foodborne infection incidence post-transplant within a single-center population of HCT recipients. Methods All HCT recipients transplanted from 2001 through 2011 at the Fred Hutchinson Cancer Research Center in Seattle, WA were followed for one year post-transplant. Data were collected retrospectively using center databases, which include information from transplant, on-site examinations, outside records, and collected laboratory data. Patients were considered to have a bacterial foodborne infection if Campylobacter jejuni/coli, Listeria monocytogenes, E. coli 0157:H7, Salmonella species, Shigella species, Vibrio species or Yersinia species were isolated in culture within one-year post-transplant. Non-foodborne infections with these agents and patients with preexisting bacterial foodborne infection (within 30 days of transplant) were excluded from analyses. Results A total of 12/4069 (0.3%) patients developed a bacterial foodborne infection within one year post-transplant. Patients with infections had a median age at transplant of 50.5 years (interquartile range [IQR]: 35–57), and the majority were adults ≥18 years of age (9/12 [75%]), male gender (8/12 [67%]) and post-allogeneic transplant (8/12 [67%]). Infectious episodes occurred at an incidence rate of 1.0 per 100,000 patient-days (95% CI: 0.5–1.7) and at a median of 50.5 days after transplant (IQR: 26–58.5). The most frequent pathogen detected was Campylobacter jejuni/coli (5/12 [42%]) followed by Yersinia (3/12 [25%]), while Salmonella (2/12 [17%]) and Listeria (2/12 [17%]) showed equal frequencies; no cases of Shigella, Vibrio, or E. coli 0157:H7 were detected. Most patients were diagnosed via stool

  16. Socioeconomic Status and Foodborne Pathogens in Connecticut, USA, 2000-2011(1).

    PubMed

    Whitney, Bridget M; Mainero, Christina; Humes, Elizabeth; Hurd, Sharon; Niccolai, Linda; Hadler, James L

    2015-09-01

    Foodborne pathogens cause >9 million illnesses annually. Food safety efforts address the entire food chain, but an essential strategy for preventing foodborne disease is educating consumers and food preparers. To better understand the epidemiology of foodborne disease and to direct prevention efforts, we examined incidence of Salmonella infection, Shiga toxin-producing Escherichia coli infection, and hemolytic uremic syndrome by census tract-level socioeconomic status (SES) in the Connecticut Foodborne Diseases Active Surveillance Network site for 2000-2011. Addresses of case-patients were geocoded to census tracts and linked to census tract-level SES data. Higher census tract-level SES was associated with Shiga toxin-producing Escherichia coli, regardless of serotype; hemolytic uremic syndrome; salmonellosis in persons ≥5 years of age; and some Salmonella serotypes. A reverse association was found for salmonellosis in children <5 years of age and for 1 Salmonella serotype. These findings will inform education and prevention efforts as well as further research. PMID:26291087

  17. Genetic variants of Kudoa septempunctata (Myxozoa: Multivalvulida), a flounder parasite causing foodborne disease.

    PubMed

    Takeuchi, F; Ogasawara, Y; Kato, K; Sekizuka, T; Nozaki, T; Sugita-Konishi, Y; Ohnishi, T; Kuroda, M

    2016-06-01

    Foodborne disease outbreaks caused by raw olive flounders (Paralichthys olivaceus) parasitized with Kudoa septempunctata have been reported in Japan. Origins of olive flounders consumed in Japan vary, being either domestic or imported, and aquaculture-raised or natural. Although it is unknown whether different sources are associated with different outcomes, it is desirable to identify whether this is the case by determining whether unique K. septempunctata strains occur and if so, whether some are associated with foodborne illness. We here developed an intraspecific genotyping method, using the sequence variation of mitochondrial genes. We collected olive flounder samples from foodborne disease outbreaks, domestic fish farms or quarantine offices and investigated whether K. septempunctata genotype is associated with pathogenicity or geographic origin. The 104 samples were classified into three genotypes, ST1, ST2 and ST3. Frequency of symptomatic cases differed by genotypes, but the association was not statistically significant. Whereas K. septempunctata detected from aquaculture-raised and natural fish from Japan were either ST1 or ST2, those from fish inspected at quarantine from Korea to Japan were ST3. Our method can be applied to phylogeographic analysis of K. septempunctata and contribute to containing the foodborne disease. The genotype database is hosted in the PubMLST website (http://pubmlst.org/kseptempunctata/). PMID:26096292

  18. Streamlined analysis for evaluating the use of preharvest interventions intended to prevent Escherichia coli O157:H7 illness in humans.

    PubMed

    Withee, James; Williams, Michael; Disney, Terry; Schlosser, Wayne; Bauer, Nate; Ebel, Eric

    2009-09-01

    The U.S. Department of Agriculture Food Safety Inspection Service is responsible for ensuring the safety of meat, poultry, and egg products consumed in the United States. Here we describe a risk assessment method that provides quantitative criteria for decision makers tasked with developing food safety policies. To demonstrate the utility of this method, we apply it to a hypothetical case study on the use of an Escherichia coli O157:H7 cattle vaccine to prevent human illness caused by consuming beef. A combination of quantitative risk assessment methods and marginal economic analysis are used to describe the maximum cost per unit that would still allow the vaccine to be a cost-effective intervention as well as the minimum effectiveness it could have at a fixed cost. We create two economic production functions where the input is number of vaccinated cattle and the output is human illnesses prevented. The production functions are then used for marginal economic analysis to assess the cost/benefit ratio of using the vaccine to prevent foodborne illness. In our case study, it was determined that vaccinating the entire U.S. herd at a cost of between $2.29 and $9.14 per unit (depending on overall effectiveness of the vaccine) would be a cost-effective intervention for preventing E. coli O157:H7 illness in humans. In addition, we determined that vaccinating only a given fraction of the herd would be cost effective for vaccines that are less effective or more costly. For example, a vaccine costing $9.00 per unit that had a 100% efficacy but required 100% herd coverage for immunity would be cost effective for use in about 500,000 cattle each year-equating to an estimated 750 human illnesses prevented per annum. We believe this approach could be useful for public health policy development in a wide range of applications. PMID:19737060

  19. Genomic Epidemiology: Whole-Genome-Sequencing-Powered Surveillance and Outbreak Investigation of Foodborne Bacterial Pathogens.

    PubMed

    Deng, Xiangyu; den Bakker, Henk C; Hendriksen, Rene S

    2016-01-01

    As we are approaching the twentieth anniversary of PulseNet, a network of public health and regulatory laboratories that has changed the landscape of foodborne illness surveillance through molecular subtyping, public health microbiology is undergoing another transformation brought about by so-called next-generation sequencing (NGS) technologies that have made whole-genome sequencing (WGS) of foodborne bacterial pathogens a realistic and superior alternative to traditional subtyping methods. Routine, real-time, and widespread application of WGS in food safety and public health is on the horizon. Technological, operational, and policy challenges are still present and being addressed by an international and multidisciplinary community of researchers, public health practitioners, and other stakeholders. PMID:26772415

  20. Assessing the applicability of currently available methods for attributing foodborne disease to sources, including food and food commodities.

    PubMed

    Pires, Sara M

    2013-03-01

    A variety of approaches to attribute foodborne diseases to specific sources are available, including hazard occurrence analysis, epidemiological methods, intervention studies, and expert elicitations. The usefulness of each method to attribute disease caused by a foodborne hazard depends on the public health question being addressed, on the data requirements, on advantages and limitations of the method, and on the data availability of the country or region in question. Previous articles have described available methods for source attribution, but have focused only on foodborne microbiological hazards. These articles have described strengths and weaknesses of each method, but no guidance on how to choose the most appropriate tool to address different public health questions has thus far been provided. We reviewed available source attribution methods; assessed their applicability to attribute illness caused by enteric, parasitic, and chemical foodborne hazards to the responsible sources; and renamed some of the approaches. The main objective was to make recommendations on the most appropriate method(s) to attribute human disease caused by different foodborne hazards. We concluded that the proportion of disease that can be attributed to specific foods items or transmission routes may be estimated for the majority of the evaluated hazards by applying one or more of the source attribution methods assessed. It was also recognized that the use of source attribution methods may be limited to specific countries, reflecting the data availability. PMID:23489045

  1. Heat Illness

    MedlinePlus

    ... humidity, sweating just isn't enough. Your body temperature can rise to dangerous levels and you can ... Heatstroke - a life-threatening illness in which body temperature may rise above 106° F in minutes; symptoms ...

  2. Heat Illness

    MedlinePlus

    ... high humidity, sweating just isn't enough. Your body temperature can rise to dangerous levels and you can ... include Heatstroke - a life-threatening illness in which body temperature may rise above 106° F in minutes; symptoms ...

  3. Effects of Integrated Care on Disease-Related Hospitalisation and Healthcare Costs in Patients with Diabetes, Cardiovascular Diseases and Respiratory Illnesses: A Propensity-Matched Cohort Study in Switzerland

    PubMed Central

    Reich, Oliver; Früh, Mathias; Rosemann, Thomas

    2016-01-01

    Background: There is an ongoing discussion on the further promotion of integrated care models in many healthcare systems. Only a few data, which examine the effect of integrated care models on medical expenditures and quality of care in chronically ill patients, exist. Aims: To investigate the effect of integrated care models on disease-related hospitalisations as a quality indicator and healthcare costs in patients with either diabetes, cardiovascular diseases or respiratory illnesses. Methods: A propensity-matched retrospective cohort study based on a large Swiss health insurance database (2012–2013) was performed for three chronic patient groups (diabetes, cardiovascular diseases, respiratory illnesses), who were enrolled in an integrated care model and compared to individuals in a standard care model. Multivariate regression models were applied to estimate the effect of integrated care models on disease-related hospitalisations and healthcare costs. Results: The matched cohorts included a total of 12,526 patients with diabetes, 71,778 with cardiovascular diseases and 17,498 with respiratory illnesses, in which each one half was enrolled in integrated care models and the other half in standard care models. Diabetes and cardiovascular patients with integrated care models had a significantly lower probability of disease-related hospitalisation compared to those with standard care models (p < 0.01). Healthcare costs were statistically significant lower in all three patient groups with integrated care, but with the highest effect in patients with diabetes (Swiss francs (CHF) –778). Conclusions: Integrated care may provide an effective strategy to improve the quality of care and to reduce healthcare costs in chronically ill patients. Study findings intend to contribute to the ongoing political discussion on integrated care and provide evidence for improved and more effective care of patients with chronic diseases.

  4. Emerging foodborne and agriculture-related viruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Viruses rapidly evolve and can emerge in unpredictable ways. Mechanisms by which food-borne viruses may enter human populations and become pathogens is discussed. It is known the majority of viruses emerge from zoonotic animal reservoirs, often by adapting and infecting intermediate hosts, such as ...

  5. YERSINIA ENTEROCOLITICA: AN IMPORTANT HUMAN FOODBORNE PATHOGEN

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Yersinia enterocolitica is a Gram-negative microbe of public health importance and is under national FoodNet surveillance in the United States. The majority of human yersiniosis cases are foodborne. Consumption of dairy products (milk, ice cream), water, vegetables (tofu), and pork have been linke...

  6. Foodborne pathogen detection using hyperspectral imaging

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foodborne pathogens can cause various diseases and even death when humans consume foods contaminated with microbial pathogens. Traditional culture-based direct plating methods are still the “gold standard” for presumptive-positive pathogen screening. Although considerable research has been devoted t...

  7. Selection tool for foodborne norovirus outbreaks.

    PubMed

    Verhoef, Linda P B; Kroneman, Annelies; van Duynhoven, Yvonne; Boshuizen, Hendriek; van Pelt, Wilfrid; Koopmans, Marion

    2009-01-01

    Detection of pathogens in the food chain is limited mainly to bacteria, and the globalization of the food industry enables international viral foodborne outbreaks to occur. Outbreaks from 2002 through 2006 recorded in a European norovirus surveillance database were investigated for virologic and epidemiologic indicators of food relatedness. The resulting validated multivariate logistic regression model comparing foodborne (n = 224) and person-to-person (n = 654) outbreaks was used to create a practical web-based tool that can be limited to epidemiologic parameters for nongenotyping countries. Non-genogroup-II.4 outbreaks, higher numbers of cases, and outbreaks in restaurants or households characterized (sensitivity = 0.80, specificity = 0.86) foodborne outbreaks and reduced the percentage of outbreaks requiring source-tracing to 31%. The selection tool enabled prospectively focused follow-up. Use of this tool is likely to improve data quality and strain typing in current surveillance systems, which is necessary for identification of potential international foodborne outbreaks. PMID:19116046

  8. Impacts of globalization on foodborne parasites

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In 2010 an estimated 3% of the world’s population lived outside their country of origin. Among immigrants, tourists, and business travellers worldwide several foodborne parasites are frequently found including Ascaris, Trichiuris, hookworms, Enterobius, Fasciola, Hymenolepis, and several protozoa. T...

  9. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010

    PubMed Central

    Havelaar, Arie H.; Kirk, Martyn D.; Torgerson, Paul R.; Gibb, Herman J.; Hald, Tine; Lake, Robin J.; Praet, Nicolas; Bellinger, David C.; de Silva, Nilanthi R.; Gargouri, Neyla; Speybroeck, Niko; Cawthorne, Amy; Mathers, Colin; Stein, Claudia; Angulo, Frederick J.; Devleesschauwer, Brecht

    2015-01-01

    Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established the Foodborne Disease Burden Epidemiology Reference Group (FERG), which here reports their first estimates of the incidence, mortality, and disease burden due to 31 foodborne hazards. We find that the global burden of FBD is comparable to those of the major infectious diseases, HIV/AIDS, malaria and tuberculosis. The most frequent causes of foodborne illness were diarrheal disease agents, particularly norovirus and Campylobacter spp. Diarrheal disease agents, especially non-typhoidal Salmonella enterica, were also responsible for the majority of deaths due to FBD. Other major causes of FBD deaths were Salmonella Typhi, Taenia solium and hepatitis A virus. The global burden of FBD caused by the 31 hazards in 2010 was 33 million Disability Adjusted Life Years (DALYs); children under five years old bore 40% of this burden. The 14 subregions, defined on the basis of child and adult mortality, had considerably different burdens of FBD, with the greatest falling on the subregions in Africa, followed by the subregions in South-East Asia and the Eastern Mediterranean D subregion. Some hazards, such as non-typhoidal S. enterica, were important causes of FBD in all regions of the world, whereas others, such as certain parasitic helminths, were highly localised. Thus, the burden of FBD is borne particularly by children under five years old–although they represent only 9% of the global population–and people living in low-income regions of the world. These estimates are conservative, i.e., underestimates rather than overestimates; further studies are needed to address the data gaps and limitations of the study. Nevertheless, all stakeholders can contribute to improvements in food safety

  10. World Health Organization Global Estimates and Regional Comparisons of the Burden of Foodborne Disease in 2010.

    PubMed

    Havelaar, Arie H; Kirk, Martyn D; Torgerson, Paul R; Gibb, Herman J; Hald, Tine; Lake, Robin J; Praet, Nicolas; Bellinger, David C; de Silva, Nilanthi R; Gargouri, Neyla; Speybroeck, Niko; Cawthorne, Amy; Mathers, Colin; Stein, Claudia; Angulo, Frederick J; Devleesschauwer, Brecht

    2015-12-01

    Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and regional burden of foodborne disease (FBD), the World Health Organization (WHO) established the Foodborne Disease Burden Epidemiology Reference Group (FERG), which here reports their first estimates of the incidence, mortality, and disease burden due to 31 foodborne hazards. We find that the global burden of FBD is comparable to those of the major infectious diseases, HIV/AIDS, malaria and tuberculosis. The most frequent causes of foodborne illness were diarrheal disease agents, particularly norovirus and Campylobacter spp. Diarrheal disease agents, especially non-typhoidal Salmonella enterica, were also responsible for the majority of deaths due to FBD. Other major causes of FBD deaths were Salmonella Typhi, Taenia solium and hepatitis A virus. The global burden of FBD caused by the 31 hazards in 2010 was 33 million Disability Adjusted Life Years (DALYs); children under five years old bore 40% of this burden. The 14 subregions, defined on the basis of child and adult mortality, had considerably different burdens of FBD, with the greatest falling on the subregions in Africa, followed by the subregions in South-East Asia and the Eastern Mediterranean D subregion. Some hazards, such as non-typhoidal S. enterica, were important causes of FBD in all regions of the world, whereas others, such as certain parasitic helminths, were highly localised. Thus, the burden of FBD is borne particularly by children under five years old-although they represent only 9% of the global population-and people living in low-income regions of the world. These estimates are conservative, i.e., underestimates rather than overestimates; further studies are needed to address the data gaps and limitations of the study. Nevertheless, all stakeholders can contribute to improvements in food safety

  11. Epidemiology of Foodborne Disease Outbreaks Caused by Clostridium perfringens, United States, 1998–2010

    PubMed Central

    Grass, Julian E.; Gould, L. Hannah; Mahon, Barbara E.

    2015-01-01

    Clostridium perfringens is estimated to be the second most common bacterial cause of foodborne illness in the United States, causing one million illnesses each year. Local, state, and territorial health departments voluntarily report C. perfringens outbreaks to the U.S. Centers for Disease Control and Prevention through the Foodborne Disease Outbreak Surveillance System. Our analysis included outbreaks confirmed by laboratory evidence during 1998–2010. A food item was implicated if C. perfringens was isolated from food or based on epidemiologic evidence. Implicated foods were classified into one of 17 standard food commodities when possible. From 1998 to 2010, 289 confirmed outbreaks of C. perfringens illness were reported with 15,208 illnesses, 83 hospitalizations, and eight deaths. The number of outbreaks reported each year ranged from 16 to 31 with no apparent trend over time. The annual number of outbreak-associated illnesses ranged from 359 to 2,173, and the median outbreak size was 24 illnesses. Outbreaks occurred year round, with the largest number in November and December. Restaurants (43%) were the most common setting of food preparation. Other settings included catering facility (19%), private home (16%), prison or jail (11%), and other (10%). Among the 144 (50%) outbreaks attributed to a single food commodity, beef was the most common commodity (66 outbreaks, 46%), followed by poultry (43 outbreaks, 30%), and pork (23 outbreaks, 16%). Meat and poultry outbreaks accounted for 92% of outbreaks with an identified single food commodity. Outbreaks caused by C. perfringens occur regularly, are often large, and can cause substantial morbidity yet are preventable if contamination of raw meat and poultry products is prevented at the farm or slaughterhouse or, after contamination, if these products are properly handled and prepared, particularly in restaurants and catering facilities. PMID:23379281

  12. Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a full economic analysis of a multicenter randomized controlled trial based on US costs

    PubMed Central

    Doig, Gordon S; Simpson, Fiona

    2013-01-01

    Purpose The provision of early enteral (gut) nutrition to critically ill patients, started within 24 hours of injury or intensive care unit admission, is accepted to improve health outcomes. However, not all patients are able to receive early enteral nutrition. The purpose of the economic analysis presented here was to estimate the cost implications of providing early parenteral (intravenous) nutrition to critically ill patients with short-term relative contraindications to early enteral nutrition. Materials and methods From the perspective of the US acute care hospital system, a cost-minimization analysis was undertaken based on large-scale Monte Carlo simulation (N = 1,000,000 trials) of a stochastic model developed using clinical outcomes and measures of resource consumption reported in a 1,363-patient multicenter clinical trial combined with cost distributions obtained from the published literature. The mean costs of acute care attributable to each study group (early parenteral nutrition versus pragmatic standard care) and the mean cost difference between groups, along with respective 95% confidence intervals, were obtained using the percentile method. Results and conclusion The use of early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition may significantly and meaningfully reduce total costs of acute hospital care by US$3,150 per patient (95% confidence interval US$1,314 to US$4,990). These findings were robust, with all sensitivity analyses demonstrating significant savings attributable to the use of early parenteral nutrition, including sensitivity analysis conducted using European cost data. PMID:23901287

  13. Control of a non-foodborne outbreak of salmonellosis: day care in isolation.

    PubMed Central

    Chorba, T L; Meriwether, R A; Jenkins, B R; Gunn, R A; MacCormack, J N

    1987-01-01

    We report an outbreak of Salmonella typhimurium in the infant room of a day care center. Time between onset dates, clustering of cases in the room, lack of a common food exposure, lack of illness among other children and staff, and lack of community-wide infection suggested person-to-person or continuing-common-source transmission. Successful preventive measures included instruction of personnel in proper handwashing and diaper-changing procedures and cohorting of infected and non-infected children. This is the second description of a non-foodborne outbreak of salmonellosis in a day care center, and the first involving S. typhimurium. PMID:3300382

  14. A review of outbreaks of foodborne disease associated with passenger ships: evidence for risk management.

    PubMed Central

    Rooney, Roisin M.; Cramer, Elaine H.; Mantha, Stacey; Nichols, Gordon; Bartram, Jamie K.; Farber, Jeffrey M.; Benembarek, Peter K.

    2004-01-01

    OBJECTIVE: Foodborne disease outbreaks on ships are of concern because of their potentially serious health consequences for passengers and crew and high costs to the industry. The authors conducted a review of outbreaks of foodborne diseases associated with passenger ships in the framework of a World Health Organization project on setting guidelines for ship sanitation. METHODS: The authors reviewed data on 50 outbreaks of foodborne disease associated with passenger ships. For each outbreak, data on pathogens/toxins, type of ship, factors contributing to outbreaks, mortality and morbidity, and food vehicles were collected. RESULTS: The findings of this review show that the majority of reported outbreaks were associated with cruise ships and that almost 10,000 people were affected. Salmonella spp were most frequently associated with outbreaks. Foodborne outbreaks due to enterotoxigenic E. coli spp, Shigella spp, noroviruses (formally called Norwalk-like viruses), Vibrio spp, Staphylococcus aureus, Clostridium perfringens, Cyclospora sp, and Trichinella sp also occurred on ships. Factors associated with the outbreaks reviewed include inadequate temperature control, infected food handlers, contaminated raw ingredients, cross-contamination, inadequate heat treatment, and onshore excursions. Seafood was the most common food vehicle implicated in outbreaks. CONCLUSIONS: Many ship-associated outbreaks could have been prevented if measures had been taken to ensure adequate temperature control, avoidance of cross-contamination, reliable food sources, adequate heat treatment, and exclusion of infected food handlers from work. PMID:15219800

  15. Managerial practices regarding workers working while ill.

    PubMed

    Norton, D M; Brown, L G; Frick, R; Carpenter, L R; Green, A L; Tobin-D'Angelo, M; Reimann, D W; Blade, H; Nicholas, D C; Egan, J S; Everstine, K

    2015-01-01

    Surveillance data indicate that handling of food by an ill worker is a cause of almost half of all restaurant-related outbreaks. The U.S. Food and Drug Administration (FDA) Food Code contains recommendations for food service establishments, including restaurants, aimed at reducing the frequency with which food workers work while ill. However, few data exist on the extent to which restaurants have implemented FDA recommendations. The Centers for Disease Control and Prevention's Environmental Health Specialists Network (EHS-Net) conducted a study on the topic of ill food workers in restaurants. We interviewed restaurant managers (n = 426) in nine EHS-Net sites. We found that many restaurant policies concerning ill food workers do not follow FDA recommendations. For example, one-third of the restaurants' policies did not specifically address the circumstances under which ill food workers should be excluded from work (i.e., not be allowed to work). We also found that, in many restaurants, managers are not actively involved in decisions about whether ill food workers should work. Additionally, almost 70% of managers said they had worked while ill; 10% said they had worked while having nausea or "stomach flu," possible symptoms of foodborne illness. When asked why they had worked when ill, a third of the managers said they felt obligated to work or their strong work ethic compelled them to work. Other reasons cited were that the restaurant was understaffed or no one was available to replace them (26%), they felt that their symptoms were mild or not contagious (19%), they had special managerial responsibilities that no one else could fulfill (11%), there was non-food handling work they could do (7%), and they would not get paid if they did not work or the restaurant had no sick leave policy (5%). Data from this study can inform future research and help policy makers target interventions designed to reduce the frequency with which food workers work while ill. PMID:25581195

  16. World Health Organization Estimates of the Global and Regional Disease Burden of 11 Foodborne Parasitic Diseases, 2010: A Data Synthesis

    PubMed Central

    Torgerson, Paul R.; Devleesschauwer, Brecht; Praet, Nicolas; Speybroeck, Niko; Willingham, Arve Lee; Kasuga, Fumiko; Rokni, Mohammad B.; Zhou, Xiao-Nong; Fèvre, Eric M.; Sripa, Banchob; Gargouri, Neyla; Fürst, Thomas; Budke, Christine M.; Carabin, Hélène; Kirk, Martyn D.; Angulo, Frederick J.; Havelaar, Arie; de Silva, Nilanthi

    2015-01-01

    % UI 1.65–2.48 million) and foodborne toxoplasmosis with 825,000 DALYs (95% UI 561,000–1.26 million) resulted in the highest burdens in terms of DALYs, mainly due to years lived with disability. Foodborne enteric protozoa, reported elsewhere, resulted in an additional 67.2 million illnesses or 492,000 DALYs. Major limitations of our study include often substantial data gaps that had to be filled by imputation and suffer from the uncertainties that surround such models. Due to resource limitations it was also not possible to consider all potentially foodborne parasites (for example Trypanosoma cruzi). Conclusions Parasites are frequently transmitted to humans through contaminated food. These estimates represent an important step forward in understanding the impact of foodborne diseases globally and regionally. The disease burden due to most foodborne parasites is highly focal and results in significant morbidity and mortality among vulnerable populations. PMID:26633705

  17. Sensitive detection of active Shiga toxin using low cost CCD based optical detector

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To reduce the sources and incidence of food-borne illness there is a need to develop inexpensive sensitive devices for detection of active toxin, such as Shiga toxin type 2 (Stx2). This approach increases the availability of foodborne bacterial toxin diagnostics in regions where there are limited r...

  18. Complete genome sequence of Vibrio parahaemolyticus strain FORC_008, a foodborne pathogen from a flounder fish in South Korea.

    PubMed

    Kim, Suyeon; Chung, Han Young; Lee, Dong-Hoon; Lim, Jong Gyu; Kim, Se Keun; Ku, Hye-Jin; Kim, You-Tae; Kim, Heebal; Ryu, Sangryeol; Lee, Ju-Hoon; Choi, Sang Ho

    2016-07-01

    Vibrio parahaemolyticus is a Gram-negative, motile, nonspore-forming pathogen that causes foodborne illness associated with the consumption of contaminated seafoods. Although many cases of foodborne outbreaks caused by V. parahaemolyticus have been reported, the genomes of only five strains have been completely sequenced and analyzed using bioinformatics. In order to characterize overall virulence factors and pathogenesis of V. parahaemolyticus associated with foodborne outbreak in South Korea, a new strain FORC_008 was isolated from flounder fish and its genome was completely sequenced. The genomic analysis revealed that the genome of FORC_008 consists of two circular DNA chromosomes of 3266 132 bp (chromosome I) and 1772 036 bp (chromosome II) with a GC content of 45.36% and 45.53%, respectively. The entire genome contains 4494 predicted open reading frames, 129 tRNAs and 31 rRNA genes. While the strain FORC_008 does not have genes encoding thermostable direct hemolysin (TDH) and TDH-related hemolysin (TRH), its genome encodes many other virulence factors including hemolysins, pathogenesis-associated secretion systems and iron acquisition systems, suggesting that it may be a potential pathogen. This report provides an extended understanding on V. parahaemolyticus in genomic level and would be helpful for rapid detection, epidemiological investigation and prevention of foodborne outbreak in South Korea. PMID:27170457

  19. Drug use disorders in the polydrug context: new epidemiological evidence from a foodborne outbreak approach.

    PubMed

    Lopez-Quintero, Catalina; Anthony, James C

    2015-09-01

    As epidemiologists studying foodborne illness outbreaks, we do not ask luncheon attendees to say which food caused their illnesses. Instead, we use measurement and analysis methods to estimate food-specific risk variations. Here, we adapt the foodborne outbreak approach to develop new estimates of drug use disorder risk for single-drug and polydrug users, without attributing the syndrome to a specific drug when multiple drugs have been used. We estimate drug use disorder risk for cannabis-only users as a reference value. We then derive comparative relative risk estimates for users of other drug subtypes, including polydrug combinations. Data are from the 2002 to 2003 U.S. National Comorbidity Survey Replication, a nationally representative sample of household residents (18+ years), with standardized drug use and drug dependence assessments. Multiple logistic regression provides odds ratio estimates of relative risk. With this approach, for every 1000 cannabis-only users, an estimated 17 had become cases (1.7%). By comparison, polydrug users and cocaine-only users had much greater cumulative incidence (>10%), even with adjustment for covariates and local area matching (P < 0.001). Using this approach, we find exceptionally low risk for cannabis-only users and greater risk for polydrug and cocaine-only users. PMID:26348487

  20. Low-fouling surface plasmon resonance biosensor for multi-step detection of foodborne bacterial pathogens in complex food samples.

    PubMed

    Vaisocherová-Lísalová, Hana; Víšová, Ivana; Ermini, Maria Laura; Špringer, Tomáš; Song, Xue Chadtová; Mrázek, Jan; Lamačová, Josefína; Scott Lynn, N; Šedivák, Petr; Homola, Jiří

    2016-06-15

    Recent outbreaks of foodborne illnesses have shown that foodborne bacterial pathogens present a significant threat to public health, resulting in an increased need for technologies capable of fast and reliable screening of food commodities. The optimal method of pathogen detection in foods should: (i) be rapid, specific, and sensitive; (ii) require minimum sample preparation; and (iii) be robust and cost-effective, thus enabling use in the field. Here we report the use of a SPR biosensor based on ultra-low fouling and functionalizable poly(carboxybetaine acrylamide) (pCBAA) brushes for the rapid and sensitive detection of bacterial pathogens in crude food samples utilizing a three-step detection assay. We studied both the surface resistance to fouling and the functional capabilities of these brushes with respect to each step of the assay, namely: (I) incubation of the sensor with crude food samples, resulting in the capture of bacteria by antibodies immobilized to the pCBAA coating, (II) binding of secondary biotinylated antibody (Ab2) to previously captured bacteria, and (III) binding of streptavidin-coated gold nanoparticles to the biotinylated Ab2 in order to enhance the sensor response. We also investigated the effects of the brush thickness on the biorecognition capabilities of the gold-grafted functionalized pCBAA coatings. We demonstrate that pCBAA-compared to standard low-fouling OEG-based alkanethiolate self-assemabled monolayers-exhibits superior surface resistance regarding both fouling from complex food samples as well as the non-specific binding of S-AuNPs. We further demonstrate that a SPR biosensor based on a pCBAA brush with a thickness as low as 20 nm was capable of detecting E. coli O157:H7 and Salmonella sp. in complex hamburger and cucumber samples with extraordinary sensitivity and specificity. The limits of detection for the two bacteria in cucumber and hamburger extracts were determined to be 57 CFU/mL and 17 CFU/mL for E. coli and 7.4 × 10

  1. Decompression illness.

    PubMed

    Vann, Richard D; Butler, Frank K; Mitchell, Simon J; Moon, Richard E

    2011-01-01

    Decompression illness is caused by intravascular or extravascular bubbles that are formed as a result of reduction in environmental pressure (decompression). The term covers both arterial gas embolism, in which alveolar gas or venous gas emboli (via cardiac shunts or via pulmonary vessels) are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas. Both syndromes can occur in divers, compressed air workers, aviators, and astronauts, but arterial gas embolism also arises from iatrogenic causes unrelated to decompression. Risk of decompression illness is affected by immersion, exercise, and heat or cold. Manifestations range from itching and minor pain to neurological symptoms, cardiac collapse, and death. First-aid treatment is 100% oxygen and definitive treatment is recompression to increased pressure, breathing 100% oxygen. Adjunctive treatment, including fluid administration and prophylaxis against venous thromboembolism in paralysed patients, is also recommended. Treatment is, in most cases, effective although residual deficits can remain in serious cases, even after several recompressions. PMID:21215883

  2. High-Throughput Biosensors for Multiplexed Food-Borne Pathogen Detection

    NASA Astrophysics Data System (ADS)

    Gehring, Andrew G.; Tu, Shu-I.

    2011-07-01

    Incidental contamination of foods by pathogenic bacteria and/or their toxins is a serious threat to public health and the global economy. The presence of food-borne pathogens and toxins must be rapidly determined at various stages of food production, processing, and distribution. Producers, processors, regulators, retailers, and public health professionals need simple and cost-effective methods to detect different species or serotypes of bacteria and associated toxins in large numbers of food samples. This review addresses the desire to replace traditional microbiological plate culture with more timely and less cumbersome rapid, biosensor-based methods. Emphasis focuses on high-throughput, multiplexed techniques that allow for simultaneous testing of numerous samples, in rapid succession, for multiple food-borne analytes (primarily pathogenic bacteria and/or toxins).

  3. Cholera Illness and Symptoms

    MedlinePlus

    ... Year Later Related Links Healthy Water Global Water, Sanitation, & Hygiene (WASH) The Safe Water System Division of Foodborne, Waterborne, and Environmental Diseases Get Email Updates To receive email updates ...

  4. A Cost of Illness Study of Children with High-Functioning Autism Spectrum Disorders and Comorbid Anxiety Disorders as Compared to Clinically Anxious and Typically Developing Children

    ERIC Educational Resources Information Center

    Steensel, Francisca J.; Dirksen, Carmen D.; Bögels, Susan M.

    2013-01-01

    The study's aim was to estimate the societal costs of children with high-functioning ASD and comorbid anxiety disorder(s) (ASD + AD-group; n = 73), and to compare these costs to children with anxiety disorders (AD-group; n = 34), and typically developing children (controls; n = 87). Mean total costs for the ASD + AD-group amounted €17,380 per…

  5. Phylogenetic identification of bacterial MazF toxin protein motifs among probiotic strains and foodborne pathogens and potential implications of engineered probiotic intervention in food

    PubMed Central

    2012-01-01

    Background Toxin-antitoxin (TA) systems are commonly found in bacteria and Archaea, and it is the most common mechanism involved in bacterial programmed cell death or apoptosis. Recently, MazF, the toxin component of the toxin-antitoxin module, has been categorized as an endoribonuclease, or it may have a function similar to that of a RNA interference enzyme. Results In this paper, with comparative data and phylogenetic analyses, we are able to identify several potential MazF-conserved motifs in limited subsets of foodborne pathogens and probiotic strains and further provide a molecular basis for the development of engineered/synthetic probiotic strains for the mitigation of foodborne illnesses. Our findings also show that some probiotic strains, as fit as many bacterial foodborne pathogens, can be genetically categorized into three major groups based on phylogenetic analysis of MazF. In each group, potential functional motifs are conserved in phylogenetically distant species, including foodborne pathogens and probiotic strains. Conclusion These data provide important knowledge for the identification and computational prediction of functional motifs related to programmed cell death. Potential implications of these findings include the use of engineered probiotic interventions in food or use of a natural probiotic cocktail with specificity for controlling targeted foodborne pathogens. PMID:23186337

  6. Advances in subtyping methods of foodborne disease pathogens.

    PubMed

    Boxrud, Dave

    2010-04-01

    Current subtyping methods for the detection of foodborne disease outbreaks have limitations that reduce their use by public health laboratories. Recent advances in subtyping of foodborne disease pathogens utilize techniques that identify nucleic acid polymorphisms. Recent methods of nucleic acid characterization such as microarrays and mass spectrometry (MS) may provide improvements such as increasing speed and data portability while decreasing labor compared to current methods. This article discusses multiple-locus variable-number tandem-repeat analysis, single-nucleotide polymorphisms, nucleic acid sequencing, whole genome sequencing, variable absent or present loci, microarrays and MS as potential subtyping methods to enhance our ability to detect foodborne disease outbreaks. PMID:20299203

  7. Bacterial Quality and Prevalence of Foodborne Pathogens in Edible Offal from Slaughterhouses in Korea.

    PubMed

    Im, Min Chan; Seo, Kwang Won; Bae, Dong Hwa; Lee, Young Ju

    2016-01-01

    Edible offal meats have recently received significant attention worldwide. However, studies evaluating the microbial quality of diverse edible offal and specifically investigating contamination by pathogens that cause foodborne illnesses are rare. Our study was conducted to investigate the microbiological quality of six kinds of edible offal produced from 11 pigs and 8 cattle slaughterhouses in the Republic of Korea and the prevalence of pathogenic microorganisms such as Salmonella, Clostridium perfringens, Staphylococcus aureus, and Escherichia coli O157:H7 in these products. The values for aerobic plate counts, coliform counts, and E. coli counts in red offal were 1.00 to 6.70, 0 (below 10 CFU) to 4.78, and 0 to 4.00 log CFU/g, respectively. For green offal, the values were 3.00 to 7.00, 1.48 to 6.30, and 0 to 6.00 log CFU/g, respectively. The most frequently detected foodborne pathogen was Salmonella (23.8% prevalence in pig offal and 7.1% prevalence in cattle offal), followed by C. perfringens (11.1 and 7.1%, respectively) and S. aureus (12.7 and 2.4%, respectively). None of the offal samples tested positive for E. coli O157:H7. Considering the microbial quality of offal from Korean slaughterhouses and the prevalence of foodborne pathogens in this material, more refined hygienic standards such as a hazard analysis critical control point system for processing, packing, and transporting edible offal are necessary for preventing further contamination. PMID:26735045

  8. Foodborne streptococcal pharyngitis after a party.

    PubMed Central

    Berkley, S F; Rigau-Pérez, J G; Facklam, R; Broome, C V

    1986-01-01

    Following a private party in Río Piedras, PR, 23 (56 percent) of those who attended developed an illness characterized by pharyngitis, myalgia, fatigue, headache, and fever. Consumption of carrucho (conch) salad was significantly associated with illness (P = 0.013, Fisher's exact test). Group A beta-hemolytic streptococci (M nontypable T12, serum opacity factor positive) were isolated both from throat cultures in 11 of 47 persons who attended the party and from the implicated food. The original source of contamination of the conch salad was not identified. Because complications may still occur from such infections and only a small percentage of persons with sore throats seek medical attention and ultimately receive treatment for their illnesses, it is important to recognize these outbreaks. PMID:3083478

  9. World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis

    PubMed Central

    Kirk, Martyn D.; Pires, Sara M.; Black, Robert E.; Caipo, Marisa; Crump, John A.; Devleesschauwer, Brecht; Döpfer, Dörte; Fazil, Aamir; Fischer-Walker, Christa L.; Hald, Tine; Hall, Aron J.; Keddy, Karen H.; Lake, Robin J.; Lanata, Claudio F.; Torgerson, Paul R.; Havelaar, Arie H.; Angulo, Frederick J.

    2015-01-01

    Background Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and viral diseases. Methods and Findings We synthesized data on the number of foodborne illnesses, sequelae, deaths, and Disability Adjusted Life Years (DALYs), for all diseases with sufficient data to support global and regional estimates, by age and region. The data sources included varied by pathogen and included systematic reviews, cohort studies, surveillance studies and other burden of disease assessments. We sought relevant data circa 2010, and included sources from 1990–2012. The number of studies per pathogen ranged from as few as 5 studies for bacterial intoxications through to 494 studies for diarrheal pathogens. To estimate mortality for Mycobacterium bovis infections and morbidity and mortality for invasive non-typhoidal Salmonella enterica infections, we excluded cases attributed to HIV infection. We excluded stillbirths in our estimates. We estimate that the 22 diseases included in our study resulted in two billion (95% uncertainty interval [UI] 1.5–2.9 billion) cases, over one million (95% UI 0.89–1.4 million) deaths, and 78.7 million (95% UI 65.0–97.7 million) DALYs in 2010. To estimate the burden due to contaminated food, we then applied proportions of infections that were estimated to be foodborne from a global expert elicitation. Waterborne transmission of disease was not included. We estimate that 29% (95% UI 23–36%) of cases caused by diseases in our study, or 582 million (95% UI 401–922 million), were transmitted by contaminated food, resulting in 25.2 million (95% UI 17.5–37.0 million) DALYs. Norovirus was the leading cause of foodborne illness causing 125 million (95% UI 70–251 million) cases, while Campylobacter spp. caused 96 million (95% UI 52–177 million) foodborne

  10. Estimating the burden of foodborne diseases in Japan

    PubMed Central

    Kumagai, Yuko; Gilmour, Stuart; Ota, Erika; Momose, Yoshika; Onishi, Toshiro; Bilano, Ver Luanni Feliciano; Kasuga, Fumiko; Sekizaki, Tsutomu

    2015-01-01

    Abstract Objective To assess the burden posed by foodborne diseases in Japan using methods developed by the World Health Organization’s Foodborne Disease Burden Epidemiology Reference Group (FERG). Methods Expert consultation and statistics on food poisoning during 2011 were used to identify three common causes of foodborne disease in Japan: Campylobacter and Salmonella species and enterohaemorrhagic Escherichia coli (EHEC). We conducted systematic reviews of English and Japanese literature on the complications caused by these pathogens, by searching Embase, the Japan medical society abstract database and Medline. We estimated the annual incidence of acute gastroenteritis from reported surveillance data, based on estimated probabilities that an affected person would visit a physician and have gastroenteritis confirmed. We then calculated disability-adjusted life-years (DALYs) lost in 2011, using the incidence estimates along with disability weights derived from published studies. Findings In 2011, foodborne disease caused by Campylobacter species, Salmonella species and EHEC led to an estimated loss of 6099, 3145 and 463 DALYs in Japan, respectively. These estimated burdens are based on the pyramid reconstruction method; are largely due to morbidity rather than mortality; and are much higher than those indicated by routine surveillance data. Conclusion Routine surveillance data may indicate foodborne disease burdens that are much lower than the true values. Most of the burden posed by foodborne disease in Japan comes from secondary complications. The tools developed by FERG appear useful in estimating disease burdens and setting priorities in the field of food safety. PMID:26478611

  11. Antibacterial Activity and Action Mechanism of the Essential Oil from Enteromorpha linza L. against Foodborne Pathogenic Bacteria.

    PubMed

    Patra, Jayanta Kumar; Baek, Kwang-Hyun

    2016-01-01

    Foodborne illness and disease caused by foodborne pathogenic bacteria is continuing to increase day by day and it has become an important topic of concern among various food industries. Many types of synthetic antibacterial agents have been used in food processing and food preservation; however, they are not safe and have resulted in various health-related issues. Therefore, in the present study, essential oil from an edible seaweed, Enteromorpha linza (AEO), was evaluated for its antibacterial activity against foodborne pathogens, along with the mechanism of its antibacterial action. AEO at 25 mg/disc was highly active against Bacillus cereus (12.3-12.7 mm inhibition zone) and Staphylococcus aureus (12.7-13.3 mm inhibition zone). The minimum inhibitory concentration and minimum bactericidal concentration values of AEO ranged from 12.5-25 mg/mL. Further investigation of the mechanism of action of AEO revealed its strong impairing effect on the viability of bacterial cells and membrane permeability, as indicated by a significant increase in leakage of 260 nm absorbing materials and K⁺ ions from the cell membrane and loss of high salt tolerance. Taken together, these data suggest that AEO has the potential for use as an effective antibacterial agent that functions by impairing cell membrane permeability via morphological alternations, resulting in cellular lysis and cell death. PMID:27007365

  12. Variations in the radiation sensitivity of foodborne pathogens associated with complex ready-to-eat food products

    NASA Astrophysics Data System (ADS)

    Sommers, Christopher H.; Boyd, Glenn

    2006-07-01

    Foodborne illness outbreaks and product recalls are occasionally associated with ready-to-eat (RTE) sandwiches and other "heat and eat" multi-component RTE products. Ionizing radiation can inactivate foodborne pathogens on meat and poultry, fruits and vegetables, seafood, and RTE meat products. However, less data are available on the ability of low-dose ionizing radiation, doses under 5 kGy typically used for pasteurization purposes, to inactivate pathogenic bacteria on complex multi-component food products. In this study, the efficacy of ionizing radiation to inactivate Salmonella spp., Listeria monocytogenes, Staphylococcus aureus, Escherichia coli O157:H7, and Yersinia enterocolitica on RTE foods including a "frankfurter on a roll", a "beef cheeseburger on a bun" and a "vegetarian cheeseburger on a bun" was investigated. The average D-10 values, the radiation dose needed to inactivate 1 log 10 of pathogen, by bacterium species, were 0.61, 0.54, 0.47, 0.36 and 0.15 kGy for Salmonella spp., S. aureus, L. monocytogenes, E. coli O157:H7, and Y. enterocolitica, respectively when inoculated onto the three product types. These results indicate that irradiation may be an effective means for inactivating common foodborne pathogens including Salmonella spp, S. aureus, L. monocytogenes, E. coli O157:H7 and Y. enterocolitica in complex RTE food products such as 'heat and eat" sandwich products.

  13. Foodborne Diseases Active Surveillance Network-2 Decades of Achievements, 1996-2015.

    PubMed

    Henao, Olga L; Jones, Timothy F; Vugia, Duc J; Griffin, Patricia M

    2015-09-01

    The Foodborne Diseases Active Surveillance Network (FoodNet) provides a foundation for food safety policy and illness prevention in the United States. FoodNet conducts active, population-based surveillance at 10 US sites for laboratory-confirmed infections of 9 bacterial and parasitic pathogens transmitted commonly through food and for hemolytic uremic syndrome. Through FoodNet, state and federal scientists collaborate to monitor trends in enteric illnesses, identify their sources, and implement special studies. FoodNet's major contributions include establishment of reliable, active population-based surveillance of enteric diseases; development and implementation of epidemiologic studies to determine risk and protective factors for sporadic enteric infections; population and laboratory surveys that describe the features of gastrointestinal illnesses, medical care-seeking behavior, frequency of eating various foods, and laboratory practices; and development of a surveillance and research platform that can be adapted to address emerging issues. The importance of FoodNet's ongoing contributions probably will grow as clinical, laboratory, and informatics technologies continue changing rapidly. PMID:26292181

  14. Foodborne Intestinal Flukes in Southeast Asia

    PubMed Central

    Shin, Eun-Hee; Lee, Soon-Hyung; Rim, Han-Jong

    2009-01-01

    In Southeast Asia, a total of 59 species of foodborne intestinal flukes have been known to occur in humans. The largest group is the family Heterophyidae, which constitutes 22 species belonging to 9 genera (Centrocestus, Haplorchis, Heterophyes, Heterophyopsis, Metagonimus, Procerovum, Pygidiopsis, Stellantchasmus, and Stictodora). The next is the family Echinostomatidae, which includes 20 species in 8 genera (Artyfechinostomum, Acanthoparyphium, Echinochasmus, Echinoparyphium, Echinostoma, Episthmium, Euparyphium, and Hypoderaeum). The family Plagiorchiidae follows the next containing 5 species in 1 genus (Plagiorchis). The family Lecithodendriidae includes 3 species in 2 genera (Phaneropsolus and Prosthodendrium). In 9 other families, 1 species in 1 genus each is involved; Cathaemaciidae (Cathaemacia), Fasciolidae (Fasciolopsis), Gastrodiscidae (Gastrodiscoides), Gymnophallidae (Gymnophalloides), Microphallidae (Spelotrema), Neodiplostomidae (Neodiplostomum), Paramphistomatidae (Fischoederius), Psilostomidae (Psilorchis), and Strigeidae (Cotylurus). Various types of foods are sources of human infections. They include freshwater fish, brackish water fish, fresh water snails, brackish water snails (including the oyster), amphibians, terrestrial snakes, aquatic insects, and aquatic plants. The reservoir hosts include various species of mammals or birds.The host-parasite relationships have been studied in Metagonimus yokogawai, Echinostoma hortense, Fasciolopsis buski, Neodiplostomum seoulense, and Gymnophalloides seoi; however, the pathogenicity of each parasite species and host mucosal defense mechanisms are yet poorly understood. Clinical aspects of each parasite infection need more clarification. Differential diagnosis by fecal examination is difficult because of morphological similarity of eggs. Praziquantel is effective for most intestinal fluke infections. Continued efforts to understand epidemiological significance of intestinal fluke infections, with

  15. Investigation of multistate foodborne disease outbreaks.

    PubMed

    Sobel, Jeremy; Griffin, Patricia M; Slutsker, Laurence; Swerdlow, David L; Tauxe, Robert V

    2002-01-01

    The U.S. food supply is characterized increasingly by centralized production and wide distribution of products, and more foodborne disease outbreaks are dispersed over broad geographic areas. Such outbreaks may present as a gradual, diffuse, and initially unapparent increase in sporadic cases. Recognition and reporting by clinicians and local public health officials and the ordering of laboratory tests by clinicians continue to be cornerstones of detecting all outbreaks. New methods--such as active laboratory-based surveillance, automated algorithms for detecting increases in infection rates, and molecular subtyping--facilitate detection of diffuse outbreaks. Routines have evolved for the investigation of multistate outbreaks; they are characterized by rapid communication between local, state, and federal public health officials; timely review of epidemiologic data by expert panels; collaboration on tracebacks with food safety regulatory agencies; and communication with the public and media. Rapid, efficient investigation of multistate outbreaks may result in control of acute public health emergencies, identification and correction of hazardous food production and processing practices, and consequent improvement in food safety. PMID:12297677

  16. Listeria monocytogenes, a food-borne pathogen.

    PubMed Central

    Farber, J M; Peterkin, P I

    1991-01-01

    The gram-positive bacterium Listeria monocytogenes is an ubiquitous, intracellular pathogen which has been implicated within the past decade as the causative organism in several outbreaks of foodborne disease. Listeriosis, with a mortality rate of about 24%, is found mainly among pregnant women, their fetuses, and immunocompromised persons, with symptoms of abortion, neonatal death, septicemia, and meningitis. Epidemiological investigations can make use of strain-typing procedures such as DNA restriction enzyme analysis or electrophoretic enzyme typing. The organism has a multifactorial virulence system, with the thiol-activated hemolysin, listeriolysin O, being identified as playing a crucial role in the organism's ability to multiply within host phagocytic cells and to spread from cell to cell. The organism occurs widely in food, with the highest incidences being found in meat, poultry, and seafood products. Improved methods for detecting and enumerating the organism in foodstuffs are now available, including those based on the use of monoclonal antibodies, DNA probes, or the polymerase chain reaction. As knowledge of the molecular and applied biology of L. monocytogenes increases, progress can be made in the prevention and control of human infection. PMID:1943998

  17. Early identification systems for emerging foodborne hazards.

    PubMed

    Marvin, H J P; Kleter, G A; Prandini, A; Dekkers, S; Bolton, D J

    2009-05-01

    This paper provides a non-exhausting overview of early warning systems for emerging foodborne hazards that are operating in the various places in the world. Special attention is given to endpoint-focussed early warning systems (i.e. ECDC, ISIS and GPHIN) and hazard-focussed early warning systems (i.e. FVO, RASFF and OIE) and their merit to successfully identify a food safety problem in an early stage is discussed. Besides these early warning systems which are based on monitoring of either disease symptoms or hazards, also early warning systems and/or activities that intend to predict the occurrence of a food safety hazard in its very beginning of development or before that are described. Examples are trend analysis, horizon scanning, early warning systems for mycotoxins in maize and/or wheat and information exchange networks (e.g. OIE and GIEWS). Furthermore, recent initiatives that aim to develop predictive early warning systems based on the holistic principle are discussed. The assumption of the researchers applying this principle is that developments outside the food production chain that are either directly or indirectly related to the development of a particular food safety hazard may also provide valuable information to predict the development of this hazard. PMID:18272277

  18. Foodborne outbreak of Salmonella subspecies IV infections associated with contamination from bearded dragons.

    PubMed

    Lowther, S A; Medus, C; Scheftel, J; Leano, F; Jawahir, S; Smith, K

    2011-12-01

    Approximately 1.4 million Salmonella infections and 400 deaths occur annually in the United States. Approximately 6% of human Salmonella cases are thought to be associated with reptiles; Salmonella enterica subspecies IV is primarily reptile-associated. During 1-4 December, 2009, three isolates of Salmonella IV 6,7:z4,z24:- with indistinguishable pulsed-field gel electrophoresis (PFGE) patterns were identified through Minnesota Department of Health laboratory-based surveillance. None of the three patients associated with the isolates reported reptile contact; however, all had attended the same potluck dinner. Dinner attendees were asked questions regarding illness history, foods they prepared for and consumed at the event, and pet ownership. Cases were defined as illness in a person who had eaten potluck food and subsequently experienced fever and diarrhoea (three or more loose stools in 24 h) or laboratory-confirmed infection with Salmonella IV matching the outbreak PFGE subtype. Nineteen days after the event, environmental samples were collected from a food preparer's house where two pet bearded dragons were kept. Sixty-six of 73 potluck food consumers were interviewed; 19 cases were identified; 18 persons reported illness but did not meet the case definition. Median incubation period was 19 h (range: 3-26 h). Median duration of illness was 5 days (range: 1-11 days). Consumption of gravy, prepared by the bearded dragons' asymptomatic owner, was associated with illness (16/32 exposed versus 1/12 unexposed; risk ratio: 6.0; exact P = 0.02). Salmonella Labadi was recovered from 10 samples, including from one bearded dragon, the bathroom door knob and sink drain, and the kitchen sink drain. The outbreak PFGE subtype of Salmonella subspecies IV was isolated from vacuum-cleaner bag contents. This foodborne outbreak probably resulted from environmental contamination from bearded dragons. Reptiles pose a community threat when food for public consumption is prepared in

  19. Estimating the Burden of Acute Gastrointestinal Illness: A Pilot Study of the Prevalence and Underreporting in Saint Lucia, Eastern Caribbean

    PubMed Central

    Jaime, Alina; Mckensie, Martin; Auguste, Ava; Pérez, Enrique; Indar, Lisa

    2013-01-01

    Saint Lucia was the first country to conduct a burden of illness study in the Caribbean to determine the community prevalence and underreporting of acute gastroenteritis (AGE). A retrospective cross-sectional population survey on AGE-related illness was administered to a random sample of residents of Saint Lucia in 20 April–16 May 2008 and 6-13 December 2009 to capture the high- and low-AGE season respectively. Of the selected 1,150 individuals, 1,006 were administered the survey through face-to-face interviews (response rate 87.4%). The overall monthly prevalence of AGE was 3.9%. The yearly incidence rate was 0.52 episodes/person-year. The age-adjusted monthly prevalence was 4.6%. The highest monthly prevalence of AGE was among children aged <5 years (7.5%) and the lowest in persons aged 45-64 years (2.6%). The average number of days an individual suffered from diarrhoea was 3.8 days [range 1-21 day(s)]. Of the reported AGE cases, only seven (18%) sought medical care; however, 83% stayed at home due to the illness [(range 1-16 day(s), mean 2.5]; and 26% required other individuals to take care of them. The estimated underreporting of syndromic AGE and laboratory-confirmed foodborne disease pathogens was 81% and 99% respectively during the study period. The economic cost for treating syndromic AGE was estimated at US$ 3,892.837 per annum. This was a pilot study on the burden of illness (BOI) in the Caribbean. The results of the study should be interpreted within the limitations and challenges of this study. Lessons learnt were used for improving the implementation procedures of other BOI studies in the Caribbean.

  20. Illness beliefs in schizophrenia.

    PubMed

    Kinderman, Peter; Setzu, Erika; Lobban, Fiona; Salmon, Peter

    2006-10-01

    Beliefs about health and illness shape emotional responses to illness, health-related behaviour and relationships with health-care providers in physical illness. Researchers are beginning to study the illness beliefs of people with psychosis, primarily using models developed in relation to physical illness. It is likely that modifications to these models will be necessary if they are to apply to mental disorders, and it is probable that some of the assumptions underlying the models will be inappropriate. In particular, different dimensions of understanding may be present in mental illness in comparison to those identified in physical illness. The present study examines the beliefs of 20 patients in the UK diagnosed with schizophrenia, including 10 currently psychotic inpatients and 10 outpatients in remission, about their experiences, using qualitative interviews and thematic analysis. Patients currently experiencing psychosis did not identify their experiences as separable 'illnesses' and did not have 'illness beliefs'. Patients currently in a period of remission appraised their experiences as distinct from their own normal behaviour, but used conceptual frameworks of understanding that deviated significantly from conventional 'health belief' models. Patients' ways of understanding mental illness did not parallel those described in physical illnesses. Methods for assessing beliefs about mental illness should therefore not be transferred directly from studies of beliefs about physical illness, but should be tailored to the nature of patients' beliefs about mental illness. PMID:16777306

  1. Systemic Analysis of Foodborne Disease Outbreak in Korea.

    PubMed

    Lee, Jong-Kyung; Kwak, No-Seong; Kim, Hyun Jung

    2016-02-01

    This study systemically analyzed data on the prevalence of foodborne pathogens and foodborne disease outbreaks to identify the priorities of foodborne infection risk management in Korea. Multiple correspondence analysis was applied to three variables: origin of food source, phase of food supply chain, and 12 pathogens using 358 cases from 76 original papers and official reports published in 1998-2012. In addition, correspondence analysis of two variables--place and pathogen--was conducted based on epidemiological data of 2357 foodborne outbreaks in 2002-2011 provided by the Korean Ministry of Food and Drug Safety. The results of this study revealed three distinct areas of food monitoring: (1) livestock-derived raw food contaminated with Campylobacter spp., pathogenic Escherichia coli, Salmonella spp., and Listeria monocytogenes; (2) multi-ingredient and ready-to-eat food related to Staphylococcus aureus; and (3) water associated with norovirus. Our findings emphasize the need to track the sources and contamination pathways of foodborne pathogens for more effective risk management. PMID:26863429

  2. A multicentre, randomised controlled trial comparing the clinical effectiveness and cost-effectiveness of early nutritional support via the parenteral versus the enteral route in critically ill patients (CALORIES).

    PubMed Central

    Harvey, Sheila E; Parrott, Francesca; Harrison, David A; Sadique, M Zia; Grieve, Richard D; Canter, Ruth R; McLennan, Blair Kp; Tan, Jermaine Ck; Bear, Danielle E; Segaran, Ella; Beale, Richard; Bellingan, Geoff; Leonard, Richard; Mythen, Michael G; Rowan, Kathryn M

    2016-01-01

    BACKGROUND Malnutrition is a common problem in critically ill patients in UK NHS critical care units. Early nutritional support is therefore recommended to address deficiencies in nutritional state and related disorders in metabolism. However, evidence is conflicting regarding the optimum route (parenteral or enteral) of delivery. OBJECTIVES To estimate the effect of early nutritional support via the parenteral route compared with the enteral route on mortality at 30 days and on incremental cost-effectiveness at 1 year. Secondary objectives were to compare the route of early nutritional support on duration of organ support; infectious and non-infectious complications; critical care unit and acute hospital length of stay; all-cause mortality at critical care unit and acute hospital discharge, at 90 days and 1 year; survival to 90 days and 1 year; nutritional and health-related quality of life, resource use and costs at 90 days and 1 year; and estimated lifetime incremental cost-effectiveness. DESIGN A pragmatic, open, multicentre, parallel-group randomised controlled trial with an integrated economic evaluation. SETTING Adult general critical care units in 33 NHS hospitals in England. PARTICIPANTS 2400 eligible patients. INTERVENTIONS Five days of early nutritional support delivered via the parenteral (n = 1200) and enteral (n = 1200) route. MAIN OUTCOME MEASURES All-cause mortality at 30 days after randomisation and incremental net benefit (INB) (at £20,000 per quality-adjusted life-year) at 1 year. RESULTS By 30 days, 393 of 1188 (33.1%) patients assigned to receive early nutritional support via the parenteral route and 409 of 1195 (34.2%) assigned to the enteral route had died [p = 0.57; absolute risk reduction 1.15%, 95% confidence interval (CI) -2.65 to 4.94; relative risk 0.97 (0.86 to 1.08)]. At 1 year, INB for the parenteral route compared with the enteral route was negative at -£1320 (95% CI -£3709 to £1069). The probability that early

  3. Resilient information networks for coordination of foodborne disease outbreaks.

    PubMed

    Hossain, Liaquat; Hassan, Muhammad Rabiul; Wigand, Rolf T

    2015-04-01

    Foodborne disease outbreaks are increasingly being seen as a greater concern by public health authorities. It has also become a global research agenda to identify improved pathways to coordinating outbreak detection. Furthermore, a significant need exists for timely coordination of the detection of potential foodborne disease outbreaks to reduce the number of infected individuals and the overall impact on public health security. This study aimed to offer an effective approach for coordinating foodborne disease outbreaks. First, we identify current coordination processes, complexities, and challenges. We then explore social media surveillance strategies, usage, and the power of these strategies to influence decision-making. Finally, based on informal (social media) and formal (organizational) surveillance approaches, we propose a hybrid information network model for improving the coordination of outbreak detection. PMID:25882125

  4. Cryptosporidium and Giardia as foodborne zoonoses.

    PubMed

    Smith, H V; Cacciò, S M; Cook, N; Nichols, R A B; Tait, A

    2007-10-21

    Cryptosporidium and Giardia are major causes of diarrhoeal disease in humans, worldwide and are major causes of protozoan waterborne diseases. Both Cryptosporidium and Giardia have life cycles which are suited to waterborne and foodborne transmission. There are 16 'valid'Cryptosporidium species and a further 33+ genotypes described. Parasites which infect humans belong to the Giardia duodenalis "type", and at least seven G. duodenalis assemblages are recognised. Cryptosporidium parvum is the major zoonotic Cryptosporidium species, while G. duodenalis assemblages A and B have been found in humans and most mammalian orders. In depth studies to determine the role of non-human hosts in the transmission of Cryptosporidium and Giardia to humans are required. The use of harmonised methodology and standardised and validated molecular markers, together with sampling strategies that provide sufficient information about all contributors to the environmental (oo)cyst pool that cause contamination of food and water, are recommended. Standardised methods for detecting (oo)cysts in water are available, as are optimised, validated methods for detecting Cryptosporidium in soft fruit and salad vegetables. These provide valuable data on (oo)cyst occurrence, and can be used for species and subspecies typing using appropriate molecular tools. Given the zoonotic potential of these organisms, epidemiological, source and disease tracking investigations involve multidisciplinary teams. Here, the role of the veterinarian is paramount, particularly in understanding the requirement for adopting comprehensive sampling strategies for analysing both sporadic and outbreak samples from all potential non-human contributors. Comprehensive sampling strategies increase our understanding of parasite population biology and structure and this knowledge can be used to determine what level of discrimination is required between isolates. Genetic exchange is frequent in C. parvum populations, leading to

  5. Surveillance for foodborne disease outbreaks in Iran, 2006-2011

    PubMed Central

    Masoumi Asl, Hossein; Gouya, Mohammad Mehdi; Soltan-dallal, Mohammad Mehdi; Aghili, Nooshin

    2015-01-01

    Background: The outbreaks of foodborne diseases is a major health problem and occur daily in all countries, from the most to the least developed. This study is the first report of foodborne outbreaks in Iran that carried out from 2006 to 2011. Methods: A retrospective, longitudinal study carried out using foodborne disease national surveillance system data from 2006-2011, which have been reported by all provincial health centers to the Center for Communicable Disease Control. Collected data were analyzed using SPSS version 18 software. Results: Since 2006 to 2011, a total of 2250 outbreaks were reported in Iran. Analyzed data showed that the outbreak rate has increased from 0.07/100000 in 2006 to 1.38/100000 population in 2011. Khuzestan, Kermanshah and Qazvin were three provinces that reported more outbreaks than nationally expected outbreak incidence rate during 2011. Analysis of epidemiological characteristics of foodborne outbreaks during 2011 indicated that the numbers of outbreaks were highest in warm months, e.g. 17.8% of total outbreaks was just reported in August. Females and age group of 16-30 years old were more affected and 55% of cases occurred in rural area. Among 684 human samples which have been tested, E. coli, Shigella, Hepatitis A and Vibrio cholera were predominant etiologic agents respectively. Conclusion: Increasing the detection rate of foodborne outbreaks imply the expansion of surveillance activities and improved primary health care in Iran in recent years. Foodborne disease surveillance system is a new program in Iran that should be continued and strengthened including diagnostic laboratory capacities. PMID:26913248

  6. Diplopia as the primary presentation of foodborne botulism

    PubMed Central

    Khakshoor, Hamid; Moghaddam, Ali Akbar Saber; Vejdani, Amir Hossein; Armstrong, Blair K.; Moshirfar, Majid

    2012-01-01

    Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six (CN VI) paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist. PMID:22993467

  7. Clinical effectiveness and cost-effectiveness of tailored intensive liaison between primary and secondary care to identify individuals at risk of a first psychotic illness (the LEGs study): a cluster-randomised controlled trial

    PubMed Central

    Perez, Jesus; Jin, Huajie; Russo, Debra A; Stochl, Jan; Painter, Michelle; Shelley, Gill; Jackson, Erica; Crane, Carolyn; Graffy, Jonathan P; Croudace, Tim J; Byford, Sarah; Jones, Peter B

    2015-01-01

    Summary Background General practitioners are usually the first health professionals to be contacted by people with early signs of psychosis. We aimed to assess whether increased liaison between primary and secondary care improves the clinical effectiveness and cost-effectiveness of detection of people with, or at high risk of developing, a first psychotic illness. Methods Our Liaison and Education in General Practices (LEGs) study was a cluster-randomised controlled trial of primary care practices (clusters) in Cambridgeshire and Peterborough, UK. Consenting practices were randomly allocated (1:1) to a 2 year low-intensity intervention (a postal campaign, consisting of biannual guidelines to help identify and refer individuals with early signs of psychosis) or a high-intensity intervention, which additionally included a specialist mental health professional who liaised with every practice and a theory-based educational package. Practices were not masked to group allocation. Practices that did not consent to be randomly assigned comprised a practice-as-usual (PAU) group. The primary outcome was number of referrals of patients at high risk of developing psychosis to the early intervention service per practice site. New referrals were assessed clinically and stratified into those who met criteria for high risk or first-episode psychotic illness (FEP; together: psychosis true positives), and those who did not fulfil such criteria for psychosis (false positives). Referrals from PAU practices were also analysed. We assessed cost-effectiveness with decision analytic modelling in terms of the incremental cost per additional true positive identified. The trial is registered at the ISRCTN registry, number ISRCTN70185866. Findings Between Dec 22, 2009, and Sept 7, 2010, 54 of 104 eligible practices provided consent and between Feb 16, 2010, and Feb 11, 2011, these practices were randomly allocated to interventions (28 to low intensity and 26 to high intensity); the remaining

  8. Rapid detection, characterization, and enumeration of foodborne pathogens.

    PubMed

    Hoorfar, J

    2011-11-01

    enough to test for many pathogens but also many pathogens can be detected with one test. The review is mainly based on the author's scientific work that has contributed with the following new developments to this field: (i) serologic tests for large-scale screening, surveillance, or eradication programs, (ii) same-day detection of Salmonella that otherwise was considered as difficult to achieve, (iii) pathogen enumeration following a short log-phase enrichment, (iv) detection of foodborne pathogens in air samples, and finally (v) biotracing of pathogens based on mathematical modeling, even in the absence of isolate. Rapid methods are discussed in a broad global health perspective, international food supply, and for improvement of quantitative microbial risk assessments. The need for quantitative sample preparation techniques, culture-independent, metagenomic-based detection, online monitoring, a global validation infrastructure has been emphasized. The cost and ease of use of rapid assays remain challenging obstacles to surmount. PMID:22250747

  9. Studying Physically Ill Elderly.

    ERIC Educational Resources Information Center

    Young, Rosalie F.; Kahana, Eva

    Research with older persons suffering from physical illness presents numerous challenges to gerontologists. Issues of conceptualization pertaining to the definition of illness, its location in the research paradigm, and the context in which illness occurs must be addressed prior to dealing with methodological problems. Access to physically ill…

  10. Economic Cost of a Listeria monocytogenes Outbreak in Canada, 2008

    PubMed Central

    Vriezen, Rachael; Farber, Jeffrey M.; Currie, Andrea; Schlech, Walter; Fazil, Aamir

    2015-01-01

    Abstract Estimates of the economic costs associated with foodborne disease are important to inform public health decision-making. In 2008, 57 cases of listeriosis and 24 deaths in Canada were linked to contaminated delicatessen meat from one meat processing plant. Costs associated with the cases (including medical costs, nonmedical costs, and productivity losses) and those incurred by the implicated plant and federal agencies responding to the outbreak were estimated to be nearly $242 million Canadian dollars (CAD, 2008). Case costs alone were estimated at approximately $2.8 million (CAD, 2008) including loss of life. This demonstrates the considerable economic burden at both the individual and population levels associated with foodborne disease and foodborne outbreaks in particular. Foodborne outbreaks due to severe pathogens, such as Listeria monocytogenes and those that result in product recalls, are typically the most costly from the individual and/or societal perspective. Additional economic estimates of foodborne disease would contribute to our understanding of the burden of foodborne disease in Canada and would support the need for ongoing prevention and control activities. PMID:26583272