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Sample records for foodborne illness costs

  1. Economic cost of foodborne illness in Ohio.

    PubMed

    Scharff, Robert L; McDowell, Joyce; Medeiros, Lydia

    2009-01-01

    Past efforts to evaluate the economic burden of risks from foodborne illness in the United States have generally taken the form of studies focused on a single or a small number of "important" pathogens. As a result, the economic impact of many less prominent pathogens has not been sufficiently explored. Consequently, currently available studies only provide cost estimates for fewer than 4 million of the 76 million cases of foodborne illness, are incomplete, and, as a result, underestimate the efficacy of broad-based intervention programs. We present a cost-of-illness model that enhances the oft-cited U.S. Department of Agriculture Economic Research Service model. Our model uses a more comprehensive set of pathogens, includes pathogen-specific hospitalization costs, and includes measures to account for lost quality of life. We also use Monte Carlo simulations to evaluate the effects of uncertainty in our analysis. We find the estimated annual expected economic cost of foodborne illness for Ohio to be between $1.0 and $7.1 billion, which translates into a per-Ohio resident cost of $91 to $624. Our results can be used to evaluate the effectiveness of broad-based food safety programs.

  2. State estimates for the annual cost of foodborne illness.

    PubMed

    Scharff, Robert L

    2015-06-01

    An understanding of the costs associated with foodborne illnesses is important to policy makers for prioritizing resources and assessing whether proposed interventions improve social welfare. At the national level, measured costs have been used by federal food safety regulatory agencies in regulatory impact analyses. However, when costs differ across states, use of national cost-of-illness values for state-based interventions will lead to biased estimates of intervention effectiveness. In this study, the costs of foodborne illness at the state level were estimated. Using a more conservative economic model, the average cost per case ranged from $888 (90% credible interval [CI], $537 to $1,419) in West Virginia to $1,766 (90% CI, $1,231 to $2,588) in the District of Columbia. A less conservative model generated average costs per case of $1,505 (90% CI, $557 to $2,836) in Kentucky to $2,591 (90% CI, $857 to $5,134) in Maryland. Aggregated across the states, the average national cost of foodborne illness was estimated as $55.5 billion (90% CI, $33.9 to $83.3 billion) using the conservative model and $93.2 billion (90% CI, $33.0 to $176.3 billion) using the enhanced model.

  3. Component costs of foodborne illness: a scoping review.

    PubMed

    McLinden, Taylor; Sargeant, Jan M; Thomas, M Kate; Papadopoulos, Andrew; Fazil, Aamir

    2014-05-26

    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. 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. 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. 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 the cost of foodborne illness literature

  4. 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

  5. Foodborne illness.

    PubMed

    Pigott, David C

    2008-05-01

    While few patients with foodborne illness present with life-threatening symptoms, there are a number of foodborne infectious diseases and toxins that the emergency physician or other health care provider must consider in the evaluation of these patients. Given the frequency of international travel, as well as the risk associated with recurrent outbreaks of foodborne illness from commercial food sources, it is important to recognize various syndromes of foodborne illness, including those which may require specific evaluation and management strategies. This article reviews a number of the most common causes of foodborne illness, as well as several less common pathogens with the potential for causing significant morbidity and mortality if not promptly identified and treated.

  6. Foodborne Illness

    MedlinePlus

    ... get sick from contaminated food. Common culprits include bacteria, parasites and viruses. Symptoms range from mild to ... cramps Nausea and vomiting Diarrhea Fever Dehydration Harmful bacteria are the most common cause of foodborne illness. ...

  7. 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 ...

  8. Foodborne Illness

    DTIC Science & Technology

    1983-02-01

    be subdivided into three major categories. The first category includes the traditional forms of food poisoning caused by preformed toxins that may...Infectious not all, kinds of food poisoning. In other forms, Diseases section. neurotoxicity may be the principal manifestation, and respiratory...foodborne illnesses PRINCIPLES OF MANAGEMENT. Principles i’, are relatively innocuous and of short duration. A the overall management of food poisoning

  9. Association between component costs, study methodologies, and foodborne illness-related factors with the cost of nontyphoidal Salmonella illness.

    PubMed

    McLinden, Taylor; Sargeant, Jan M; Thomas, M Kate; Papadopoulos, Andrew; Fazil, Aamir

    2014-09-01

    Nontyphoidal Salmonella spp. are one of the most common causes of bacterial foodborne illness. Variability in cost inventories and study methodologies limits the possibility of meaningfully interpreting and comparing cost-of-illness (COI) estimates, reducing their usefulness. However, little is known about the relative effect these factors have on a cost-of-illness estimate. This is important for comparing existing estimates and when designing new cost-of-illness studies. Cost-of-illness estimates, identified through a scoping review, were used to investigate the association between descriptive, component cost, methodological, and foodborne illness-related factors such as chronic sequelae and under-reporting with the cost of nontyphoidal Salmonella spp. illness. The standardized cost of nontyphoidal Salmonella spp. illness from 30 estimates reported in 29 studies ranged from $0.01568 to $41.22 United States dollars (USD)/person/year (2012). The mean cost of nontyphoidal Salmonella spp. illness was $10.37 USD/person/year (2012). The following factors were found to be significant in multiple linear regression (p≤0.05): the number of direct component cost categories included in an estimate (0-4, particularly long-term care costs) and chronic sequelae costs (inclusion/exclusion), which had positive associations with the cost of nontyphoidal Salmonella spp. illness. Factors related to study methodology were not significant. Our findings indicated that study methodology may not be as influential as other factors, such as the number of direct component cost categories included in an estimate and costs incurred due to chronic sequelae. Therefore, these may be the most important factors to consider when designing, interpreting, and comparing cost of foodborne illness studies.

  10. 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. © 2014 Society for Risk Analysis.

  11. Parasites and Foodborne Illness

    MedlinePlus

    ... Administrative Forms Standard Forms Skip Navigation Z7_0Q0619C0JGR010IFST1G5B10H1 Web Content Viewer (JSR 286) Actions ${title} Loading... / Topics / ... and Disease / Parasites and Foodborne Illness Z7_0Q0619C0JGR010IFST1G5B10H3 Web Content Viewer (JSR 286) Actions ${title} Loading... Z7_ ...

  12. Treating foodborne illness.

    PubMed

    Steiner, Theodore

    2013-09-01

    In healthy adults and children in developed countries, most foodborne and water-borne infections are short-lived and resolve without specific treatment. In developing areas, these infections may produce acute mortality and chronic morbidity caused by developmental impairment. Immune-compromised hosts are at increased risk of life-threatening complications. This article reviews recommendations for the treatment of the most common and important foodborne illnesses, focusing on those caused by infections or toxins of microbial origin. The cornerstone of life-saving treatment remains oral rehydration therapy, although the use of other supportive measures as well as antibiotics for certain infections is also recommended. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Foodborne illness: is it on the rise?

    PubMed

    Nyachuba, David G

    2010-05-01

    Foodborne illness is a serious public health threat. The Centers for Disease Control and Prevention (CDC) estimates that 76 million foodborne illnesses, including 325,000 hospitalizations and 5,000 deaths, occur in the United States each year. Two recently published Foodborne Diseases Active Surveillance Network (FoodNet) reports showed that Salmonella, Campylobacter, Shigella, Cryptosporidium, and Shiga toxin Escherichia coli (STEC) O157 continue to be leading causes of both the number and incidence of laboratory-confirmed foodborne infections in the United States. According to the United States Department of Agriculture (USDA), foodborne illness costs the US economy $10-83 billion per year. Recent large foodborne outbreaks have led to claims that the number of foodborne disease outbreaks and concomitant illnesses has increased in recent years. However, a comparison of data from the CDC showed very little change in the incidence of foodborne illness caused by common pathogens between 2008 and the preceding 3 years (2005-2007). Nevertheless, despite intensified prevention efforts, foodborne illness remains a persistent problem in the United States. Food can become contaminated at any point in the farm-to-table continuum, as well as in consumers' own kitchens. Therefore, foodborne illness risk reduction and control interventions must be implemented at every step throughout the food preparation process, from farm to table. In addition, more effective food safety education programs for foodhandlers and consumers are needed. Strategies should take into account food safety-related trends including large-scale production and wide distribution of food, globalization of the food supply, eating outside of the home, emergence of new pathogens, and growing population of at-risk consumers.

  14. Annual cost of illness and quality-adjusted life year losses in the United States due to 14 foodborne pathogens.

    PubMed

    Hoffmann, Sandra; Batz, Michael B; Morris, J Glenn

    2012-07-01

    In this article we estimate the annual cost of illness and quality-adjusted life year (QALY) loss in the United States caused by 14 of the 31 major foodborne pathogens reported on by Scallan et al. (Emerg. Infect. Dis. 17:7-15, 2011), based on their incidence estimates of foodborne illness in the United States. These 14 pathogens account for 95 % of illnesses and hospitalizations and 98 % of deaths due to identifiable pathogens estimated by Scallan et al. We estimate that these 14 pathogens cause $14.0 billion (ranging from $4.4 billion to $33.0 billion) in cost of illness and a loss of 61,000 QALYs (ranging from 19,000 to 145,000 QALYs) per year. Roughly 90 % of this loss is caused by five pathogens: nontyphoidal Salmonella enterica ($3.3 billion; 17,000 QALYs), Campylobacter spp. ($1.7 billion; 13,300 QALYs), Listeria monocytogenes ($2.6 billion; 9,400 QALYs), Toxoplasma gondii ($3 billion; 11,000 QALYs), and norovirus ($2 billion; 5,000 QALYs). A companion article attributes losses estimated in this study to the consumption of specific categories of foods. To arrive at these estimates, for each pathogen we create disease outcome trees that characterize the symptoms, severities, durations, outcomes, and likelihoods of health states associated with that pathogen. We then estimate the cost of illness (medical costs, productivity loss, and valuation of premature mortality) for each pathogen. We also estimate QALY loss for each health state associated with a given pathogen, using the EuroQol 5D scale. Construction of disease outcome trees, outcome-specific cost of illness, and EuroQol 5D scoring are described in greater detail in a second companion article.

  15. Foodborne Germs and Illnesses

    MedlinePlus

    ... Germs Botulism Campylobacter Clostridium perfringens Cyclospora E. coli Listeria Norovirus Salmonella Shigella Vibrio For a more complete ... has a few surprising exceptions: Two foodborne bacteria, Listeria monocytogenes and Yersinia enterocolitica can actually grow at ...

  16. Foodborne illness and microbial agents

    USDA-ARS?s Scientific Manuscript database

    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...

  17. 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.

  18. Foodborne illness: implications for the future.

    PubMed Central

    Hall, R. L.

    1997-01-01

    Many outbreaks of foodborne illness, even those involving newly recognized pathogens, could have been avoided if certain precautions had been taken. This article will draw on existing information to suggest realistic measures that, if implemented, are most likely to avert or diminish the impact of new foodborne disease outbreaks. PMID:9366609

  19. [Foodborne illness report systems in China].

    PubMed

    Zhu, Jianghui; Li, Fengqin; Li, Ning; Yan, Weixing; Xu, Haibin; Ma, Ning; Song, Xiaoyu; Liang, Jiang; Wang, Xiaodan; Gao, Peng

    2013-09-01

    To introduce the current foodborne illness report system in China. Foodborne illness (food poisoning included) report system and food related unusual cases reported system were characterized by their report definitions, scopes and report procedures as well as their differences. From October, 2010 to June, 2012, there are 2961 centers of disease control and prevention and heath executive organizations at the different local levels registered in the foodborne illness (food poisoning included) report system and 1525 incidents were reported. There were 553 hospitals registered in the food related unusual cases reported system while only 38 cases reported. The foodborne illness report system has been set up in China and further efforts in capacities building are needed.

  20. How to diagnose a foodborne illness.

    PubMed

    Donnenberg, Michael S; Narayanan, Shivakumar

    2013-09-01

    Timely diagnosis of foodborne infection can be critical not only for the patient, but also for the larger community because of the potential to interrupt further spread. This article presents the diagnostic approach to patients with foodborne illness, discussing epidemiologic clues of various foodborne pathogens and their distinguishing clinical features of diagnostic importance. Also discussed are situations whereby stool cultures should be ordered; other helpful stool tests; nonculture methods of identifying organisms and their applicability in clinical settings; the role of pulsed-field gel electrophoresis in typing organisms; and large-scale sharing of data to aid in identification of large outbreaks. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. The economics of enteric infections: human foodborne disease costs.

    PubMed

    Buzby, Jean C; Roberts, Tanya

    2009-05-01

    The World Health Organization estimates that in 2005, 1.5 million people died, worldwide, from diarrheal diseases. A separate study estimated that 70% of diarrheal diseases are foodborne. The widely cited US estimate is that there are 76 million foodborne illnesses annually, resulting in 325,000 hospitalizations and 5200 deaths. However, there are epidemiologic and methodologic challenges to accurately estimate the economic burden of foodborne disease on society, either in terms of monetary costs or non-monetary units of measurement. Studies on the economic burden of foodborne disease vary considerably: some analyze the effects of a single pathogen or a single outbreak, whereas others attempt to estimate all foodborne disease in a country. Differences in surveillance systems, methodology, and other factors preclude meaningful comparisons across existing studies. However, if it were possible to completely estimate the societal costs for all acute foodborne diseases and their chronic sequelae worldwide, on the basis of currently available data, worldwide costs from these illnesses would be substantial. Moreover, foodborne infections are largely manifested as intestinal illnesses and are largely preventable. Total costs of foodborne disease would be much smaller in the United States and the world if economic incentives for industry to produce safer food were improved. However, costs of implementing new food safety prevention and control rules must be weighed against the estimated benefits of reducing foodborne disease to determine net benefits so that governments have information to efficiently allocate funds among competing programs.

  2. 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.

  3. 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

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

    PubMed

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

    2013-08-19

    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.

  5. 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

  6. Mesenteric venous thrombosis precipitated by foodborne gastrointestinal illness.

    PubMed

    Wojciechowski, Amy L; Bajwa, Rajinder Ps; Thatigotla, Bala

    2017-03-01

    Foodborne illnesses are common and are usually considered as part of the differential diagnosis when a patient presents with gastrointestinal symptoms including nausea, vomiting, abdominal pain, diarrhea and fever. The majority of foodborne illness is transient and self-limited, while life threatening complications are rare. Here, we describe a case of a patient presenting with inflammatory diarrhea after consumption of undercooked seafood. She developed mesenteric and portal venous thrombosis and small bowel infarction requiring surgical intervention and resection of gangrenous small bowel. This is a rare presentation and outcome of common food poisoning. The case report is followed by a brief discussion of common foodborne illnesses and mesenteric venous thrombosis.

  7. Foodborne illness, Australia, circa 2000 and circa 2010.

    PubMed

    Kirk, Martyn; Ford, Laura; Glass, Kathryn; Hall, Gillian

    2014-11-01

    Foodborne disease is a major public health problem worldwide. To examine changes in foodborne illness in Australia, we estimated the incidence, hospitalizations, and deaths attributed to contaminated food circa 2010 and recalculated estimates from circa 2000. Approximately 25% of gastroenteritis cases were caused by contaminated food; to account for uncertainty we used simulation techniques to estimate 90% credible intervals. We estimate that circa 2010, 4.1 million foodborne gastroenteritis cases occurred, and circa 2000, 4.3 million cases occurred. Circa 2010, contaminated food was estimated to be responsible for 30,840 gastroenteritis-associated hospitalizations, 76 associated deaths, and 5,140 nongastrointestinal illnesses. Cases of salmonellosis and campylobacteriosis increased from 2000 to 2010 and were the leading causes of gastroenteritis-associated hospitalizations; Listeria monocytogenes and nontyphoidal Salmonella spp. infections were the leading causes of death. Although the overall incidence of foodborne illnesses declined over time in Australia, cases of foodborne gastroenteritis are still common.

  8. Foodborne Illness, Australia, Circa 2000 and Circa 2010

    PubMed Central

    Ford, Laura; Glass, Kathryn; Hall, Gillian

    2014-01-01

    Foodborne disease is a major public health problem worldwide. To examine changes in foodborne illness in Australia, we estimated the incidence, hospitalizations, and deaths attributed to contaminated food circa 2010 and recalculated estimates from circa 2000. Approximately 25% of gastroenteritis cases were caused by contaminated food; to account for uncertainty we used simulation techniques to estimate 90% credible intervals. We estimate that circa 2010, 4.1 million foodborne gastroenteritis cases occurred, and circa 2000, 4.3 million cases occurred. Circa 2010, contaminated food was estimated to be responsible for 30,840 gastroenteritis-associated hospitalizations, 76 associated deaths, and 5,140 nongastrointestinal illnesses. Cases of salmonellosis and campylobacteriosis increased from 2000 to 2010 and were the leading causes of gastroenteritis-associated hospitalizations; Listeria monocytogenes and nontyphoidal Salmonella spp. infections were the leading causes of death. Although the overall incidence of foodborne illnesses declined over time in Australia, cases of foodborne gastroenteritis are still common. PMID:25340705

  9. Surveillance for foodborne illness outbreaks in Qassim, Saudi Arabia, 2006.

    PubMed

    Al-Goblan, Abdullah Saleh; Jahan, Saulat

    2010-12-01

    The objectives of this study were to determine the burden of foodborne illness, and to identify the specific foods and causative organisms responsible for foodborne illness outbreaks in Qassim, Saudi Arabia, during the year 2006. The study is a descriptive analysis of the surveillance data for foodborne illness outbreaks, collected by the Preventive Medicine Department, Primary Health Care Administration, Qassim province. We analyzed the foodborne illness surveillance data for the year 2006, using SPSS-11 statistical package. The distribution of foodborne illnesses was examined in relation to age, sex, nationality, and month of occurrence. In addition, types of food, place of food preparation, and pathogenic agent responsible for the outbreaks were also analyzed. During the year 2006, 31 foodborne illness outbreaks, accounting for 251 cases, were reported. The highest proportion (64.5%) of outbreaks was reported during summer months of June to August. Men constituted 66.9% of the cases, and 68.1% were adults. Salmonella species was the commonest causative agent, followed by Staphylococcus aureus. The majority (68.9%) of the cases got sick after consuming commercially prepared foods. Meat intake caused 67.7% cases, and Middle Eastern meat sandwich was a commonly implicated food. Our study concludes that foodborne illness is an important public health problem in Qassim province. A comprehensive approach is required to assure food safety in commercial food establishments. Health education of the community, food handlers, and food industry workers regarding food and personal hygiene will reduce the incidence of foodborne illnesses in Qassim and Saudi Arabia.

  10. Economic burden from health losses due to foodborne illness in the United States.

    PubMed

    Scharff, Robert L

    2012-01-01

    The Centers for Disease Control and Prevention (CDC) recently revised their estimates for the annual number of foodborne illnesses; 48 million Americans suffer from domestically acquired foodborne illness associated with 31 identified pathogens and a broad category of unspecified agents. Consequently, economic studies based on the previous estimates are now obsolete. This study was conducted to provide improved and updated estimates of the cost of foodborne illness by adding a replication of the 2011 CDC model to existing cost-of-illness models. The basic cost-of-illness model includes economic estimates for medical costs, productivity losses, and illness-related mortality (based on hedonic value-of-statistical-life studies). The enhanced cost-of-illness model replaces the productivity loss estimates with a more inclusive pain, suffering, and functional disability measure based on monetized quality-adjusted life year estimates. Costs are estimated for each pathogen and a broader class of unknown pathogens. The addition of updated cost data and improvements to methodology enhanced the performance of each existing economic model. Uncertainty in these models was characterized using Monte Carlo simulations in @Risk version 5.5. With this model, the average cost per case of foodborne illness was $1,626 (90% credible interval [CI], $607 to $3,073) for the enhanced cost-of-illness model and $1,068 (90% CI, $683 to $1,646) for the basic model. The resulting aggregated annual cost of illness was $77.7 billion (90% CI, $28.6 to $144.6 billion) and $51.0 billion (90% CI, $31.2 to $76.1 billion) for the enhanced and basic models, respectively.

  11. Foodborne illness acquired in the United States--unspecified agents.

    PubMed

    Scallan, Elaine; Griffin, Patricia M; Angulo, Frederick J; Tauxe, Robert V; Hoekstra, Robert M

    2011-01-01

    Each year, 31 major known pathogens acquired in the United States caused an estimated 9.4 million episodes of foodborne illness. Additional episodes of illness were caused by unspecified agents, including known agents with insufficient data to estimate agent-specific illness, known agents not yet recognized as causing foodborne illness, substances known to be in food but of unproven pathogenicity, and unknown agents. To estimate these additional illnesses, we used data from surveys, hospital records, and death certificates to estimate illnesses, hospitalizations, and deaths from acute gastroenteritis and subtracted illnesses caused by known gastroenteritis pathogens. If the proportions acquired by domestic foodborne transmission were similar to those for known gastroenteritis pathogens, then an estimated 38.4 million (90% credible interval [CrI] 19.8-61.2 million) episodes of domestically acquired foodborne illness were caused by unspecified agents, resulting in 71,878 hospitalizations (90% CrI 9,924-157,340) and 1,686 deaths (90% CrI 369-3,338).

  12. Foodborne Illness Acquired in the United States—Unspecified Agents

    PubMed Central

    Griffin, Patricia M.; Angulo, Frederick J.; Tauxe, Robert V.; Hoekstra, Robert M.

    2011-01-01

    Each year, 31 major known pathogens acquired in the United States caused an estimated 9.4 million episodes of foodborne illness. Additional episodes of illness were caused by unspecified agents, including known agents with insufficient data to estimate agent-specific illness, known agents not yet recognized as causing foodborne illness, substances known to be in food but of unproven pathogenicity, and unknown agents. To estimate these additional illnesses, we used data from surveys, hospital records, and death certificates to estimate illnesses, hospitalizations, and deaths from acute gastroenteritis and subtracted illnesses caused by known gastroenteritis pathogens. If the proportions acquired by domestic foodborne transmission were similar to those for known gastroenteritis pathogens, then an estimated 38.4 million (90% credible interval [CrI] 19.8–61.2 million) episodes of domestically acquired foodborne illness were caused by unspecified agents, resulting in 71,878 hospitalizations (90% CrI 9,924–157,340) and 1,686 deaths (90% CrI 369–3,338). PMID:21192849

  13. Online reports of foodborne illness capture foods implicated in official foodborne outbreak reports.

    PubMed

    Nsoesie, Elaine O; Kluberg, Sheryl A; Brownstein, John S

    2014-10-01

    Traditional surveillance systems capture only 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. We obtained reviews from 2005 to 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). 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. 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. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  14. 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

  15. Food safety: emerging trends in foodborne illness surveillance and prevention.

    PubMed

    McCabe-Sellers, Beverly J; Beattie, Samuel E

    2004-11-01

    Between 250 and 350 million Americans are estimated to suffer acute gastroenteritis annually, with 25% to 30% thought to be caused by foodborne illnesses. Most vulnerable to foodborne diseases are elderly people, pregnant women, immune-compromised people, and children. While bacterial causes such as Salmonella are widely recognized and monitored as foodborne infections, other important bacterial causes such as Clostridium perfringens , Bacillus cereus , and Staphylococcus aureus are less well known. While the majority of cases of foodborne diseases are of unknown cause, bacteria and viruses are the most likely causative agents. Caliciviridae (Norwalk-like) virus cases are more difficult to identify, but represent the most common cause of known and probably unknown cases. Fresh produce has to be added to the traditional list of foods requiring careful selection and handling to prevent foodborne disease. To assess the disease burden in the United States, morbidity and mortality surveillance activities are done by several networks and systems with collaboration among federal agencies and health departments. Not all important causes are being equally monitored. Critical behaviors by food processors, food retailers, foodservice personnel, and consumers can reduce the risk of foodborne illness episodes. Dietetics professionals can more readily monitor new developments and update knowledge and practice through online resources.

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

    PubMed Central

    Tran, Tuan Anh; Ha, Anh Duc; Nguyen, Viet Hung

    2015-01-01

    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

  17. 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.

  18. Association of Paid Sick Leave Laws With Foodborne Illness Rates.

    PubMed

    Hsuan, Charleen; Ryan-Ibarra, Suzanne; DeBurgh, Kat; Jacobson, Dawn M

    2017-09-01

    Previous studies suggest an association between paid sick leave (PSL) and better population health, including fewer infectious and nosocomial gastrointestinal disease outbreaks. Yet few studies examine whether laws requiring employers to offer PSL demonstrate a similar association. This mixed-methods study examined whether laws requiring employers to provide PSL are associated with decreased foodborne illness rates, particularly laws that are more supportive of employees taking leave. The four earliest PSL laws were classified by whether they were more or less supportive of employees taking leave. Jurisdictions with PSL were matched to comparison jurisdictions by population size and density. Using difference-in-differences, monthly foodborne illness rates (2000-2014) in implementation and comparison jurisdictions before and after the laws were effective were compared, stratifying by how supportive the laws were of employees taking leave, and then by disease. The empirical analysis was conducted from 2015-2017. Foodborne illness rates declined after implementation of the PSL law in jurisdictions with laws more supportive of employees taking leave, but increased in jurisdictions with laws that are less supportive. In adjusted analyses, PSL laws that were more supportive of employees taking sick leave were associated with an adjusted 22% decrease in foodborne illness rates (p=0.005). These results are driven by campylobacteriosis. Although the results suggest an association between more supportive PSL laws and decreased foodborne illness rates, they should be interpreted cautiously because the trend is driven by campylobacteriosis, which has low person-to-person transmission. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. Foodborne Illnesses: What You Need to Know

    MedlinePlus

    ... to all persons. ORGANISM Bacillus cereus Campylobacter jejuni Clostridium botulinum COMMON NAME OF ILLNESS B. cereus food poisoning Campylobacteriosis Botulism Clostridium perfringens Perfringens food poisoning Cryptosporidium Intestinal cryptosporidiosis Cyclospora ...

  1. Foodborne illness associated with Cryptosporidium and Giardia from livestock.

    PubMed

    Budu-Amoako, Ebo; Greenwood, Spencer J; Dixon, Brent R; Barkema, Herman W; McClure, J T

    2011-11-01

    Waterborne outbreaks caused by Cryptosporidium and Giardia are well documented, while the public health implications for foodborne illness from these parasites have not been adequately considered. Cryptosporidium and Giardia are common in domestic livestock, where young animals can have a high prevalence of infection, shedding large numbers of oocysts and cysts. Molecular epidemiological studies have advanced our knowledge on the distribution of Cryptosporidium and Giardia species and genotypes in specific livestock. This has enabled better source tracking of contaminated foods. Livestock generate large volumes of fecal waste, which can contaminate the environment with (oo)cysts. Evidence suggests that livestock, particularly cattle, play a significant role in food contamination, leading to outbreaks of cryptosporidiosis. However, foodborne giardiasis seems to originate primarily from anthroponotic sources. Foodborne cryptosporidiosis and giardiasis are underreported because of the limited knowledge of the zoonotic potential and public health implications. Methods more sensitive and cheaper are needed to detect the often-low numbers of (oo)cysts in contaminated food and water. As the environmental burden of Cryptosporidium oocysts and Giardia cysts from livestock waste increases with the projected increase in animal agriculture, public health is further compromised. Contamination of food by livestock feces containing Cryptosporidium oocysts and Giardia cysts could occur via routes that span the entire food production continuum. Intervention strategies aimed at preventing food contamination with Cryptosporidium and Giardia will require an integrated approach based on knowledge of the potential points of entry for these parasites into the food chain. This review examines the potential for foodborne illness from Cryptosporidium and Giardia from livestock sources and discusses possible mechanisms for prevention and control.

  2. 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

  3. Foodborne illness acquired in the United States--major pathogens.

    PubMed

    Scallan, Elaine; 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.

  4. 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

  5. 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

  6. 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.

  7. A Platform for Crowdsourced Foodborne Illness Surveillance: Description of Users and Reports.

    PubMed

    Quade, Patrick; Nsoesie, Elaine Okanyene

    2017-07-05

    Underreporting of foodborne illness makes foodborne disease burden estimation, timely outbreak detection, and evaluation of policies toward improving food safety challenging. The objective of this study was to present and evaluate Iwaspoisoned.com, an openly accessible Internet-based crowdsourcing platform that was launched in 2009 for the surveillance of foodborne illness. The goal of this system is to collect data that can be used to augment traditional approaches to foodborne disease surveillance. Individuals affected by a foodborne illness can use this system to report their symptoms and the suspected location (eg, restaurant, hotel, hospital) of infection. We present descriptive statistics of users and businesses and highlight three instances where reports of foodborne illness were submitted before the outbreaks were officially confirmed by the local departments of health. More than 49,000 reports of suspected foodborne illness have been submitted on Iwaspoisoned.com since its inception by individuals from 89 countries and every state in the United States. Approximately 95.51% (42,139/44,119) of complaints implicated restaurants as the source of illness. Furthermore, an estimated 67.55% (3118/4616) of users who responded to a demographic survey were between the ages of 18 and 34, and 60.14% (2776/4616) of the respondents were female. The platform is also currently used by health departments in 90% (45/50) of states in the US to supplement existing programs on foodborne illness reporting. Crowdsourced disease surveillance through systems such as Iwaspoisoned.com uses the influence and familiarity of social media to create an infrastructure for easy reporting and surveillance of suspected foodborne illness events. If combined with traditional surveillance approaches, these systems have the potential to lessen the problem of foodborne illness underreporting and aid in early detection and monitoring of foodborne disease outbreaks.

  8. A Platform for Crowdsourced Foodborne Illness Surveillance: Description of Users and Reports

    PubMed Central

    2017-01-01

    Background Underreporting of foodborne illness makes foodborne disease burden estimation, timely outbreak detection, and evaluation of policies toward improving food safety challenging. Objective The objective of this study was to present and evaluate Iwaspoisoned.com, an openly accessible Internet-based crowdsourcing platform that was launched in 2009 for the surveillance of foodborne illness. The goal of this system is to collect data that can be used to augment traditional approaches to foodborne disease surveillance. Methods Individuals affected by a foodborne illness can use this system to report their symptoms and the suspected location (eg, restaurant, hotel, hospital) of infection. We present descriptive statistics of users and businesses and highlight three instances where reports of foodborne illness were submitted before the outbreaks were officially confirmed by the local departments of health. Results More than 49,000 reports of suspected foodborne illness have been submitted on Iwaspoisoned.com since its inception by individuals from 89 countries and every state in the United States. Approximately 95.51% (42,139/44,119) of complaints implicated restaurants as the source of illness. Furthermore, an estimated 67.55% (3118/4616) of users who responded to a demographic survey were between the ages of 18 and 34, and 60.14% (2776/4616) of the respondents were female. The platform is also currently used by health departments in 90% (45/50) of states in the US to supplement existing programs on foodborne illness reporting. Conclusions Crowdsourced disease surveillance through systems such as Iwaspoisoned.com uses the influence and familiarity of social media to create an infrastructure for easy reporting and surveillance of suspected foodborne illness events. If combined with traditional surveillance approaches, these systems have the potential to lessen the problem of foodborne illness underreporting and aid in early detection and monitoring of foodborne

  9. An investigation to determine association between foodborne illness and number of citations in a food establishment.

    PubMed

    Sharkey, Kenneth W; Alam, Mohammad; Mase, William; Ying, Jun

    2012-09-01

    This article analyzes the inspectional data for the food protection program at the Cincinnati Health Department prior to the implementation of a standardization program for food inspections and food inspection training. The main objectives of the authors' study were to assess if current foodborne illness risk factors were associated with different risk classes of food establishments and the relationships between foodborne illness risk factors using non-Centers for Disease Control and Prevention (CDC) foodborne illness risk factors and CDC foodborne illness risk factor criteria. Additionally the authors' study provides information on whether the standardization of staff reduced the number of risk factors at food establishments, reducing the opportunity for a foodborne illness. This research compares the mean number of violations cited per inspection at food establishments of various risk classes. The authors' findings show that both CDC and non-CDC foodborne illness risk factors were positively associated to the risk class of the food establishment; however, more non-CDC than CDC foodborne illness risk factors were cited by the sanitarians at each level of risk class.

  10. Norovirus surveillance among callers to foodborne illness complaint hotline, Minnesota, USA, 2011-2013.

    PubMed

    Saupe, Amy A; Kaehler, Dawn; Cebelinski, Elizabeth A; Nefzger, Brian; Hall, Aron J; Smith, Kirk E

    2013-08-01

    Norovirus is the leading cause of foodborne disease in the United States. During October 2011-January 2013, we conducted surveillance for norovirus infection in Minnesota among callers to a complaint-based foodborne illness hotline who reported diarrhea or vomiting. Of 241 complainants tested, 127 (52.7%) were positive for norovirus.

  11. Estimated Annual Numbers of Foodborne Pathogen-Associated Illnesses, Hospitalizations, and Deaths, France, 2008-2013.

    PubMed

    Van Cauteren, Dieter; Le Strat, Yann; Sommen, Cécile; Bruyand, Mathias; Tourdjman, Mathieu; Da Silva, Nathalie Jourdan; Couturier, Elisabeth; Fournet, Nelly; de Valk, Henriette; Desenclos, Jean-Claude

    2017-09-01

    Estimates of the annual numbers of foodborne illnesses and associated hospitalizations and deaths are needed to set priorities for surveillance, prevention, and control strategies. The objective of this study was to determine such estimates for 2008-2013 in France. We considered 15 major foodborne pathogens (10 bacteria, 3 viruses, and 2 parasites) and estimated that each year, the pathogens accounted for 1.28-2.23 million illnesses, 16,500-20,800 hospitalizations, and 250 deaths. Campylobacter spp., nontyphoidal Salmonella spp., and norovirus accounted for >70% of all foodborne pathogen-associated illnesses and hospitalizations; nontyphoidal Salmonella spp. and Listeria monocytogenes were the main causes of foodborne pathogen-associated deaths; and hepatitis E virus appeared to be a previously unrecognized foodborne pathogen causing ≈68,000 illnesses in France every year. The substantial annual numbers of foodborne illnesses and associated hospitalizations and deaths in France highlight the need for food-safety policymakers to prioritize foodborne disease prevention and control strategies.

  12. Estimated Annual Numbers of Foodborne Pathogen–Associated Illnesses, Hospitalizations, and Deaths, France, 2008–2013

    PubMed Central

    Le Strat, Yann; Sommen, Cécile; Bruyand, Mathias; Tourdjman, Mathieu; Da Silva, Nathalie Jourdan; Couturier, Elisabeth; Fournet, Nelly; de Valk, Henriette; Desenclos, Jean-Claude

    2017-01-01

    Estimates of the annual numbers of foodborne illnesses and associated hospitalizations and deaths are needed to set priorities for surveillance, prevention, and control strategies. The objective of this study was to determine such estimates for 2008–2013 in France. We considered 15 major foodborne pathogens (10 bacteria, 3 viruses, and 2 parasites) and estimated that each year, the pathogens accounted for 1.28–2.23 million illnesses, 16,500–20,800 hospitalizations, and 250 deaths. Campylobacter spp., nontyphoidal Salmonella spp., and norovirus accounted for >70% of all foodborne pathogen–associated illnesses and hospitalizations; nontyphoidal Salmonella spp. and Listeria monocytogenes were the main causes of foodborne pathogen–associated deaths; and hepatitis E virus appeared to be a previously unrecognized foodborne pathogen causing ≈68,000 illnesses in France every year. The substantial annual numbers of foodborne illnesses and associated hospitalizations and deaths in France highlight the need for food-safety policymakers to prioritize foodborne disease prevention and control strategies. PMID:28820137

  13. Availability of Foodborne Illness Reporting Mechanisms for the Public on Local Health Department Web Sites.

    PubMed

    Harris, Jenine K; Wong, Roger; Matthew, Megan G; Mansour, Raed

    2017-04-04

    Foodborne illness is a serious and preventable public health problem, with high health and economic tolls in the United States. Local governments play an important role in food safety, with local health departments (LHDs) responsible for licensing and inspecting restaurants. Foodborne illness complaints from the public result in identification of more serious and critical food safety violations than regularly scheduled inspections; however, few people report foodborne illness. Availability of existing methods for the public to report foodborne illness to LHDs across the United States was examined. In 2016, data were collected and analyzed from a nationally representative stratified sample of 816 LHDs. Each LHD Web site was examined to determine whether the Web site included a way for constituents to report a suspected foodborne illness. Just 27.6% of LHD Web sites included a way for constituents to report a suspected foodborne illness. LHDs with reporting mechanisms were serving significantly larger populations and had significantly more staff members, higher revenues, and higher expenditures. Health departments with reporting mechanisms were also significantly more likely to conduct environmental health surveillance activities, to regulate, inspect, and/or license food service establishments, and to be involved in food safety policy. Consumer reports of suspected foodborne illness help identify serious and critical food safety violations in food establishments; however, foodborne illness is vastly underreported by the US public. While more evidence is needed on how current systems are working, increasing the visibility and availability of Web-based reporting mechanisms through the following strategies is recommended: (1) test and modify search functions on LHD Web sites to ensure consumers find reporting mechanisms; (2) add a downloadable form as an option for reporting; (3) coordinate with state health departments to ensure clear instructions are available for

  14. 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

  15. 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.

  16. 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

  17. Self-reported hand washing behaviors and foodborne illness: a propensity score matching approach.

    PubMed

    Ali, Mir M; Verrill, Linda; Zhang, Yuanting

    2014-03-01

    Hand washing is a simple and effective but easily overlooked way to reduce cross-contamination and the transmission of foodborne pathogens. In this study, we used the propensity score matching methodology to account for potential selection bias to explore our hypothesis that always washing hands before food preparation tasks is associated with a reduction in the probability of reported foodborne illness. Propensity score matching can simulate random assignment to a condition so that pretreatment observable differences between a treatment group and a control group are homogenous on all the covariates except the treatment variable. Using the U.S. Food and Drug Administration's 2010 Food Safety Survey, we estimated the effect of self-reported hand washing behavior on the probability of self-reported foodborne illness. Our results indicate that reported washing of hands with soap always before food preparation leads to a reduction in the probability of reported foodborne illness.

  18. 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.

  19. Proportion of illness acquired by foodborne transmission for nine enteric pathogens in Australia: an expert elicitation.

    PubMed

    Vally, Hassan; Glass, Kathryn; Ford, Laura; Hall, Gillian; Kirk, Martyn D; Shadbolt, Craig; Veitch, Mark; Fullerton, Katie E; Musto, Jennie; Becker, Niels

    2014-09-01

    Estimates of the burden of illness acquired from food inform public health policy and prioritize interventions. A key component of such estimates is the proportion of illnesses that are acquired by foodborne transmission. In view of the shortage of requisite data, these proportions are commonly obtained through a process known as expert elicitation. We report findings from an elicitation process used to assess the importance of the foodborne transmission route for nine pathogens in Australia, circa 2010. Eleven experts were asked to estimate the proportion of illness acquired by five transmission routes: food, environmental, water, person, and zoonotic, together with a 90% certainty interval for foodborne transmission. Foodborne estimates and intervals from each expert were combined using both modified triangular and Program Evaluation and Review Technique (PERT) distributions, in @Risk version 6, to generate final distributions from which median estimates and 95% Credible Intervals (CrI) were calculated. Shiga toxin-producing Escherichia coli (STEC) was the only pathogen believed to have an important zoonotic transmission route, while norovirus, hepatitis A virus, non-STEC pathogenic E. coli, and Shigella spp. were all thought to be primarily spread from person to person. Foodborne transmission was the main route for Clostridium perfringens (98%, CrI: 84-100), Listeria monocytogenes (98%, CrI: 86-100), nontyphoidal Salmonella spp. (72%, CrI: 50-87), and Campylobacter spp. (77%, CrI: 60-90). Foodborne estimates using the modified triangular distribution had wider CrI than these calculated using the PERT distribution. Foodborne proportions for most pathogens in this study were the same or lower than those estimated circa 2000 in Australia, with the greatest decline for non-STEC pathogenic E. coli. Inclusion of certainty intervals from experts helps to quantify the precision of foodborne proportions. A decline in estimates of the foodborne proportion for common

  20. The impact of local environmental health capacity on foodborne illness morbidity in Maryland.

    PubMed

    Zablotsky Kufel, Joanna S; Resnick, Beth A; Fox, Mary A; McGready, John; Yager, James P; Burke, Thomas A

    2011-08-01

    We evaluated the relationship between local food protection capacity and service provision in Maryland's 24 local food protection programs (FPPs) and incidence of foodborne illness at the county level. We conducted regression analyses to determine the relationship between foodborne illness and local FPP characteristics. We used the Centers for Disease Control and Prevention's FoodNet and Maryland Department of Health and Mental Hygiene outbreak data set, along with data on Maryland's local FPP capacity (workforce size and experience levels, budget) and service provision (food service facility inspections, public notification programs). Counties with higher capacity, such as larger workforce, higher budget, and greater employee experience, had fewer foodborne illnesses. Counties with better performance and county-level regulations, such as high food service facility inspection rates and requiring certified food manager programs, respectively, had lower rates of illness. Counties with strong local food protection capacity and services can protect the public from foodborne illness. Research on public health services can enhance our understanding of the food protection infrastructure, and the effectiveness of food protection programs in preventing foodborne illness.

  1. Food safety for the solid organ transplant patient: preventing foodborne illness while on chronic immunosuppressive drugs.

    PubMed

    Obayashi, Patricia A C

    2012-12-01

    Issues regarding food safety are seen increasingly in the news; outbreaks of foodborne illness have been associated with public health concerns ranging from mild illness to death. For the solid organ transplant patient, immunosuppressive and antibacterial drugs, which maintain transplant organ function, can expose the transplant patient to increased risk of foodborne illness from bacteria, viruses, fungi, and parasites. This review article describes the clinical consequences, sources of foodborne illness, and food safety practices needed to minimize risks to the solid organ transplant patient who must take lifelong immunosuppressive drugs. All members of the transplant team share responsibility for education of the solid organ transplant patient in preventing infections. The registered dietitian, as part of the transplant team, is the recognized expert in providing food safety education in the context of medical nutrition therapy to solid organ transplant patients, the patients' caregivers, and other healthcare providers.

  2. The role of extraintestinal foodborne pathogens in human illness

    USDA-ARS?s Scientific Manuscript database

    In recent years understanding the role of foodborne pathogens in human disease has evolved to include conditions outside the gastrointestinal diseases typically associated with bacteria such as Salmonella, Shiga toxin-producing Escherichia coli (STEC), Listeria monocytogenes, etc. Other human pathog...

  3. Development of a Salmonella screening tool for consumer complaint-based foodborne illness surveillance systems.

    PubMed

    Li, John; Maclehose, Rich; Smith, Kirk; Kaehler, Dawn; Hedberg, Craig

    2011-01-01

    Foodborne illness surveillance based on consumer complaints detects outbreaks by finding common exposures among callers, but this process is often difficult. Laboratory testing of ill callers could also help identify potential outbreaks. However, collection of stool samples from all callers is not feasible. Methods to help screen calls for etiology are needed to increase the efficiency of complaint surveillance systems and increase the likelihood of detecting foodborne outbreaks caused by Salmonella. Data from the Minnesota Department of Health foodborne illness surveillance database (2000 to 2008) were analyzed. Complaints with identified etiologies were examined to create a predictive model for Salmonella. Bootstrap methods were used to internally validate the model. Seventy-one percent of complaints in the foodborne illness database with known etiologies were due to norovirus. The predictive model had a good discriminatory ability to identify Salmonella calls. Three cutoffs for the predictive model were tested: one that maximized sensitivity, one that maximized specificity, and one that maximized predictive ability, providing sensitivities and specificities of 32 and 96%, 100 and 54%, and 89 and 72%, respectively. Development of a predictive model for Salmonella could help screen calls for etiology. The cutoff that provided the best predictive ability for Salmonella corresponded to a caller reporting diarrhea and fever with no vomiting, and five or fewer people ill. Screening calls for etiology would help identify complaints for further follow-up and result in identifying Salmonella cases that would otherwise go unconfirmed; in turn, this could lead to the identification of more outbreaks.

  4. Modeling the relationship between food animal health and human foodborne illness.

    PubMed

    Singer, Randall S; Cox, Louis A; Dickson, James S; Hurd, H Scott; Phillips, Ian; Miller, Gay Y

    2007-05-16

    To achieve further reductions in foodborne illness levels in humans, effective pre-harvest interventions are needed. The health status of food animals that are destined to enter the human food supply chain may be an important, although often overlooked, factor in predicting the risk of human foodborne infections. The health status of food animals can potentially influence foodborne pathogen levels in three ways. First, diseased animals may shed higher levels of foodborne pathogens. Second, animals that require further handling in the processing plant to remove affected parts may lead to increased microbial contamination and cross-contamination. Finally, certain animal illnesses may lead to a higher probability of mistakes in the processing plant, such as gastrointestinal ruptures, which would lead to increased microbial contamination and cross-contamination. Consequently, interventions that reduce the incidence of food animal illnesses might also help reduce bacterial contamination on meat, thereby reducing human illness. Some of these interventions, however, might also present a risk to human health. For example, the use of antibiotics in food animals can reduce rates of animal illness but can also select for antibiotic-resistant bacteria which can threaten human treatment options. In this study, we present a mathematical model to evaluate human health risks from foodborne pathogens associated with changes in animal illness. The model is designed so that potential human health risks and benefits from interventions such as the continued use of antibiotics in animal agriculture can be evaluated simultaneously. We applied the model to a hypothetical example of Campylobacter from chicken. In general, the model suggests that very minor perturbations in microbial loads on meat products could have relatively large impacts on human health, and consequently, small improvements in food animal health might result in significant reductions in human illness.

  5. 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. © 2013 American Society of Law, Medicine & Ethics, Inc.

  6. Understanding the Relationships Between Inspection Results and Risk of Foodborne Illness in Restaurants.

    PubMed

    Lee, Petrona; Hedberg, Craig W

    2016-10-01

    Restaurants are important settings for foodborne disease outbreaks and consumers are increasingly using restaurant inspection results to guide decisions about where to eat. Although public posting of inspection results may lead to improved sanitary practices in the restaurant, the relationship between inspection results and risk of foodborne illness appears to be pathogen specific. To further examine the relationship between inspection results and the risk of foodborne disease outbreaks, we evaluated results of routine inspections conducted in multiple restaurants in a chain (Chain A) that was associated with a large Salmonella outbreak in Illinois. Inspection results were collected from 106 Chain A establishments in eight counties. Forty-six outbreak-associated cases were linked to 23 of these Chain A restaurants. There were no significant differences between the outbreak and nonoutbreak restaurants for overall demerit points or for the number of demerit points attributed to hand washing or cross-contamination. Our analyses strongly suggest that the outbreak resulted from consumption of a contaminated fresh produce item without further amplification within individual restaurants. Inspections at these facilities would be unlikely to detect or predict the foodborne illness outbreak because there are no Food Code items in place to stop the introduction of contaminated food from an otherwise approved commercial food source. The results of our study suggest that the agent and food item pairing and route of transmission must be taken into consideration to improve our understanding of the relationship between inspection results and the risk of foodborne illness in restaurants.

  7. Foodborne illnesses in Brazil: control measures for 2014 FIFA World Cup travellers.

    PubMed

    Ritter, Ana Carolina; Tondo, Eduardo Cesar

    2014-03-13

    Foodborne diseases are typically caused by the ingestion of food contaminated with micro-organisms or their toxins, resulting in gastrointestinal disorders and in some severe cases hospitalization and death. In Brazil, foodborne illnesses are caused mainly by Salmonella, Staphylococcus aureus and Escherichia coli. The most important contributing factors for outbreaks are exposure of foods to unsuitable temperatures, inadequate food preparation and contamination of raw material or water used to prepare food. Recently, aiming to prevent foodborne illnesses during the 2014 FIFA World Cup, Brazil has developed a risk-based evaluation tool able to assess and grade Brazilian food services in cities that will host football matches. This tool has been used by the Brazilian sanitary surveillance officers during the inspection of facilities where food services. This is considered an innovative preventative sanitary action because it was created based on scientific information, statistical calculation and on risks of foodborne diseases occurrence. In this mini-review we summarize general data, control measures and how travellers can prevent foodborne illness in Brazil during the 2014 FIFA World Cup.

  8. 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.

  9. Evaluation of a statewide foodborne illness complaint surveillance system in Minnesota, 2000 through 2006.

    PubMed

    Li, John; Smith, Kirk; Kaehler, Dawn; Everstine, Karen; Rounds, Josh; Hedberg, Craig

    2010-11-01

    Foodborne outbreaks are detected by recognition of similar illnesses among persons with a common exposure or by identification of case clusters through pathogen-specific surveillance. PulseNet USA has created a national framework for pathogen-specific surveillance, but no comparable effort has been made to improve surveillance of consumer complaints of suspected foodborne illness. The purpose of this study was to characterize the complaint surveillance system in Minnesota and to evaluate its use for detecting outbreaks. Minnesota Department of Health foodborne illness surveillance data from 2000 through 2006 were analyzed for this study. During this period, consumer complaint surveillance led to detection of 79% of confirmed foodborne outbreaks. Most norovirus infection outbreaks were detected through complaints. Complaint surveillance also directly led or contributed to detection of 25% of salmonellosis outbreaks. Eighty-one percent of complainants did not seek medical attention. The number of ill persons in a complainant's party was significantly associated with a complaint ultimately resulting in identification of a foodborne outbreak. Outbreak confirmation was related to a complainant's ability to identify a common exposure and was likely related to the process by which the Minnesota Department of Health chooses complaints to investigate. A significant difference (P < 0.001) was found in incubation periods between complaints that were outbreak associated (median, 27 h) and those that were not outbreak associated (median, 6 h). Complaint systems can be used to detect outbreaks caused by a variety of pathogens. Case detection for foodborne disease surveillance in Minnesota happens through a multitude of mechanisms. The ability to integrate these mechanisms and carry out rapid investigations leads to improved outbreak detection.

  10. 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…

  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. Quantitative Microbial Risk Assessment for Campylobacter Foodborne Illness in Raw Beef Offal Consumption in South Korea.

    PubMed

    Jeong, Jiyeon; Lee, Jeeyeon; Lee, Heeyoung; Lee, Soomin; Kim, Sejeong; Ha, Jimyeong; Yoon, Ki-Sun; Yoon, Yohan

    2017-04-01

    This study evaluated the risk of Campylobacter foodborne illness caused by the intake of raw beef offal in South Korea. The prevalence of Campylobacter spp. in raw beef offal (liver and tripe) was investigated by plating samples on modified charcoal-cefoperazone-deoxycholate agar with Preston enrichment broth. Data were collected about storage temperature and length of storage of raw beef offal, and probabilistic distributions for the data were determined, using @RISK software. Predictive models were developed to describe the fate of Campylobacter in raw beef offal, and the amount and frequency of consumption and dose-response model were surveyed. Subsequently, these data were used to estimate the risk of Campylobacter foodborne illness caused by the intake of raw beef offal. Of 80 beef offal samples, 1 (1.25%) was contaminated with Campylobacter jejuni . Predictive models were used for exposure assessment. An exponential distribution was selected to represent beef offal consumption by people who eat this occasionally, with a mean of 60.2 g and 3.6% monthly consumption frequency. Simulations using @RISK predicted that the probability of Campylobacter foodborne illness per person per month is 1.56 × 10(-5) for home consumption and 1.74 × 10(-5) for restaurant consumption in South Korea, which indicates the risk of Campylobacter foodborne illness by intake of raw beef offal in South Korea.

  13. Pathogen-specific risk of chronic gastrointestinal disorders following bacterial causes of foodborne illness.

    PubMed

    Porter, Chad K; Choi, Daniel; Cash, Brooks; Pimentel, Mark; Murray, Joseph; May, Larissa; Riddle, Mark S

    2013-03-08

    The US CDC estimates over 2 million foodborne illnesses are annually caused by 4 major enteropathogens: non-typhoid Salmonella spp., Campylobacter spp., Shigella spp. and Yersinia enterocoltica. While data suggest a number of costly and morbid chronic sequelae associated with these infections, pathogen-specific risk estimates are lacking. We utilized a US Department of Defense medical encounter database to evaluate the risk of several gastrointestinal disorders following select foodborne infections. We identified subjects with acute gastroenteritis between 1998 to 2009 attributed to Salmonella (nontyphoidal) spp., Shigella spp., Campylobacter spp. or Yersinia enterocolitica and matched each with up to 4 unexposed subjects. Medical history was analyzed for the duration of military service time (or a minimum of 1 year) to assess for incident chronic gastrointestinal disorders. Relative risks were calculated using modified Poisson regression while controlling for the effect of covariates. A total of 1,753 pathogen-specific gastroenteritis cases (Campylobacter: 738, Salmonella: 624, Shigella: 376, Yersinia: 17) were identified and followed for a median of 3.8 years. The incidence (per 100,000 person-years) of PI sequelae among exposed was as follows: irritable bowel syndrome (IBS), 3.0; dyspepsia, 1.8; constipation, 3.9; gastroesophageal reflux disease (GERD), 9.7. In multivariate analyses, we found pathogen-specific increased risk of IBS, dyspepsia, constipation and GERD. These data confirm previous studies demonstrating risk of chronic gastrointestinal sequelae following bacterial enteric infections and highlight additional preventable burden of disease which may inform better food security policies and practices, and prompt further research into pathogenic mechanisms.

  14. 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. © 2011 Society for Risk Analysis.

  15. 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

  16. Attribution of foodborne illnesses, hospitalizations, and deaths to food commodities by using outbreak data, United States, 1998-2008.

    PubMed

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

    2013-03-01

    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.

  17. Estimates of the Burden of Foodborne Illness in Canada for 30 Specified Pathogens and Unspecified Agents, Circa 2006

    PubMed Central

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

    2013-01-01

    Abstract Estimates of foodborne illness are important for setting food safety priorities and making public health policies. The objective of this analysis is to estimate domestically acquired, foodborne illness in Canada, while identifying data gaps and areas for further research. Estimates of illness due to 30 pathogens and unspecified agents were based on data from the 2000–2010 time period from Canadian surveillance systems, relevant international literature, and the Canadian census population for 2006. The modeling approach required accounting for under-reporting and underdiagnosis and to estimate the proportion of illness domestically acquired and through foodborne transmission. To account for uncertainty, Monte Carlo simulations were performed to generate a mean estimate and 90% credible interval. It is estimated that each year there are 1.6 million (1.2–2.0 million) and 2.4 million (1.8–3.0 million) episodes of domestically acquired foodborne illness related to 30 known pathogens and unspecified agents, respectively, for a total estimate of 4.0 million (3.1–5.0 million) episodes of domestically acquired foodborne illness in Canada. Norovirus, Clostridium perfringens, Campylobacter spp., and nontyphoidal Salmonella spp. are the leading pathogens and account for approximately 90% of the pathogen-specific total. Approximately one in eight Canadians experience an episode of domestically acquired foodborne illness each year in Canada. These estimates cannot be compared with prior crude estimates in Canada to assess illness trends as different methodologies were used. PMID:23659355

  18. Estimates of the burden of foodborne illness in Canada for 30 specified pathogens and unspecified agents, circa 2006.

    PubMed

    Thomas, M Kate; Murray, Regan; Flockhart, Logan; Pintar, Katarina; Pollari, Frank; Fazil, Aamir; Nesbitt, Andrea; Marshall, Barbara

    2013-07-01

    Estimates of foodborne illness are important for setting food safety priorities and making public health policies. The objective of this analysis is to estimate domestically acquired, foodborne illness in Canada, while identifying data gaps and areas for further research. Estimates of illness due to 30 pathogens and unspecified agents were based on data from the 2000-2010 time period from Canadian surveillance systems, relevant international literature, and the Canadian census population for 2006. The modeling approach required accounting for under-reporting and underdiagnosis and to estimate the proportion of illness domestically acquired and through foodborne transmission. To account for uncertainty, Monte Carlo simulations were performed to generate a mean estimate and 90% credible interval. It is estimated that each year there are 1.6 million (1.2-2.0 million) and 2.4 million (1.8-3.0 million) episodes of domestically acquired foodborne illness related to 30 known pathogens and unspecified agents, respectively, for a total estimate of 4.0 million (3.1-5.0 million) episodes of domestically acquired foodborne illness in Canada. Norovirus, Clostridium perfringens, Campylobacter spp., and nontyphoidal Salmonella spp. are the leading pathogens and account for approximately 90% of the pathogen-specific total. Approximately one in eight Canadians experience an episode of domestically acquired foodborne illness each year in Canada. These estimates cannot be compared with prior crude estimates in Canada to assess illness trends as different methodologies were used.

  19. Estimates of foodborne illness-related hospitalizations and deaths in Canada for 30 specified pathogens and unspecified agents.

    PubMed

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

    2015-10-01

    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.

  20. 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.

  1. Association of Food Premises Inspection and Disclosure Program with retail-acquired foodborne illness and operator noncompliance in Toronto.

    PubMed

    Serapiglia, Tino; Kennedy, Erin; Thompson, Sylvanus; de Burger, Ron

    2007-01-01

    In 2001, the city of Toronto was the only health unit in Canada to have implemented a multi-component disclosure system as part of its provincially mandated food safety program. To measure the impact on the ultimate goal of preventing foodborne illness, the authors of the study reported here assessed directly the association of Toronto Public Health's program with the specific incidence of retail-acquired foodborne illness by analyzing secondary data on reportable local enteric disease. In addition, the study indirectly measured prevention of retail-acquired foodborne illness by assessing existing data on regulatory compliance in Toronto food premises as an inherent performance indicator. Results of the statistical analysis show that although there has not been a significant difference in the overall incidence rate of retail foodborne illness (Chi-squared = 0.009, p = .93), certain key diseases, such as Campylobacter infection, have decreased significantly since the implementation of the disclosure program in Toronto. There has also been a significant trend in the reduction of operator noncompliance rates (Z = 32, p < .0001). Further analysis shows that the decrease in operator non-compliance is positively correlated with a decrease in retail foodborne illness (r = .73, p < .0001). These results suggest that the Food Premises Inspection and Disclosure Program is an effective intervention for reducing retail-acquired foodborne illness and decreasing operator noncompliance in the city of Toronto. Programs of this type may assist other local health units to achieve similar results.

  2. Foodborne Illness Among School Children in Ga East, Accra.

    PubMed

    Malm, K L; Nyarko, K M; Yawson, A E; Gogo, B; Lawson, A; Afari, E

    2015-06-01

    A food borne illness was reported in Ga-East district of Greater Accra Region among school children in May, 2007 after eating food provided at school. The objective of the investigation was to determine the source, mode of contamination and the causative agent. A case-control study was conducted, cases were schoolchildren with abdominal symptoms and controls were children of the same sex and class without any symptom during the same period. The school children were selected by systematic sampling. Food handlers and the children were interviewed by a structured questionnaire. Food handlers were physically examined and their stools and blood examined. The kitchen for food preparation was inspected. Risks of food borne infection from the foods eaten were determined using attack rates. The minimum, peak and maximum incubation periods were 2, 11 and 61 hours respectively. The source was rice and groundnut soup (with the highest attack rate difference). Stool and blood samples of food handlers were not infective. Storage facility for food items was poor. No food samples were available for organism isolation. A protocol to prevent such outbreaks was nonexistent. The short incubation period and symptoms presented suggest an infective origin. The storage of the meat may potentially have been the point of contamination. The study showed that the schoolchildren ate contaminated food although the investigation could not determine the causative agent. Protocols to prevent such outbreaks need to be developed for the schools.

  3. Sequelae of Foodborne Illness Caused by 5 Pathogens, Australia, Circa 2010

    PubMed Central

    Ford, Laura; Glass, Kathryn; Hall, Gillian

    2014-01-01

    In Australia circa 2010, 4.1 million (90% credible interval [CrI] 2.3–6.4 million) episodes of foodborne gastroenteritis occurred, many of which might have resulted in sequelae. We estimated the number of illnesses, hospitalizations, and deaths from Guillain-Barré syndrome, hemolytic uremic syndrome, irritable bowel syndrome, and reactive arthritis that were associated with contaminated food in Australia. Data from published studies, hospital records, and mortality reports were combined with multipliers to adjust for different transmission routes. We used Monte Carlo simulation to estimate median estimates and 90% CrIs. In Australia, circa 2010, we estimated that 35,840 (90% CrI 25,000–54,000) illnesses, 1,080 (90% CrI 700–1,600) hospitalizations, and 10 (90% CrI 5–14) deaths occurred from foodborne gastroenteritis–associated sequelae. Campylobacter spp. infection was responsible for 80% of incident cases. Reducing the incidence of campylobacteriosis and other foodborne diseases would minimize the health effects of sequelae. PMID:25340885

  4. Sequelae of foodborne illness caused by 5 pathogens, Australia, circa 2010.

    PubMed

    Ford, Laura; Kirk, Martyn; Glass, Kathryn; Hall, Gillian

    2014-11-01

    In Australia circa 2010, 4.1 million (90% credible interval [CrI] 2.3-6.4 million) episodes of foodborne gastroenteritis occurred, many of which might have resulted in sequelae. We estimated the number of illnesses, hospitalizations, and deaths from Guillain-Barré syndrome, hemolytic uremic syndrome, irritable bowel syndrome, and reactive arthritis that were associated with contaminated food in Australia. Data from published studies, hospital records, and mortality reports were combined with multipliers to adjust for different transmission routes. We used Monte Carlo simulation to estimate median estimates and 90% CrIs. In Australia, circa 2010, we estimated that 35,840 (90% CrI 25,000-54,000) illnesses, 1,080 (90% CrI 700-1,600) hospitalizations, and 10 (90% CrI 5-14) deaths occurred from foodborne gastroenteritis-associated sequelae. Campylobacter spp. infection was responsible for 80% of incident cases. Reducing the incidence of campylobacteriosis and other foodborne diseases would minimize the health effects of sequelae.

  5. Foodborne Illness Outbreak Investigation in a High-Profile Sports Club.

    PubMed

    Cavanagh, Kwendy; Johnstone, Travers; Huhtinen, Essi; Najjar, Zeina; Lorentzos, Peter; Shadbolt, Craig; Shields, John; Gupta, Leena

    2017-12-01

    A foodborne illness outbreak involving an elite sports team was investigated by a public health unit in Sydney, Australia. An epidemiological association was established between gastrointestinal illness and the consumption of food supplied by an external caterer, with a lamb meal most strongly associated with illness. Genetically identical Salmonella isolates were identified from clinical specimens, residual food items, and an environmental swab taken from the catering premises. The training schedule and other club operations were significantly affected by this outbreak. Increased susceptibility due to regular shared activities and the potential for significant impact upon performance indicates that sports clubs must ensure that food suppliers comply with the highest standards of hygiene. Collaboration with public health authorities assists in source identification and prevention of further transmission.

  6. Outbreak characteristics associated with identification of contributing factors to foodborne illness outbreaks.

    PubMed

    Brown, L G; Hoover, E R; Selman, C A; Coleman, E W; Schurz Rogers, H

    2017-08-01

    Information on the factors that cause or amplify foodborne illness outbreaks (contributing factors), such as ill workers or cross-contamination of food by workers, is critical to outbreak prevention. However, only about half of foodborne illness outbreaks reported to the United States' Centers for Disease Control and Prevention (CDC) have an identified contributing factor, and data on outbreak characteristics that promote contributing factor identification are limited. To address these gaps, we analyzed data from 297 single-setting outbreaks reported to CDC's new outbreak surveillance system, which collects data from the environmental health component of outbreak investigations (often called environmental assessments), to identify outbreak characteristics associated with contributing factor identification. These analyses showed that outbreak contributing factors were more often identified when an outbreak etiologic agent had been identified, when the outbreak establishment prepared all meals on location and served more than 150 meals a day, when investigators contacted the establishment to schedule the environmental assessment within a day of the establishment being linked with an outbreak, and when multiple establishment visits were made to complete the environmental assessment. These findings suggest that contributing factor identification is influenced by multiple outbreak characteristics, and that timely and comprehensive environmental assessments are important to contributing factor identification. They also highlight the need for strong environmental health and food safety programs that have the capacity to complete such environmental assessments during outbreak investigations.

  7. 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.

  8. Where does foodborne illness happen-in the home, at foodservice, or elsewhere-and does it matter?

    PubMed

    Jacob, C J; Powell, D A

    2009-11-01

    Foodservice professionals, politicians, and the media are often cited making claims as to which locations most often expose consumers to foodborne pathogens. Many times, it is implied that most foodborne illnesses originate from food consumed where dishes are prepared to order, such as restaurants or in private homes. The manner in which the question is posed and answered frequently reveals a speculative bias that either favors homemade or foodservice meals as the most common source of foodborne pathogens. Many answers have little or no scientific grounding, while others use data compiled by passive surveillance systems. Current surveillance systems focus on the place where food is consumed rather than the point where food is contaminated. Rather than focusing on the location of consumption-and blaming consumers and others-analysis of the steps leading to foodborne illness should center on the causes of contamination in a complex farm-to-fork food safety system.

  9. 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.

  10. Risk factors in causing outbreaks of food-borne illness originating in schoollunch facilities in Japan.

    PubMed

    Michino, H; Otsuki, K

    2000-05-01

    We reviewed records of all outbreaks of food-borne illnesses due to schoollunch in Japan from 1987 through 1996 to determine the risk factors causing these outbreaks. Major hazards in 269 outbreaks were Salmonella spp., Campylobacter jejuni, Escherichia coli and Staphylococcus aureus. Foods including uncooked or partially cooked items, salad or egg products presented a high risk in 62 outbreaks with confirmed food sources. Contaminated food items were involved in 29 incidents (46.8%); storage of foods for an extended period before serving in 29 incidents (46.8%), inadequate cooking and cross contamination in 21 incidents (33.9%) each; infected employees in nine incidents (14.5%).

  11. 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.

  12. Population-based estimates of acute gastrointestinal and foodborne illness in Barbados: a retrospective cross-sectional study.

    PubMed

    Ingram, Maria; St John, Joy; Applewhaite, Tyrone; Gaskin, Pamela; Springer, Karen; Indar, Lisa

    2013-12-01

    The aim of this study was to determine the burden and impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Barbados through a retrospective, cross-sectional population survey and laboratory study in August 2010-August 2011. Face-to-face interviews were conducted with one person from each of 1,710 randomly-selected households. Of these, 1,433 (84%) interviews were completed. A total of 70 respondents reported having experienced AGE in the 28 days prior to the interview, representing a prevalence of 4.9% and an annual incidence rate of 0.652 episodes per person-year. Age (p = 0.01132), season (p = 0.00343), and income (p < 0.005) were statistically associated with the occurrence of AGE in the population. Norovirus was the leading foodborne pathogen causing AGE-related illness. An estimated 44,270 cases of AGE were found to occur during the period of the study and, for every case of AGE detected by surveillance, an additional 204 cases occurred in the community. Economic costs of AGE ranged from BD$ 9.5 million to 16.5 million (US$ 4.25-8.25) annually. This study demonstrated that the public-health burden and impact of AGE and FBD in Barbados were high and provided the necessary baseline information to guide targeted interventions.

  13. Foodborne proportion of gastrointestinal illness: estimates from a Canadian expert elicitation survey.

    PubMed

    Ravel, André; Davidson, Valerie J; Ruzante, Juliana M; Fazil, Aamir

    2010-12-01

    The study used a structured expert elicitation survey to derive estimates of the foodborne attributable proportion for nine illnesses caused by enteric pathogens in Canada. It was based on a similar study conducted in the United States and focused on Campylobacter, Escherichia coli O157:H7, Listeria monocytogenes, nontyphoidal Salmonella enterica, Shigella spp., Vibrio spp., Yersinia enterocolitica, Cryptosporidium parvum, and Norwalk-like virus. For each pathogen, experts were asked to provide their best estimate and low and high limits for the proportion of foodborne illness relative to total cases. In addition, they provided background information with regard to food safety experience, including self-evaluated expertise for each pathogen on a 5-point scale. A snowball approach was used to identify 152 experts within Canada. The experts' background details were summarized using descriptive statistics. Factor analysis was used to determine whether the variability in best estimates was related to self-assessed level of expertise or other background information. Cluster analysis followed by beta function fitting was undertaken on best estimates from experts who self-evaluated their expertise 3 or higher. In parallel, Monte Carlo resampling was run using triangular distributions based on each expert's best estimate and its limits. Sixty-six experts encompassing various academic backgrounds, fields of expertise, and experiences relevant to food safety provided usable data. Considerable variation between experts in their estimated foodborne attributable proportions was observed over all diseases, without any relationship to the expert's background. Uncertainty about their estimate (measured by the low and high limits) varied between experts and between pathogens as well. Both cluster analysis and Monte Carlo resampling clearly indicated disagreement between experts for Campylobacter, E. coli O157, L. monocytogenes, Salmonella, Vibrio, and Y. enterocolitica. In the

  14. New pharmaceuticals reduce cost of illness.

    PubMed

    Hansen, R W

    1986-06-01

    The cost of illness includes not only the funds required to treat illness, but also the effect on the patient's quality of life. Recent concern about rising health costs have focused on the direct expenditures without noting that the cost of illness in terms of mortality and morbidity has declined significantly. Pharmaceuticals have played a major role in reducing the total cost of illness. Several studies of the cost-effectiveness of past introductions of vaccines and pharmaceuticals reveal large cost savings. Although the focus of most studies has been on major advances, the continuing process of less dramatic therapeutic improvements has significantly trimmed the cost of illness. Cost-benefit studies of new drugs or changes in drug use, while more difficult to perform, make it possible to influence the selection of therapy. Since pharmaceuticals represent less than 10% of total treatment costs, reduction in the cost of pharmaceutical products can only have a minor impact on the total cost of illness. Pharmaceuticals can reduce the cost of illness by providing alternative therapies that reduce direct treatment cost or improve the public health.

  15. An outbreak of foodborne illness among attendees of a wedding reception in Wisconsin likely caused by Arcobacter butzleri.

    PubMed

    Lappi, Victoria; Archer, John R; Cebelinski, Elizabeth; Leano, Fe; Besser, John M; Klos, Rachel F; Medus, Carlota; Smith, Kirk E; Fitzgerald, Collette; Davis, Jeffrey P

    2013-03-01

    Arcobacter species, primarily Arcobacter butzleri, are widely distributed among animals, infrequently isolated from humans, and previously not associated with outbreaks of foodborne illness. We report results of an investigation of a foodborne outbreak that occurred among attendees of a wedding reception in Wisconsin, United States, and was likely caused by A. butzleri. We conducted a case-control study among reception attendees and a laboratory investigation to determine the extent, source, and cause of the outbreak. A clinical case was defined as diarrhea in an attendee with illness onset ≤7 days following the wedding reception. The case-control study included 47 of 51 case patients and 43 non-ill attendees. Results demonstrated that consuming broasted chicken was the only factor significantly associated with illness (odds ratio 10.51; 95% confidence interval 1.28, 476.4). Five patients provided stool specimens. Comprehensive culture and polymerase chain reaction (PCR) testing did not detect common bacterial or viral pathogens. Subsequent testing with PCRs targeting 16S/23S rDNA of the three most clinically relevant Arcobacter spp. and the rpoB/C gene of A. butzleri provided products confirmed as A. butzleri (four patients) and A. cryaerophilus (one patient) by sequence analysis. The results of this investigation suggest that A. butzleri should be considered an agent that can cause outbreaks of foodborne illness. Rigorous investigation of outbreaks of undetermined etiology is valuable for incrementally increasing our understanding of emerging agents causing foodborne illnesses.

  16. Exploring historical Canadian foodborne outbreak data sets for human illness attribution.

    PubMed

    Ravel, A; Greig, J; Tinga, C; Todd, E; Campbell, G; Cassidy, M; Marshall, B; Pollari, F

    2009-09-01

    Human illness attribution has been recently recognized as an important tool to better inform food safety decisions. Analysis of outbreak data sets has been used for that purpose. This study was conducted to explore the usefulness of three comprehensive Canadian foodborne outbreak data sets covering 30 years for estimating food attribution in cases of gastrointestinal illness, providing Canadian food attribution estimates from a historical perspective. Information concerning the microbiological etiology and food vehicles recorded for each outbreak was standardized between the data sets. The agent-food vehicle combinations were described and analyzed for changes over time by using multiple correspondence analysis. Overall, 6,908 foodborne outbreaks were available for three decades (1976 through 2005), but the agent and the food vehicle were identified in only 2,107 of these outbreaks. Differences between the data sets were found in the distribution of the cause, the vehicle, and the location or size of the outbreaks. Multiple correspondence analysis revealed an association between Clostridium botulinum and wild meat and between C. botulinum and seafood. This analysis also highlighted changes in food attribution over time and generated the most up-to-date food attribution values for salmonellosis (29% of cases associated with produce, 15% with poultry, and 15% with meat other than poultry, pork, and beef), campylobacteriosis (56% of cases associated with poultry and 22% with dairy products other than fluid milk), and Escherichia coli infection (37% of cases associated with beef, 23% with cooked multi-ingredient dishes, and 11% with meat other than beef, poultry, and pork). Because of the inherent limitations of this approach, only the main findings should be considered for policy making. The use of other human illness attribution approaches may provide further clarification.

  17. 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…

  18. Determining the Community Prevalence of Acute Gastrointestinal Illness and Gaps in Surveillance of Acute Gastroenteritis and Foodborne Diseases in Guyana

    PubMed Central

    Mohamed-Rambaran, Pheona; Wilson, Alexis; James, Colin; Indar, Lisa

    2013-01-01

    Guyana is an English-speaking country in South America and, culturally, it is part of the Caribbean. Objective of this study was to determine the community prevalence and true burden and economic impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Guyana. A cross-sectional population-based survey was conducted in 7 of the 10 regions in Guyana during August and November 2009 to capture the high- and low-AGE season respectively. Overall, 1,254 individual surveys were administered at a response rate of 96.5%. The overall monthly prevalence of self-reported cases of AGE was 7.7% (97 cases) (95% CI 6.3-9.3), and the yearly incidence was 1.0 episodes per person-year. The highest monthly prevalence of AGE was observed in region 4 (8.9%) and in children aged 1-4 year(s) (12.7%). Of the 97 AGE cases, 23% sought medical care; 65% reported spending time at home due to their illness [range 1-20 day(s), mean 2.7 days], of whom 51% required other individuals to look after them while ill. The maximum number of stools per 24 hours ranged from 3 to 9 (mean 4.5), and number of days an individual suffered from AGE ranged from 1 to 21 day(s) (mean 2.7 days). The burden of syndromic AGE cases in the population for 2009 was estimated to be 131,012 cases compared to the reported 30,468 cases (76.7% underreporting), which implies that, for every syndromic case of AGE reported, there were additional 4.3 cases occurring in the community. For every laboratory-confirmed case of FBD/AGE pathogen reported, it was estimated that approximately 2,881 more cases were occurring in the population. Giardia was the most common foodborne pathogen isolated. The minimum estimated annual cost associated with the treatment for AGE was US$ 2,358,233.2, showing that AGE and FBD pose a huge economic burden on Guyana. Underreporting of AGE and foodborne pathogens, stool collection, and laboratory capacity were major gaps, affecting the surveillance of AGE in Guyana.

  19. Pylephlebitis and acute mesenteric ischemia in a young man with inherited thrombophilia and suspected foodborne illness.

    PubMed

    Pradka, Sarah P; Trankiem, Christine T; Ricotta, John J

    2012-06-01

    We report on a young man who developed complicated pylephlebitis after foodborne illness. Despite antibiotics and resection of the focus of infectious colitis, he developed extensive small bowel infarction. He was treated with anticoagulation, local thrombolytic infusion, and resection of irreversibly ischemic small bowel. Thrombophilia workup demonstrated heterozygosity for factor V Leiden and the prothrombin G20210A mutation. The complications of pylephlebitis can be minimized by using systemic anticoagulation, thrombectomy, and/or local thrombolytic infusion along with antibiotics and surgical management of the infection. Evaluation for thrombophilic states should be considered, particularly if a patient does not respond to initial therapy. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  20. 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.

  1. 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.

  2. Foodborne illness among factory workers, Gweru, Zimbabwe, 2012: a retrospective cohort study.

    PubMed

    Gabida, Meggie; Gombe, Notion T; Chemhuru, Milton; Takundwa, Lucia; Bangure, Donewell; Tshimanga, Mufuta

    2015-09-29

    On the 20th September 2012 the Gweru district medical officer (DMO) reported a sudden increase in the number of factory workers complaining of symptoms suggestive of gastrointestinal illness. We conducted a retrospective cohort study to determine factors associated with illness among factory workers. A retrospective cohort study was conducted from September to October 2012 among 98 randomly selected factory workers. Interviewer administered questionnaires were used to evaluate possible risk factors from which food attack rates, relative risks (RR) and adjusted odds ratios (AOR) were calculated using Epi info version 3.5.1. Bacteriological examination of food samples was performed. In addition rectal swabs and specimens from food handlers and patients were collected for analysis. Of the 98 workers interviewed, 87/98 (89%) were males. Consumption of beef stew (AOR = 9.28, 95% CI 2.78-30.91) was independently associated with foodborne illness. Klebsiella spp. were isolated from beef stew and stool specimen of patients. Watery diarrhoea 51/98 (52%), fatigue 48/98 (49%) and abdominal cramps 41/98 (42%) were the most presenting symptoms. Klebsiella spp. was the aetiological agent for the food borne illness at the factory and this resulted from consumption of contaminated beef stew by the workers. As a result of this evidence, the implicated beef was withdrawn from the canteen and the menu cycle was revised to minimise exposure to the same food. Food handlers training in food safety and hygiene and regular canteen inspections for quality assurance were recommended and adopted. No further food borne illness has been reported from the factory.

  3. Estimated Costs of Sporadic Gastrointestinal Illness ...

    EPA Pesticide Factsheets

    BACKGROUND: The ·burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost. attributable disease burden estimates can be useful for environmental management decisions. OBJECTIVES: We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation. METHODS: Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U.S. states, and CHEERS, which evaluated illness after incidental-contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI. RESULTS: Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338-$1,681) and $1,676 for swimming/wading (range $425-2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs. CONCLUSIONS: Our estimates suggest gastrointestinal illness attributed to surface water rec

  4. Foodborne illness and seasonality related to mobile food sources at festivals and group gatherings in the state of Georgia.

    PubMed

    Wilson, Erica

    2015-03-01

    Little is known about the relationship of location and season to the pathogen and impact of foodborne illness. A sample of 244 foodborne illness outbreaks from the Foodborne Outbreak Online Database System stemming from festivals (mobile food sources) and group gatherings in Georgia between 1998 and 2010 was examined to determine if season and location were related to pathogen and the number of ill or hospitalized individuals. Results of Chi-square tests of independence, one-way analysis of variance, and the Kruskal-Wallis test showed that norovirus and Salmonella were more strongly associated with group gatherings; Staphylococcus outbreaks were more associated with festivals; norovirus was more frequent during winter; and Salmonella was more associated with summer and autumn events. Location and impact were significant for outbreaks associated with group gatherings, resulting in more hospitalizations than outbreaks associated with festivals. No statistically significant difference occurred between the numbers of reported illnesses stemming from festivals versus group gatherings nor did a seasonal difference occur in the total number of individuals who fell ill or were hospitalized.

  5. Public health foodborne illness case study during a Special Operations Forces deployment to South America.

    PubMed

    McCown, Michael; Grzeszak, Benjamin

    2010-01-01

    Although many public health articles have been published detailing foodborne illness outbreaks, a medical literature search revealed no articles that detail a case study or a specific response of a deployed U.S. military unit to a potential foodborne illness. This article describes a recent public health case study of a U.S. Special Operations Forces (SOF) team sickened while deployed to South America. It highlights public health factors which may affect U.S. personnel deployed or serving overseas and may serve as a guide for a deployed SOF medic to reference in response to a potential food- or waterborne illness outbreak. Eight food samples and five water samples were collected. The food samples were obtained from the host nation kitchen that provided food to the SOF team. The water samples were collected from the kitchen as well as from multiple sites on the host nation base. These samples were packaged in sterile containers, stored at appropriate temperatures, and submitted to a U.S. Army diagnostic laboratory for analysis. Laboratory results confirmed the presence of elevated aerobic plate counts (APCs) in the food prepared by the host nation and consumed by the SOF team. High APCs in food are the primary indicator of improper sanitation of food preparation surfaces and utensils. This case study concluded that poor kitchen sanitation, improper food storage, preparation, and/or holding were the probable conditions that led to the team?s symptoms. These results emphasize the importance of ensuring safe food and water for U.S. personnel serving overseas, especially in a deployment or combat setting. Contaminated food and/or water will negatively impact the health and availability of forces, which may lead to mission failure. The SOF medic must respond to potential outbreaks and be able to (1) critically inspect food preparation areas and accurately advise commanders in order to correct deficiencies and (2) perform food/water surveillance testing consistently

  6. Old Friends in New Places: Exploring the Role of Extraintestinal E. coli in Intestinal Disease and Foodborne Illness.

    PubMed

    Markland, S M; LeStrange, K J; Sharma, M; Kniel, K E

    2015-11-01

    The emergence of new antibiotic-resistant Escherichia coli pathotypes associated with human disease has led to an investigation in terms of the origins of these pathogens. According to the Centers for Disease Control and Prevention, unspecified agents are responsible for 38.4 million of the 48 million (80%) cases of foodborne illnesses each year in the United States. It is hypothesized that environmental E. coli not typically associated with the ability to cause disease in humans could potentially be responsible for some of these cases. In order for an environmental E. coli isolate to have the ability to cause foodborne illness, it must be able to utilize the same attachment and virulence mechanisms utilized by other human pathogenic E. coli. Recent research has shown that many avian pathogenic E. coli (APEC) isolated from poultry harbour attachment and virulence genes also currently found in human pathogenic E. coli isolates. Research also suggests that, in addition to the ability to cause gastrointestinal illnesses, APEC may also be an etiological agent of foodborne urinary tract infections (FUTIs). The purpose of this article was to evaluate the evidence pertaining to the ability of APEC to cause disease in humans, their potential for zoonotic transfer along with discussion on the types of illnesses that may be associated with these pathogens. © 2015 Blackwell Verlag GmbH.

  7. Costs of illness due to endemic cholera.

    PubMed

    Poulos, C; Riewpaiboon, A; Stewart, J F; Clemens, J; Guh, S; Agtini, M; Sur, D; Islam, Z; Lucas, M; Whittington, D

    2012-03-01

    Economic analyses of cholera immunization programmes require estimates of the costs of cholera. The Diseases of the Most Impoverished programme measured the public, provider, and patient costs of culture-confirmed cholera in four study sites with endemic cholera using a combination of hospital- and community-based studies. Families with culture-proven cases were surveyed at home 7 and 14 days after confirmation of illness. Public costs were measured at local health facilities using a micro-costing methodology. Hospital-based studies found that the costs of severe cholera were US$32 and US$47 in Matlab and Beira. Community-based studies in North Jakarta and Kolkata found that cholera cases cost between US$28 and US$206, depending on hospitalization. Patients' cost of illness as a percentage of average monthly income were 21% and 65% for hospitalized cases in Kolkata and North Jakarta, respectively. This burden on families is not captured by studies that adopt a provider perspective.

  8. Transcriptional Profile during Deoxycholate-Induced Sporulation in a Clostridium perfringens Isolate Causing Foodborne Illness.

    PubMed

    Yasugi, Mayo; Okuzaki, Daisuke; Kuwana, Ritsuko; Takamatsu, Hiromu; Fujita, Masaya; Sarker, Mahfuzur R; Miyake, Masami

    2016-05-15

    Clostridium perfringens type A is a common source of foodborne illness (FBI) in humans. Vegetative cells sporulate in the small intestinal tract and produce the major pathogenic factor C. perfringens enterotoxin. Although sporulation plays a critical role in the pathogenesis of FBI, the mechanisms inducing sporulation remain unclear. Bile salts were shown previously to induce sporulation, and we confirmed deoxycholate (DCA)-induced sporulation in C. perfringens strain NCTC8239 cocultured with human intestinal epithelial Caco-2 cells. In the present study, we performed transcriptome analyses of strain NCTC8239 in order to elucidate the mechanism underlying DCA-induced sporulation. Of the 2,761 genes analyzed, 333 were up- or downregulated during DCA-induced sporulation and included genes for cell division, nutrient metabolism, signal transduction, and defense mechanisms. In contrast, the virulence-associated transcriptional regulators (the VirR/VirS system, the agr system, codY, and abrB) were not activated by DCA. DCA markedly increased the expression of signaling molecules controlled by Spo0A, the master regulator of the sporulation process, whereas the expression of spo0A itself was not altered in the presence or absence of DCA. The phosphorylation of Spo0A was enhanced in the presence of DCA. Collectively, these results demonstrated that DCA induced sporulation, at least partially, by facilitating the phosphorylation of Spo0A and activating Spo0A-regulated genes in strain NCTC8239 while altering the expression of various genes. Disease caused by Clostridium perfringens type A consistently ranks among the most common bacterial foodborne illnesses in humans in developed countries. The sporulation of C. perfringens in the small intestinal tract is a key event for its pathogenesis, but the factors and underlying mechanisms by which C. perfringens sporulates in vivo currently remain unclear. Bile salts, major components of bile, which is secreted from the liver for

  9. Transcriptional Profile during Deoxycholate-Induced Sporulation in a Clostridium perfringens Isolate Causing Foodborne Illness

    PubMed Central

    Okuzaki, Daisuke; Kuwana, Ritsuko; Takamatsu, Hiromu; Fujita, Masaya; Sarker, Mahfuzur R.; Miyake, Masami

    2016-01-01

    ABSTRACT Clostridium perfringens type A is a common source of foodborne illness (FBI) in humans. Vegetative cells sporulate in the small intestinal tract and produce the major pathogenic factor C. perfringens enterotoxin. Although sporulation plays a critical role in the pathogenesis of FBI, the mechanisms inducing sporulation remain unclear. Bile salts were shown previously to induce sporulation, and we confirmed deoxycholate (DCA)-induced sporulation in C. perfringens strain NCTC8239 cocultured with human intestinal epithelial Caco-2 cells. In the present study, we performed transcriptome analyses of strain NCTC8239 in order to elucidate the mechanism underlying DCA-induced sporulation. Of the 2,761 genes analyzed, 333 were up- or downregulated during DCA-induced sporulation and included genes for cell division, nutrient metabolism, signal transduction, and defense mechanisms. In contrast, the virulence-associated transcriptional regulators (the VirR/VirS system, the agr system, codY, and abrB) were not activated by DCA. DCA markedly increased the expression of signaling molecules controlled by Spo0A, the master regulator of the sporulation process, whereas the expression of spo0A itself was not altered in the presence or absence of DCA. The phosphorylation of Spo0A was enhanced in the presence of DCA. Collectively, these results demonstrated that DCA induced sporulation, at least partially, by facilitating the phosphorylation of Spo0A and activating Spo0A-regulated genes in strain NCTC8239 while altering the expression of various genes. IMPORTANCE Disease caused by Clostridium perfringens type A consistently ranks among the most common bacterial foodborne illnesses in humans in developed countries. The sporulation of C. perfringens in the small intestinal tract is a key event for its pathogenesis, but the factors and underlying mechanisms by which C. perfringens sporulates in vivo currently remain unclear. Bile salts, major components of bile, which is secreted

  10. Pathogen-specific risk of celiac disease following bacterial causes of foodborne illness: a retrospective cohort study.

    PubMed

    Riddle, Mark S; Murray, Joseph A; Cash, Brooks D; Pimentel, Mark; Porter, Chad K

    2013-11-01

    The US CDC recently estimated over 2 million foodborne illnesses annually are caused by 4 major enteropathogens: non-typhoid Salmonella spp., Campylobacter spp., Shigella spp., and Yersinia enterocolitica. While recent data suggest functional gastrointestinal disorders are associated with these infections, studies linking foodborne illness to celiac disease (CD) are limited. We utilized a US Department of Defense medical encounter database to evaluate the risk of CD following select foodborne infections. We identified subjects with acute gastroenteritis between 1998 and 2009 attributed to Salmonella (nontyphoidal) spp., Shigella spp., Campylobacter spp., or Y. enterocolitica and matched each with up to 4 unexposed subjects. Exposed and unexposed subjects were followed for incident CD diagnosis for their entire military record duration (or a minimum of 1 year). Relative risks were calculated using modified Poisson regression to determine the relationship between pathogen-attributable gastroenteritis and CD while controlling for covariates. A total of 1,753 pathogen-specific gastroenteritis cases (Campylobacter: 738; Salmonella: 624; Shigella: 376; Yersinia: 17) were identified and followed for a median of 3.8 years. The incidence (per 100,000 person-years) of CD was 0.05. We found a suggested risk of CD after Campylobacter, but not other foodborne infection etiologies. These data support a previous study demonstrating increased risk of CD following Campylobacteriosis and highlight the need for additional research into how infections might trigger CD in susceptible individuals.

  11. Determining the community prevalence of acute gastrointestinal illness and gaps in surveillance of acute gastroenteritis and foodborne diseases in Guyana.

    PubMed

    Persuad, Shamdeo; Mohamed-Rambaran, Pheona; Wilson, Alexis; James, Colin; Indar, Lisa

    2013-12-01

    Guyana is an English-speaking country in South America and, culturally, it is part of the Caribbean. Objective of this study was to determine the community prevalence and true burden and economic impact of acute gastroenteritis (AGE) and foodborne diseases (FBDs) in Guyana. A cross-sectional population-based survey was conducted in 7 of the 10 regions in Guyana during August and November 2009 to capture the high- and low-AGE season respectively. Overall, 1,254 individual surveys were administered at a response rate of 96.5%. The overall monthly prevalence of self-reported cases of AGE was 7.7% (97 cases) (95% CI 6.3-9.3), and the yearly incidence was 1.0 episodes per person-year. The highest monthly prevalence of AGE was observed in region 4 (8.9%) and in children aged 1-4 year(s) (12.7%). Of the 97 AGE cases, 23% sought medical care; 65% reported spending time at home due to their illness [range 1-20 day(s), mean 2.7 days], of whom 51% required other individuals to look after them while ill. The maximum number of stools per 24 hours ranged from 3 to 9 (mean 4.5), and number of days an individual suffered from AGE ranged from 1 to 21 day(s) (mean 2.7 days). The burden of syndromic AGE cases in the population for 2009 was estimated to be 131,012 cases compared to the reported 30,468 cases (76.7% underreporting), which implies that, for every syndromic case of AGE reported, there were additional 4.3 cases occurring in the community. For every laboratory-confirmed case of FBD/AGE pathogen reported, it was estimated that approximately 2,881 more cases were occurring in the population. Giardia was the most common foodborne pathogen isolated. The minimum estimated annual cost associated with the treatment for AGE was US$ 2,358,233.2, showing that AGE and FBD pose a huge economic burden on Guyana. Underreporting of AGE and foodbome pathogens, stool collection, and laboratory capacity were major gaps, affecting the surveillance of AGE in Guyana.

  12. 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.

  13. 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.

  14. 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.

  15. [Pre-warning model of bacterial foodborne illness based on performance of principal component analysis combined with support vector machine].

    PubMed

    Duan, Hejun; Shao, Bing

    2010-11-01

    Based on the historical data of bacterial foodborne illness, the scoring system applied on the pre-warning model system was established in this study according to the rated harm factors. It could build up effectively the predictive model in the analysis of foodborne illness accidents. Extracting the useful information, the principal component analysis was performed on the normalized raw data to reduce the dimension. The result was split into 70% data randomly for training set into the regression model of support vector machine that was used to predict the remaining 30% . Through reducing the dimensions for selecting the optional PCs, it could optimize the calibration and improve the efficiency. The combining method of principal component analysis (PCA) and support vector machine (SVM) could provide the reliable results in the pre-warning model, especially for the high-dimensional data with the limited sample populations. Furthermore, it could achieve 80% accuracy with the optimized parameters. The pre-warning model of bacterial foodborne illness could give the assessment of the poisoning accidents and provided the scientific theory for reducing the incidence of bacterial of food poisoning.

  16. Factors associated with seeking medical care and submitting a stool sample in estimating the burden of foodborne illness.

    PubMed

    Scallan, Elaine; Jones, Timothy F; Cronquist, Alicia; Thomas, Stepy; Frenzen, Paul; Hoefer, Dina; Medus, Carlota; Angulo, Fredrick J

    2006-01-01

    Laboratory-based surveillance is a foundation for public health and is essential for determining the incidence of most foodborne diseases caused by bacterial pathogens; however, reported cases represent a subset of infections in the community. To identify the factors associated with seeking medical care and submitting a stool specimen among persons with acute diarrheal illness, we used multivariate logistic regression to analyze data from two 12- month population-based telephone surveys conducted in the Foodborne Diseases Active Surveillance Network (FoodNet) from 2000 to 2003. Of 31,082 persons interviewed, 5% reported an acute diarrheal illness in the four weeks prior to the interview; of these, 20% sought medical care. On multivariate analysis, among persons with an acute diarrheal illness, factors associated with seeking medical care included: male sex; age <5 or >or=65 years; household income <25,000 dollars; having health insurance; diarrhea duration >or=3 days; having bloody diarrhea, fever, vomiting, sore throat, or cough. Of those seeking medical care, 19% provided a stool sample. Bloody diarrhea (odds ratio [OR] 3.35; 95% confidence interval [CI] 1.18-9.51) and diarrhea duration >or=3 days (OR 3.81; 95% CI: 1.50-9.69) were the most important factors associated with submission of a stool specimen. Cases of acute diarrheal illness ascertained through laboratory-based public health surveillance are likely to differ systematically from unreported cases and likely over-represent those with bloody diarrhea and longer diarrhea duration.

  17. Capacity of state and territorial health agencies to prevent foodborne illness.

    PubMed

    Hoffman, Richard E; Greenblatt, Jesse; Matyas, Bela T; Sharp, Donald J; Esteban, Emilio; Hodge, Knachelle; Liang, Arthur

    2005-01-01

    The capacity of state and territorial health departments to investigate foodborne diseases was assessed by the Council of State and Territorial Epidemiologists from 2001 to 2002 with a self-administered, Web-based survey. Forty-eight health departments responded (47 states and 1 territory). The primary reason for not conducting more active case surveillance of enteric disease is lack of staff, while the primary reasons for not investigating foodborne disease outbreaks are limited staff and delayed notification of the outbreak. Sixty-four percent of respondents have the capacity to conduct analytic epidemiologic investigations. States receiving Emerging Infections Program (EIP) funding from the Centers for Disease Control and Prevention more often reported having a dedicated foodborne disease epidemiologist and the capability to perform analytic studies than non-EIP states. We conclude that by addressing shortages in the number of dedicated personnel and reducing delays in reporting, the capacity of state health departments to respond to foodborne disease can be improved.

  18. Costs of Illness Due to Endemic Cholera

    PubMed Central

    Poulos, C.; Riewpaiboon, A.; Stewart, J.F.; Clemens, J.; Guh, S.; Agtini, M.; Sur, D.; Islam, Z.; Lucas, M.; Whittington, D.

    2013-01-01

    Summary Economic analyses of cholera immunization programmes require estimates of the costs of cholera. The Diseases of the Most Impoverished programme measured the public, provider, and patient costs of culture-confirmed cholera in four study sites with endemic cholera using a combination of hospital- and community-based studies. Families with culture-proven cases were surveyed at home 7 and 14 days after confirmation of illness. Public costs were measured at local health facilities using a micro-costing methodology. Hospital-based studies found that the costs of severe cholera were USD 32 and 47 in Matlab and Beira. Community-based studies in North Jakarta and Kolkata found that cholera cases cost between USD 28 and USD 206, depending on hospitalization. Patient costs of illness as a percentage of average monthly income were 21% and 65% for hospitalized cases in Kolkata and North Jakarta, respectively. This burden on families is not captured by studies that adopt a provider perspective. PMID:21554781

  19. Labor market costs of illness: prevalence matters.

    PubMed

    DeLeire, Thomas; Manning, Willard

    2004-03-01

    We present a model of the labor market effects of health impairments. In particular, we describe several economic models in which health affects worker productivity and the demand for and supply of market labor services. These models provide a framework for estimating the social cost of prevalent health impairments - a necessary step in conducting cost-benefit analyses and in determining the cost-effectiveness of potential health interventions from a broader social perspective. Our approach suggests that several measures used in the literature provide an incomplete and systematically biased assessment of the economic impact of health impairment or of the treatment of illness and impairment. The problem arises because of the reliance on an approximation at the firm level and from the bias from the neglect of the effect of impairment in shifting the labor market equilibrium. If the illness is prevalent, the effects on labor market equilibrium wage rates could be substantial. In addition, many analyses also ignore the effects of illness on producers' surplus. Copyright 2003 John Wiley & Sons, Ltd.

  20. A foodborne outbreak of gastrointestinal illness caused by enterotoxigenic Escherichia coli serotype O169:H41 in Osaka, Japan.

    PubMed

    Harada, Tetsuya; Itoh, Kaoru; Yamaguchi, Yuko; Hirai, Yuji; Kanki, Masashi; Kawatsu, Kentaro; Seto, Kazuko; Taguchi, Masumi; Kumeda, Yuko

    2013-01-01

    We describe our laboratory investigation of a massive foodborne outbreak of gastrointestinal illness caused by enterotoxigenic Escherichia coli (ETEC) serotype O169:H41 that occurred during a 2-day traditional festival held in September 2012 in Osaka Prefecture, Japan. Of 126 customers who patronized a particular Japanese restaurant during the event, 102 developed symptoms of gastrointestinal disease. We isolated strains of ETEC serotype O169:H41 from 1 food sample and from fecal samples collected from 19 of 34 patients and 2 of 4 food handlers. Pulsed-field gel electrophoresis analysis of these isolates suggested that the foodborne pathogen that caused the diarrheal outbreak was a specific clone of ETEC serotype O169:H41. Based on these findings and our interviews with the restaurant owner and employees, we concluded that a likely cause of the outbreak was an overwhelmed capacity of the restaurant kitchen in terms of preservation of sanitary procedures during the festival and the inability of the restaurant staff to handle the relatively large quantity of food to ensure a lack of contamination with ETEC. Thus, we reconfirm that ETEC strains of serotype O169:H41 remain important causes of domestic foodborne outbreaks in developed countries, including Japan.

  1. 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.

  2. 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…

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

    USDA-ARS?s Scientific Manuscript database

    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 ...

  4. 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…

  5. 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…

  6. 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…

  7. 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

  8. Foodborne illness incidence rates and food safety risks for populations of low socioeconomic status and minority race/ethnicity: a review of the literature.

    PubMed

    Quinlan, Jennifer J

    2013-08-15

    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.

  9. 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…

  10. The socioeconomic costs of mental illness in Spain.

    PubMed

    Oliva-Moreno, Juan; López-Bastida, Julio; Montejo-González, Angel Luis; Osuna-Guerrero, Rubén; Duque-González, Beatriz

    2009-10-01

    Mental illness affects a large number of people in the world, seriously impairing their quality of life and resulting in high socioeconomic costs for health care systems and society. Our aim is to estimate the socioeconomic impact of mental illness in Spain for the year 2002, including health care resources, informal care and loss of labour productivity. A prevalence-based approach was used to estimate direct medical costs, direct non-medical costs, and loss of labour productivity. The total costs of mental illness have been estimated at 7,019 million euros. Direct medical costs represented 39.6% of the total costs and 7.3% of total public healthcare expenditure in Spain. Informal care costs represented 17.7% of the total costs. Loss of labour productivity accounted for 42.7% of total costs. In conclusion, the costs of mental illness in Spain make a considerable economic impact from a societal perspective.

  11. Foodborne illness outbreaks from microbial contaminants in spices, 1973-2010.

    PubMed

    Van Doren, Jane M; Neil, Karen P; Parish, Mickey; Gieraltowski, Laura; Gould, L Hannah; Gombas, Kathy L

    2013-12-01

    This review identified fourteen reported illness outbreaks attributed to consumption of pathogen-contaminated spice during the period 1973-2010. Countries reporting outbreaks included Canada, Denmark, England and Wales, France, Germany, New Zealand, Norway, Serbia, and the United States. Together, these outbreaks resulted in 1946 reported human illnesses, 128 hospitalizations and two deaths. Infants/children were the primary population segments impacted by 36% (5/14) of spice-attributed outbreaks. Four outbreaks were associated with multiple organisms. Salmonella enterica subspecies enterica was identified as the causative agent in 71% (10/14) of outbreaks, accounting for 87% of reported illnesses. Bacillus spp. was identified as the causative agent in 29% (4/10) of outbreaks, accounting for 13% of illnesses. 71% (10/14) of outbreaks were associated with spices classified as fruits or seeds of the source plant. Consumption of ready-to-eat foods prepared with spices applied after the final food manufacturing pathogen reduction step accounted for 70% of illnesses. Pathogen growth in spiced food is suspected to have played a role in some outbreaks, but it was not likely a contributing factor in three of the larger Salmonella outbreaks, which involved low-moisture foods. Root causes of spice contamination included contributions from both early and late stages of the farm-to-table continuum.

  12. Foodborne viruses.

    PubMed

    Koopmans, Marion; von Bonsdorff, Carl Henrik; Vinjé, Jan; de Medici, Dario; Monroe, Steve

    2002-06-01

    Foodborne and waterborne viral infections are increasingly recognized as causes of illness in humans. This increase is partly explained by changes in food processing and consumption patterns that lead to the worldwide availability of high-risk food. As a result, vast outbreaks may occur due to contamination of food by a single foodhandler or at a single source. Although there are numerous fecal-orally transmitted viruses, most reports of foodborne transmission describe infections with Norwalk-like caliciviruses (NLV) and hepatitis A virus (HAV), suggesting that these viruses are associated with the greatest risk of foodborne transmission. NLV and HAV can be transmitted from person to person, or indirectly via food, water, or fomites contaminated with virus-containing feces or vomit. People can be infected without showing symptoms. The high frequency of secondary cases of NLV illness and - to a lesser extent - of hepatitis A following a foodborne outbreak results in amplification of the problem. The burden of illness is highest in the elderly, and therefore is likely to increase due to the aging population. For HAV, the burden of illness may increase following hygienic control measures, due to a decreasing population of naturally immune individuals and a concurrent increase in the population at risk. Recent advances in the research of NLV and HAV have led to the development of molecular methods which can be used for molecular tracing of virus strains. These methods can be and have been used for the detection of common source outbreaks. While traditionally certain foods have been implicated in virus outbreaks, it is clear that almost any food item can be involved, provided it has been handled by an infected person. There are no established methods for detection of viruses in foods other than shellfish. Little information is available on disinfection and preventive measures specifically for these viruses. Studies addressing this issue are hampered by the lack of

  13. 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. © 2015 Society for Risk Analysis.

  14. Foodborne Illness Outbreak Investigation Training Needs: A Survey Among State Public Health Staff in the Northeast and Mid-Atlantic United States.

    PubMed

    Ho, Alphina; Pennell-Huth, Paula; Newman, Alexandra; Zansky, Shelley; Wiedmann, Martin

    2017-03-01

    In 2011, the Food Safety and Modernization Act established Integrated Food Safety Centers of Excellence across the United States to train, educate, and enhance the skill of foodborne illness outbreak investigation teams. To target regional training efforts, the New York Integrated Food Safety Center of Excellence (NYCoE) identified training needs in food safety and foodborne illness investigations among public heath staff in 11 states and 1 large metropolitan area in the Northeast. To identify topics so as to develop training materials relevant to food safety and foodborne disease outbreaks in order to improve and impact foodborne outbreak investigations regionally and nationally. Cross-sectional, paper-based survey conducted in January-February 2016. Eleven Northeast and Mid-Atlantic states, and 1 large metropolitan area. Foodborne illness outbreak investigators in the NYCoE region. Identification of training needs, as self-reported by participants, regarding general foodborne outbreak investigation needs and those specific to epidemiologists, environmental health specialists, and laboratorians. Topics included basic food safety/processing knowledge, communication and metrics, and training formats. Information regarding demographics, utility of the NYCoE, and certificate programs was also collected. Surveys returned from 33 respondents (from 10 states and 1 metropolitan area) identified metrics (100%), increasing use of culture-independent diagnostic tests (85%), and guidance on implementation of the Council to Improve Foodborne Outbreak Response (guidelines (89%) as the top training needs. By field, epidemiologists cited training in applying whole genome sequencing (100%), environmental health specialists cited training on the National Outbreak Reporting System (67%), and laboratorians cited training on whole genome sequencing (91%) as important. Short, online, or in-person, 1- to 2-day trainings were the preferred training formats (≥91%). Respondents wanted

  15. Prevalence of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in food samples associated with foodborne illness in Alberta, Canada from 2007 to 2010.

    PubMed

    Crago, B; Ferrato, C; Drews, S J; Svenson, L W; Tyrrell, G; Louie, M

    2012-10-01

    Consumption of foods containing Staphylococcus aureus can cause severe gastro-intestinal illness. Given the fact that over the past decade, Canada has seen increasing rates of methicillin-resistant S. aureus (MRSA) carriage and infection, the objective of this study was to investigate the impact of methicillin-susceptible S. aureus (MSSA) and MRSA on foodborne illness in Alberta, Canada. Between January 2007 and December 2010, there were 693 food samples associated with foodborne investigations submitted to the Alberta Provincial Laboratory for Public Health (ProvLab). These foods were screened for: Bacillus cereus, Clostridium perfringens, S. aureus, Aeromonas spp., Campylobacter spp., Escherichia coli O157:H7, Salmonella, Shigella spp., and Yersinia spp. S. aureus was identified in 10.5% (73/693) of samples, and of these, 59% (43/73) were co-contaminated with at least one other organism on the screening panel. The S. aureus positive samples included 29 meat, 20 prepared foods containing meat, 11 prepared foods not containing meat, 10 dairy, and three produce. Methicillin-resistance was not detected in any isolates tested. These findings indicate that the presence of S. aureus in food associated with foodborne investigations is a cause for concern, and although MRSA was not found, the potential for outbreaks exists, and ongoing surveillance should be sustained. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  16. Whole genome sequencing of Shigella sonnei through PulseNet Latin America and Caribbean: advancing global surveillance of foodborne illnesses.

    PubMed

    Baker, K S; Campos, J; Pichel, M; Della Gaspera, A; Duarte-Martínez, F; Campos-Chacón, E; Bolaños-Acuña, H M; Guzmán-Verri, C; Mather, A E; Diaz Velasco, S; Zamudio Rojas, M L; Forbester, J L; Connor, T R; Keddy, K H; Smith, A M; López de Delgado, E A; Angiolillo, G; Cuaical, N; Fernández, J; Aguayo, C; Morales Aguilar, M; Valenzuela, C; Morales Medrano, A J; Sirok, A; Weiler Gustafson, N; Diaz Guevara, P L; Montaño, L A; Perez, E; Thomson, N R

    2017-04-04

    Shigella sonnei is a globally important diarrhoeal pathogen tracked through the surveillance network PulseNet Latin America and Caribbean (PNLA&C), which participates in PulseNet International. PNLA&C laboratories use common molecular techniques to track pathogens causing foodborne illness. We aimed to demonstrate the possibility and advantages of transitioning to whole genome sequencing (WGS) for surveillance within existing networks across a continent where S. sonnei is endemic. We applied WGS to representative archive isolates of S. sonnei (n = 323) from laboratories in nine PNLA&C countries to generate a regional phylogenomic reference for S. sonnei and put this in the global context. We used this reference to contextualise 16 S. sonnei from three Argentinian outbreaks, using locally generated sequence data. Assembled genome sequences were used to predict antimicrobial resistance (AMR) phenotypes and identify AMR determinants. S. sonnei isolates clustered in five Latin American sublineages in the global phylogeny, with many (46%, 149 of 323) belonging to previously undescribed sublineages. Predicted multidrug resistance was common (77%, 249 of 323), and clinically relevant differences in AMR were found among sublineages. The regional overview showed that Argentinian outbreak isolates belonged to distinct sublineages and had different epidemiologic origins. Latin America contains novel genetic diversity of S. sonnei that is relevant on a global scale and commonly exhibits multidrug resistance. Retrospective passive surveillance with WGS has utility for informing treatment, identifying regionally epidemic sublineages and providing a framework for interpretation of prospective, locally sequenced outbreaks. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. Diabetes: cost of illness in Norway

    PubMed Central

    2010-01-01

    Background Diabetes mellitus places a considerable burden on patients in terms of morbidity and mortality and on society in terms of costs. Costs related to diabetes are expected to increase due to increasing prevalence of type 2 diabetes. The aim of this study was to estimate the health care costs attributable to type 1 and type 2 diabetes in Norway in 2005. Methods Data on inpatient hospital services, outpatient clinic visits, physician services, drugs, medical equipment, nutrition guidance, physiotherapy, acupuncture, foot therapy and indirect costs were collected from national registers and responses to a survey of 584 patients with diabetes. The study was performed with a prevalence approach. Uncertainty was explored by means of bootstrapping. Results When hospital stays with diabetes as a secondary diagnosis were excluded, the total costs were €293 million, which represents about 1.4% of the total health care expenditure. Pharmaceuticals accounted for €95 million (32%), disability pensions €48 million (16%), medical devices €40 million (14%) and hospital admissions €21 million (7%). Patient expenditures for acupuncture, physiotherapy and foot therapy were many times higher than expenditure for nutritional guidance. Indirect costs (lost production from job absenteeism) accounted for €70.1 million (24% of the €293 million) and included sick leave (€16.7 million), disability support and disability pensions (€48.2 million) and other indirect costs (€5.3 million). If all diabetes related hospital stays are included (primary- and secondary diagnosis) total costs amounts to €535 million, about 2.6% of the total health care expenditure in Norway. Conclusions Diabetes represents a considerable burden to society in terms of health care costs and productivity losses. PMID:20854689

  18. 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…

  19. Methodological considerations in cost of illness studies on Alzheimer disease

    PubMed Central

    2012-01-01

    Cost-of-illness studies (COI) can identify and measure all the costs of a particular disease, including the direct, indirect and intangible dimensions. They are intended to provide estimates about the economic impact of costly disease. Alzheimer disease (AD) is a relevant example to review cost of illness studies because of its costliness.The aim of this study was to review relevant published cost studies of AD to analyze the method used and to identify which dimension had to be improved from a methodological perspective. First, we described the key points of cost study methodology. Secondly, cost studies relating to AD were systematically reviewed, focussing on an analysis of the different methods used. The methodological choices of the studies were analysed using an analytical grid which contains the main methodological items of COI studies. Seventeen articles were retained. Depending on the studies, annual total costs per patient vary from $2,935 to $52, 954. The methods, data sources, and estimated cost categories in each study varied widely. The review showed that cost studies adopted different approaches to estimate costs of AD, reflecting a lack of consensus on the methodology of cost studies. To increase its credibility, closer agreement among researchers on the methodological principles of cost studies would be desirable. PMID:22963680

  20. Cost of illness of tuberculosis in Penang, Malaysia.

    PubMed

    Elamin, Elfatih Ibrahim; Ibrahim, Mohamed Izham Mohamed; Sulaiman, Syed Azhar Syed; Muttalif, Abdul Razak

    2008-06-01

    To assess the costs incurred by the public health services and patients as a result of tuberculosis (TB) treatment. Setting The study was conducted in a government hospital located in the northern region of Malaysia. Retrospective data were collected from medical records and the patients were observed until the completion of their medication. A pharmacoeconomic evaluation was applied to calculate direct and indirect costs. Direct and indirect costs of tuberculosis treatment in a government health institution. Two hundred and one tuberculosis patients were included in the study. Different regimens with various durations of treatments were used. The direct medical and non-medical costs as well as indirect costs were calculated and were found to be as follows: US$61.44 for anti-tuberculosis drugs and supplies, US$28.63 for X-ray examinations, US$28.53 for laboratory tests, US$20.03 for healthcare staff time, US$4.28 for hospitalisation, US$43.20 for overhead costs, US$608.11 for transportation and meals and US$118.78 for time away from work. The cost to the patients constitutes approximately 80% of the total cost of the treatment. The cost of treating the illness of tuberculosis per patient was US$916.4. The cost of anti-tuberculosis drugs constituted the highest proportion of the cost to the public health services (31.7%) while the cost to the patient constituted the major proportion of the total cost of the illness (79.4%).

  1. Using a theoretical predictive tool for the analysis of recent health department inspections at outbreak restaurants and relation of this information to foodborne illness likelihood.

    PubMed

    Petran, Ruth L; White, Bruce W; Hedberg, Craig W

    2012-11-01

    Because U.S. restaurants are inspected at least annually against criteria in the U.S. Food and Drug Administration Model Food Code, large amounts of data are generated and should be systematically reviewed. The purpose of this study was to determine the relationships among the data obtained through health department inspections, the contributing factors to foodborne illness identified by the Centers for Disease Control and Prevention, and the risks of outbreaks of norovirus, Salmonella, and Clostridium perfringens infection associated with a specific restaurant. These agents were chosen for the analysis because they cause the majority of foodborne illnesses. A theoretical predictive assessment tool was built that extracts data from routine health department inspection reports for specific restaurants to establish a risk profile for each restaurant and identify the likelihood of a norovirus, Salmonella, or C. perfringens outbreak at that restaurant. The tool was used to examine inspection reports from restaurants known to have had confirmed norovirus, Salmonella, and C. perfringens outbreaks. Although evaluation of an extensive data set revealed lack of an overall association between outbreak inspection scores and routine inspection scores obtained at outbreak restaurant locations, certain specific violations were significantly more likely to be recorded. Significant differences in types of violations recorded during outbreak and routine inspections were determined. When risks based on violation type can be identified, targeted actions may be able to be prioritized and implemented to help decrease illnesses.

  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. Perspectives in foodborne illness.

    PubMed

    Keusch, Gerald T

    2013-09-01

    This article provides a historical framework on food safety for more contemporary details to rest on, focusing primarily on the past 100 years or so (with a touch of ancient history) as particular issues that affect how the safety of the food we eat have been appreciated, have evolved or at times have been successfully dealt with, or have newly emerged or reemerged, in large part because of the impact of technology, trade, and travel.

  4. Draft Genome Sequence of Campylobacter jejuni CAM970 and C. coli CAM962, Associated with a Large Outbreak of Foodborne Illness in Fukuoka, Japan, in 2016.

    PubMed

    Asakura, Hiroshi; Takahashi, Naoto; Yamamoto, Shiori; Maruyama, Hiroyuki

    2017-06-15

    Here, we report the draft genome sequences of Campylobacter jejuni CAM970 and C. coli CAM962, which were associated with a large outbreak of foodborne illness originating from undercooked chicken sushi in Fukuoka, Japan, in May 2016. Their genome sizes were 1,690,901 and 1,704,736 bp, with 22 and 23 rRNAs, 9 and 9 tRNAs, and 411× and 419× coverage for C. jejuni CAM970 and C. coli CAM962, respectively. Copyright © 2017 Asakura et al.

  5. 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

  6. Productivity Cost Due to Maternal Ill Health in Sri Lanka

    PubMed Central

    Agampodi, Suneth; Agampodi, Thilini; Wickramasinghe, Nuwan; Fernando, Santhushya; Chathurani, Umanga; Adhikari, Wathsala; Dharshika, Ishani; Nugegoda, Dhanaseela; Dharmaratne, Samath; Newlands, David

    2012-01-01

    Background The global impact of maternal ill health on economic productivity is estimated to be over 15 billion USD per year. Global data on productivity cost associated with maternal ill health are limited to estimations based on secondary data. Purpose of our study was to determine the productivity cost due to maternal ill health during pregnancy in Sri Lanka. Methods and Findings We studied 466 pregnant women, aged 24 to 36 weeks, residing in Anuradhapura, Sri Lanka. A two stage cluster sampling procedure was used in a cross sectional design and all pregnant women were interviewed at clinic centers, using the culturally adapted Immpact tool kit for productivity cost assessment. Of the 466 pregnant women studied, 421 (90.3%) reported at least one ill health condition during the pregnancy period, and 353 (83.8%) of them had conditions affecting their daily life. Total incapacitation requiring another person to carry out all their routine activities was reported by 122 (26.1%) of the women. In this study sample, during the last episode of ill health, total number of days lost due to absenteeism was 3,356 (32.9% of total loss) and the days lost due to presenteeism was 6,832.8 (67.1% of the total loss). Of the 353 women with ill health conditions affecting their daily life, 280 (60%) had coping strategies to recover loss of productivity. Of the coping strategies used to recover productivity loss during maternal ill health, 76.8% (n = 215) was an intra-household adaptation, and 22.8% (n = 64) was through social networks. Loss of productivity was 28.9 days per episode of maternal ill health. The mean productivity cost due to last episode of ill health in this sample was Rs.8,444.26 (95% CI-Rs.6888.74-Rs.9999.78). Conclusions Maternal ill health has a major impact on household productivity and economy. The major impact is due to, generally ignored minor ailments during pregnancy. PMID:22879943

  7. Cost-of-illness studies of depression: a systematic review.

    PubMed

    Luppa, Melanie; Heinrich, Sven; Angermeyer, Matthias C; König, Hans-Helmut; Riedel-Heller, Steffi G

    2007-02-01

    Depression is a very common disease with substantial economic consequences. This paper reviews all published cost-of-illness studies of depression worldwide. A systematic search of cost-of-illness studies of depression in the databases MEDLINE, Web of Science, Cochrane Library, and PSYNDEXplus was conducted. Identified studies were classified by their basic characteristics. Costs reported were inflated in original currency to the year 2003 and then converted into US-dollar using purchasing power parities (US$ PPP). Additionally, national-costs were converted in costs per case and per inhabitant. 24 papers with notable methodical differences were identified and classified by their basic characteristics. Summary estimates from the studies for the average annual costs per case ranged from $1000 to $2500 for direct costs, from $2000 to $3700 for morbidity costs and from $200 to $400 for mortality costs. The basic quantity of interest in COI-studies of depression was stated. Methodical differences limited comparison substantially. Depression is associated with a high economic burden. Conducting COI-studies of depression along the line noted in the review could help provide the opportunity to expose differences in costs associated with different approaches to disease management.

  8. Deaths due to Unknown Foodborne Agents

    PubMed Central

    2004-01-01

    This study reviews the available evidence on unknown pathogenic agents transmitted in food and examines the methods that have been used to estimate that such agents cause 3,400 deaths per year in the United States. The estimate of deaths was derived from hospital discharge and death certificate data on deaths attributed to gastroenteritis of unknown cause. Fatal illnesses due to unknown foodborne agents do not always involve gastroenteritis, and gastroenteritis may not be accurately diagnosed or reported on hospital charts or death certificates. The death estimate consequently omitted deaths from unknown foodborne agents that do not cause gastroenteritis and likely overstated the number of deaths from agents that cause gastroenteritis. Although the number of deaths from unknown foodborne agents is uncertain, the possible economic cost of these deaths is so large that increased efforts to identify the causal agents are warranted. PMID:15498153

  9. Costs of venous thromboembolism associated with hospitalization for medical illness.

    PubMed

    Cohoon, Kevin P; Leibson, Cynthia L; Ransom, Jeanine E; Ashrani, Aneel A; Petterson, Tanya M; Long, Kirsten Hall; Bailey, Kent R; Heit, Johm A

    2015-04-01

    To determine population-based estimates of medical costs attributable to venous thromboembolism (VTE) among patients currently or recently hospitalized for acute medical illness. Population-based cohort study conducted in Olmsted County, Minnesota. Using Rochester Epidemiology Project (REP) resources, we identified all Olmsted County residents with objectively diagnosed incident VTE during or within 92 days of hospitalization for acute medical illness over the 18-year period of 1988 to 2005 (n=286). One Olmsted County resident hospitalized for medical illness without VTE was matched to each case for event date (±1 year), duration of prior medical history, and active cancer status. Subjects were followed forward in REP provider-linked billing data for standardized, inflation-adjusted direct medical costs (excluding outpatient pharmaceutical costs) from 1 year before their respective event or index date to the earliest of death, emigration from Olmsted County, or December 31, 2011 (study end date). We censored follow-up such that each case and matched control had similar periods of observation. We used generalized linear modeling (controlling for age, sex, preexisting conditions, and costs 1 year before index) to predict costs for cases and controls. Adjusted mean predicted costs were 2.5-fold higher for cases ($62,838) than for controls ($24,464) (P<.001) from index to up to 5 years post index. Cost differences between cases and controls were greatest within the first 3 months after the event date (mean difference=$16,897) but costs remained significantly higher for cases compared with controls for up to 3 years. VTE during or after recent hospitalization for medical illness contributes a substantial economic burden.

  10. Costs of Venous Thromboembolism Associated with Hospitalization for Medical Illness

    PubMed Central

    Cohoon, Kevin P.; Leibson, Cynthia L.; Ransom, Jeanine E.; Ashrani, Aneel A.; Petterson, Tanya M.; Long, Kirsten Hall; Bailey, Kent R.; Heit, John A.

    2015-01-01

    Objective To determine population-based estimates of medical costs attributable to venous thromboembolism (VTE) among patients currently or recently hospitalized for acute medical illness. Study Design Population-based cohort study conducted in Olmsted County, Minn. Methods Using Rochester Epidemiology Project (REP) resources, we identified all Olmsted County, MN residents with objectively-diagnosed incident VTE within 92 days of hospitalization for acute medical illness over the 18-year period, 1988–2005 (n=286). One Olmsted County resident hospitalized for medical illness without VTE was matched to each case on event date (± 1 year), duration of prior medical history and active cancer status. Subjects were followed forward in REP provider-linked billing data for standardized, inflation-adjusted direct medical costs (excluding outpatient pharmaceutical costs) from 1 year before their respective event or index date to the earliest of death, emigration from Olmsted County, or 12/31/2011 (study end date). We censored follow-up such that each case and match control had similar periods of observation. We also controlled for length of follow-up from index to up to 5-years post-index. We used generalized linear modeling (controlling for age, sex, pre-existing conditions and costs 1 year before index) to predict costs for cases and controls. Results Adjusted mean predicted costs were 2.5-fold higher for cases ($62,838) than for controls ($24,464) (P=<0.001) from index to up to 5-years post-index. Cost differences between cases and controls were greatest within the first 3 months after the event date (mean difference=$16,897) but costs remained significantly higher for cases compared to controls for up to 3 years. Conclusions VTE during or after recent hospitalization for medical illness contributes a substantial economic burden. PMID:26244788

  11. Costs of occupational injury and illness across industries.

    PubMed

    Leigh, J Paul; Waehrer, Geetha; Miller, Ted R; Keenan, Craig

    2004-06-01

    This study has ranked industries using estimated total costs and costs per worker. This incidence study of nationwide data was carried out in 1993. The main outcome measure was total cost for medical care, lost productivity, and pain and suffering for the entire United States (US). The analysis was conducted using fatal and nonfatal injury and illness data recorded in large data sets from the US Bureau of Labor Statistics. Cost data were derived from workers' compensation records, estimates of lost wages, and jury awards. Current-value calculations were used to express all costs in 1993 in US dollars. The following industries were at the top of the list for average cost (cost per worker): taxicabs, bituminous coal and lignite mining, logging, crushed stone, oil field services, water transportation services, sand and gravel, and trucking. Industries high on the total-cost list were trucking, eating and drinking places, hospitals, grocery stores, nursing homes, motor vehicles, and department stores. Industries at the bottom of the cost-per-worker list included legal services, security brokers, mortgage bankers, security exchanges, and labor union offices. Detailed methodology was developed for ranking industries by total cost and cost per worker. Ranking by total costs provided information on total burden of hazards, and ranking by cost per worker provided information on risk. Industries that ranked high on both lists deserve increased research and regulatory attention.

  12. 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.

  13. Occupational Injuries and Illnesses and Associated Costs in Thailand

    PubMed Central

    Thepaksorn, Phayong; Pongpanich, Sathirakorn

    2014-01-01

    Background The purpose of this study was to enumerate the annual morbidity and mortality incidence and estimate the direct and indirect costs associated with occupational injuries and illnesses in Bangkok in 2008. In this study, data on workmen compensation claims and costs from the Thai Workmen Compensation Fund, Social Security Office of Ministry of Labor, were aggregated and analyzed. Methods To assess costs, this study focuses on direct costs associated with the payment of workmen compensation claims for medical care and health services. Results A total of 52,074 nonfatal cases of occupational injury were reported, with an overall incidence rate of 16.9 per 1,000. The incidence rate for male workers was four times higher than that for female workers. Out of a total direct cost of $13.87 million, $9.88 million were for medical services and related expenses and $3.98 million for compensable reimbursement. The estimated amount of noncompensated lost earnings was an additional $2.66 million. Conclusion Occupational injuries and illnesses contributed to the total cost; it has been estimated that workers' compensation covers less than one-half to one-tenth of this cost. PMID:25180136

  14. Results of routine restaurant inspections can predict outbreaks of foodborne illness: the Seattle-King County experience.

    PubMed Central

    Irwin, K; Ballard, J; Grendon, J; Kobayashi, J

    1989-01-01

    To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foodborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle-King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results. PMID:2705592

  15. 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

  16. 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

  17. Foodborne Parasites

    USDA-ARS?s Scientific Manuscript database

    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 ...

  18. Patient Attitudes Regarding the Cost of Illness in Cancer Care

    PubMed Central

    Varner, Ashley; Ellis, Erin; Ebner, Stephen; Moxley, John; Siegrist, Erika; Weng, David

    2015-01-01

    Background and Purpose. The cost of illness in cancer care and the subsequent distress has attracted scrutiny. Guidelines recommend enhanced discussion of costs, assuming this will reduce both stress and costs. Little is known about patient attitudes about cost considerations influencing treatment decisions. Methods. A convenience-sample survey of patients currently receiving radiation and/or intravenous chemotherapy at an outpatient cancer center was performed. Assessments included prevalence and extent of financial burden, level of financial distress, attitudes about using costs to influence treatment decisions, and frequency or desirability of cost discussions with oncologists. Results. A total of 132 participants (94%) responded. Overall, 47% reported high financial stress, 30.8% felt well informed about costs prior to treatment, and 71% rarely spoke to their oncologists about cost. More than 71% of patients did not want either society’s or personal costs to influence treatment, and this result did not change based on degree of financial stress. Even when asked to assume that lower cost regimens were equally effective, only 28% would definitely want the lower cost regimen. Patients did not believe it was the oncologist’s duty to perform cost discussions. Conclusion. Even insured patients have a high degree of financial distress. Most, including those with the highest levels of distress, did not speak often with oncologists about costs and were strongly adverse to having cost considerations influence choice of regimen. The findings suggest that patients are not cost sensitive with regard to treatment decisions. Oncologists will require improved tools to have meaningful cost discussion, as recommended by the American Society of Clinical Oncology. Implications for Practice: This study raises important questions regarding optimal communication with patients about costs. If patients are not cost sensitive regarding treatment decisions, they will not be full

  19. Concurrent outbreaks of Shigella sonnei and enterotoxigenic Escherichia coli infections associated with parsley: implications for surveillance and control of foodborne illness.

    PubMed

    Naimi, Timothy S; Wicklund, Julie H; Olsen, Sonja J; Krause, Gerard; Wells, Joy G; Bartkus, Joanne M; Boxrud, David J; Sullivan, Maureen; Kassenborg, Heidi; Besser, John M; Mintz, Eric D; Osterholm, Michael T; Hedberg, Craig W

    2003-04-01

    In recent years, the globalization of the food supply and the development of extensive food distribution networks have increased the risk of foodborne disease outbreaks involving multiple states or countries. In particular, outbreaks associated with fresh produce have emerged as an important public health concern. During July and August 1998, eight restaurant-associated outbreaks of shigellosis caused by a common strain of Shigella sonnei occurred in the United States and Canada. The outbreak strain was characterized by unique pulsed-field gel electrophoresis patterns. Epidemiologic investigation determined that the illness was associated with the ingestion of parsley at four restaurants; at the other four restaurants, the majority of the people who contracted the illness ate parsley. Isolates from patrons in two unrelated restaurant-associated enterotoxigenic Escherichia coli (ETEC) outbreaks in Minnesota shared a common serotype and pulsed-field gel electrophoresis (PFGE) pattern. Parsley was the implicated or suspected source of both ETEC outbreaks. In each of the outbreak-associated restaurants, parsley was chopped, held at room temperature, and used as an ingredient or garnish for multiple dishes. Infected food workers at several restaurants may also have contributed to the propagation of the outbreak. The sources of parsley served in outbreak-associated restaurants were traced, and a 1,600-acre farm in Baja California, Mexico, was identified as a likely source of the parsley implicated in six of the seven Shigella outbreaks and as a possible source of the parsley implicated in the two ETEC outbreaks. Global food supplies and large distribution networks demand strengthened laboratory and epidemiologic capacity to enable state and local public health agencies to conduct foodborne disease surveillance and to promote effective responses to multistate outbreaks.

  20. 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

  1. Eggs and Foodborne Disease

    USDA-ARS?s Scientific Manuscript database

    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 ...

  2. Care fragmentation, quality, and costs among chronically ill patients.

    PubMed

    Frandsen, Brigham R; Joynt, Karen E; Rebitzer, James B; Jha, Ashish K

    2015-05-01

    To assess the relationship between care fragmentation and both quality and costs of care for commercially insured, chronically ill patients. We used claims data from 2004 to 2008 for 506,376 chronically ill, privately insured enrollees of a large commercial insurance company to construct measures of fragmentation. We included patients in the sample if they had chronic conditions in any of the following categories: cardiovascular disease, diabetes, asthma, arthritis, or migraine. We assigned each patient a fragmentation index based on the patterns of care of their primary care provider (PCP), with care patterns spread across a higher number of providers considered to be more fragmented. We used regression analysis to examine the relationship between fragmentation and both quality and cost outcomes. Patients of PCPs in the highest quartile of fragmentation had a higher chance of having a departure from clinical best practice (32.8%, vs 25.9% among patients of PCPs in the lowest quartile of fragmentation; P < .001). Similarly, patients of PCPs with high fragmentation had higher rates of preventable hospitalizations (9.1% in highest quartile vs 7.1% in lowest quartile; P < .001). High fragmentation was associated with $4542 higher healthcare spending ($10,396 in the highest quartile vs $5854 in the lowest quartile; P < .001). We found similar or larger effects on quality and costs among patients when we examined the most frequently occurring disease groups individually. Chronically ill patients whose primary care providers offer highly fragmented care more often experience lapses in care quality and incur greater healthcare costs.

  3. Attributing human foodborne illness to food sources and water in Latin America and the Caribbean using data from outbreak investigations.

    PubMed

    Pires, Sara M; Vieira, Antonio R; Perez, Enrique; Lo Fo Wong, Danilo; Hald, Tine

    2012-01-16

    Foodborne pathogens are responsible for an increasing burden of disease worldwide. Knowledge on the contribution of different food sources and water for disease is essential to prioritize food safety interventions and implement appropriate control measures. Source attribution using outbreak data utilizes readily available data from outbreak surveillance to estimate the contribution of different sources to human disease. We developed a probabilistic model based on outbreak data that attributes human foodborne disease by various bacterial pathogens to sources in Latin America and the Caribbean (LA&C). Foods implicated in outbreaks were classified by their ingredients as simple foods (i.e. belonging to one single food category), or complex foods (i.e. belonging to multiple food categories). For each agent, the data from simple-food outbreaks were summarized, and the proportion of outbreaks caused by each category was used to define the probability that an outbreak was caused by a source. For the calculation of the number of outbreaks attributed to each source, simple-food outbreaks were attributed to the single food category in question, and complex-food outbreaks were partitioned to each category proportionally to the estimated probability. We analysed all bacterial pathogens together, focused on important bacterial pathogens separately, and, when data were sufficient, performed analyses by country, decade and location. Between 1993 and 2010, 6313 bacterial outbreaks were reported by 20 countries. In general, the most important sources of bacterial disease were meat, dairy products, water and vegetables in the 1990s, and eggs, vegetables, and grains and beans in the 2000s. We observed fluctuations of the most important sources of disease for each pathogen between decades and countries, which may be a consequence of changes in the control of zoonotic disease over the years, of changes in food consumption habits, or of changes in public health focus and availability of

  4. 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…

  5. Evaluation of a structured expert elicitation estimating the proportion of illness acquired by foodborne transmission for nine enteric pathogens in Australia.

    PubMed

    Vally, H; Glass, K; Ford, L; Hall, G; Kirk, M D; Shadbolt, C; Veitch, M G K; Fullerton, K E; Musto, J; Becker, N

    2016-04-01

    Estimates of the proportion of illness transmitted by food for different enteric pathogens are essential for foodborne burden-of-disease studies. Owing to insufficient scientific data, a formal synthesis of expert opinion, an expert elicitation, is commonly used to produce such estimates. Eleven experts participated in an elicitation to estimate the proportion of illnesses due to food in Australia for nine pathogens over three rounds: first, based on their own knowledge alone; second, after being provided with systematic reviews of the literature and Australian data; and finally, at a workshop where experts reflected on the evidence. Estimates changed significantly across the three rounds (P = 0·002) as measured by analysis of variance. Following the workshop in round 3, estimates showed smoother distributions with significantly less variation for several pathogens. When estimates were combined to provide combined distributions for each pathogen, the width of these combined distributions reflected experts' perceptions of the availability of evidence, with narrower intervals for pathogens for which evidence was judged to be strongest. Our findings show that the choice of expert elicitation process can significantly influence final estimates. Our structured process - and the workshop in particular - produced robust estimates and distributions appropriate for inclusion in burden-of-disease studies.

  6. The PANDORA project: results of the cost of illness analysis.

    PubMed

    Degli Esposti, E; Berto, P; Ruffo, P; Buda, S; Degli Esposti, L; Sturani, A

    2001-05-01

    To evaluate the cost of illness from hypertension for the Italian National Health System (NHS). A prospective analysis was carried out on clinical and economic data recorded in the general practitioners' (GPs) database. Twenty-one GPs working in the Ravenna area in Italy took part in the project on a voluntary basis. The study included 1047 hypertensive patients enrolled between 1 June and 31 December 1997 and continued for 365 days from the date of enrolment. The following costs were calculated: antihypertensive drugs, laboratory tests and instrumental procedures, GP visits for blood pressure control, specialist visits, casualty visits, hospitalisation due to cardiovascular problems. In the whole sample, the most relevant cost is due to antihypertensive drugs (42.7%), followed by hospital admission (28.4%), GP visits (15.1%) and tests (10.6%). The total mean cost was significantly lower in incident (no previous treatment) than in prevalent patients (already treated) (457 512 vs 725 573 Italian Lira (ITL), P < 0.05) and in older rather than in younger patients (1171 410 vs 796 452 (ITL) P < 0.05). (In the text the equivalent is given in Euros, Pounds Sterling and US dollars). Our study should be considered as preliminary, nevertheless it could represent a step towards the evaluation of the true cost of hypertension.

  7. Comprehensive Cost of Illness of Three Major Diseases in Japan.

    PubMed

    Matsumoto, Kunichika; Hanaoka, Simpei; Wu, Yinghui; Hasegawa, Tomonori

    2017-09-01

    The purpose of this study was to calculate the burden of 3 major diseases (cancer, heart disease, and cerebrovascular disease [CVD]) using the cost of illness (COI) method. As a modification of the original COI method developed by Rice, the estimated comprehensive COI (C-COI) of cancer, heart disease, and CVD were redefined. C-COI consists of medical direct, morbidity, and mortality costs (MtCs; components of the original COI); long-term care (LTC) direct cost (DC); and family burden (FB). LTC DC is an insurance benefit, and FB is the unpaid care cost incurred by the family, relatives, and friends for in-home and in-community medical expenses (opportunity cost). All costs for 2008-2014 were calculated using official statistics of the Japanese government. The C-COI of cancer, heart disease, and CVD in 2014 amounted to 9815 billion Japanese yen (JPY), 4461 billion JPY, and 6501 billion JPY, respectively. As for the composition of the C-COI, the MtC accounted for the largest portion of medical expenses for treatment of cancer (63.5%) and heart disease (50.6%), but the DC (LTC) accounted for the largest portion of medical expenses for CVD (26.7%). This study, based on government statistics, demonstrated that C-COI, including LTC DC and FB, could be estimated, and the latter was found to be a major cost component in CVD, whereas long-term disability is a salient feature of the disease. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. 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.

  9. 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.

  10. Economic costs of drug abuse: financial, cost of illness, and services.

    PubMed

    Cartwright, William S

    2008-03-01

    This article examines costs as they relate to the financial costs of providing drug abuse treatment in private and public health plans, costs to society relating to drug abuse, and many smaller costing studies of various stakeholders in the health care system. A bibliography is developed from searches across PubMed, Web of Science, and other bibliographic sources. The review indicates that a wide collection of cost findings is available to policy makers. For example, the financial aspects of health plans have been dominated by considerations of actuarial costs of parity for drug abuse treatment. Cost-of-illness methods have been developed and extended to drug abuse costing to measure the national level of burden and are important to the economic evaluation of interventions at the program level. Costing is done in many small and focused studies, reflecting the interests of different stakeholders in the health care system. For costs in programs and health plans, as well as cost offsets of the impact of substance abuse treatment on medical expenditures, findings are surprisingly important to policy makers. Maintaining ongoing research that is highly policy relevant from the point of view of health services, more is needed on costing concepts and measurement applications.

  11. Estimating Foodborne Gastroenteritis, Australia

    PubMed Central

    Kirk, Martyn D.; Becker, Niels; Gregory, Joy E.; Unicomb, Leanne; Millard, Geoffrey; Stafford, Russell; Lalor, Karin

    2005-01-01

    We estimated for Australia the number of cases, hospitalizations, and deaths due to foodborne gastroenteritis in a typical year, circa 2000. The total amount of infectious gastroenteritis was measured by using a national telephone survey. The foodborne proportion was estimated from Australian data on each of 16 pathogens. To account for uncertainty, we used simulation techniques to calculate 95% credibility intervals (CrI). The estimate of incidence of gastroenteritis in Australia is 17.2 million (95% confidence interval 14.5–19.9 million) cases per year. We estimate that 32% (95% CrI 24%–40%) are foodborne, which equals 0.3 (95% CrI 0.2–0.4) episodes per person, or 5.4 million (95% CrI 4.0–6.9 million) cases annually in Australia. Norovirus, enteropathogenic Escherichia coli, Campylobacter spp., and Salmonella spp. cause the most illnesses. In addition, foodborne gastroenteritis causes ≈15,000 (95% CrI 11,000–18,000) hospitalizations and 80 (95% CrI 40–120) deaths annually. This study highlights global public health concerns about foodborne diseases and the need for standardized methods, including assessment of uncertainty, for international comparison. PMID:16102316

  12. Cost-of-illness studies: a guide to critical evaluation.

    PubMed

    Larg, Allison; Moss, John R

    2011-08-01

    Cost-of-illness (COI) studies aim to assess the economic burden of health problems on the population overall, and they are conducted for an ever widening range of health conditions and geographical settings. While they attract much interest from public health advocates and healthcare policy makers, inconsistencies in the way in which they are conducted and a lack of transparency in reporting have made interpretation difficult, and have ostensibly limited their usefulness. Yet there is surprisingly little in the literature to assist the non-expert in critically evaluating these studies. This article aims to provide non-expert readers with a straightforward guide to understanding and evaluating traditional COI studies. The intention is to equip a general audience with an understanding of the most important issues that influence the validity of a COI study, and the ability to recognize the most common limitations in such work.

  13. Socio-economic costs of osteoarthritis: a systematic review of cost-of-illness studies.

    PubMed

    Puig-Junoy, Jaume; Ruiz Zamora, Alba

    2015-04-01

    The burden of illness that can be attributed to osteoarthritis is considerable and ever increasing. The aim of this systematic review is to analyze currently available data derived from cost-of-illness studies on the healthcare and non-healthcare costs of osteoarthritis. PubMed, Index Medicus Español (IME), and the Spanish Database of Health Sciences [Índice Bibliográfico Español en Ciencias de la Salud (IBECS)] were searched up to the end of April 2013. This study adhered to the PRISMA guidelines. Articles were reviewed and the study quality assessed by two independent investigators with consensus resolution of discrepancies. We identified 39 studies that investigated the socio-economic cost of osteoarthritis. Only nine studies took a social perspective. Rather than estimating the incremental cost of osteoarthritis, nine studies estimated the total cost of treating patients with osteoarthritis without a control for comorbidity. The other 30 studies determined the incremental cost with or without a control group. Only nine studies assessed a comprehensive list of healthcare resources. The annual incremental healthcare costs of generalized osteoarthritis ranged from €705 to €19,715. The annual incremental non-healthcare-related costs of generalized osteoarthritis ranged from €432 to €11,956. The study concludes that the social cost of osteoarthritis could be between 0.25% and 0.50% of a country׳s GDP. This should be considered in order to foster studies that take into account both healthcare and non-healthcare costs. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Application of the Central Limit Theorem in microbial risk assessment: high number of servings reduces the Coefficient of Variation of food-borne burden-of-illness.

    PubMed

    Pérez-Rodríguez, Fernando; Zwietering, Marcel H

    2012-02-15

    The Central Limit Theorem (CLT) is proposed as a means of understanding microbial risk in foods from a Public Health perspective. One variant of the CLT states that as the number of random variables, each with a finite mean and variance, increases (→∞), the distribution of the sum (or mean) of those variables approximates a normal distribution. On the basis of the CLT, the hypothesis introduced by this paper states that the Coefficient of Variation (CV) of the annual number of food-borne illness cases decreases as a result of a larger number of exposures (or servings) (n). Second-order Monte-Carlo analysis and classical statistics were used to support the hypothesis, based on existing risk models on Listeria monocytogenes in deli meat products focused on elderly people in the United States. Likewise, the hypothesis was tested on epidemiological data of annual incidence of salmonellosis and listeriosis in different countries (i.e. different n). Although different sources of error affected the accuracy of the results, both the Monte-Carlo analysis (in silico) and epidemiological data (in vivo), especially for salmonellosis, demonstrated that the CV of the annual number of cases decreased as n increased as stated by the CLT. Furthermore, results from this work showed that classical statistical methods can be helpful to provide reliable risk estimates based on simple and well-established statistical principles.

  15. 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

  16. The cost of borderline personality disorder: societal cost of illness in BPD-patients.

    PubMed

    van Asselt, A D I; Dirksen, C D; Arntz, A; Severens, J L

    2007-09-01

    Borderline personality disorder (BPD) is a highly prevalent, chronic condition. Because of its very problematic nature BPD is expected to be associated with substantial societal costs, although this has never been comprehensively assessed. Estimate the societal cost of BPD in the Netherlands. We used a prevalence-based bottom-up approach with a sample of 88 BPD patients who enrolled in a multicenter clinical trial comparing two kinds of outpatient psychotherapy. Costs were assessed by means of a structured interview, covering all healthcare costs, medication, informal care, productivity losses, and out-of-pocket expenses. Only BPD-related costs were included. All costs were expressed in Euros for the year 2000. A bootstrap procedure was performed to determine statistical uncertainty. All patients had been diagnosed with BPD using DSM-IV criteria. Mean age was 30.5 years and 92% was female. Based on a prevalence of 1.1% and an adult population of 11,990,942, we derived that there were 131,900 BPD patients in the Netherlands. Total bootstrapped yearly cost of illness was 2,222,763,789 euros (1,372,412,403-3,260,248,300 euros), only 22% was healthcare-related. Costs per patient were 16,852 euros. Although healthcare costs of non-institutionalized Borderline patients might not be disproportionate, total societal costs are substantial.

  17. Campylobacter jejuni--an emerging foodborne pathogen.

    PubMed Central

    Altekruse, S. F.; Stern, N. J.; Fields, P. I.; Swerdlow, D. L.

    1999-01-01

    Campylobacter jejuni is the most commonly reported bacterial cause of foodborne infection in the United States. Adding to the human and economic costs are chronic sequelae associated with C. jejuni infection--Guillian-Barré syndrome and reactive arthritis. In addition, an increasing proportion of human infections caused by C. jejuni are resistant to antimicrobial therapy. Mishandling of raw poultry and consumption of undercooked poultry are the major risk factors for human campylobacteriosis. Efforts to prevent human illness are needed throughout each link in the food chain. PMID:10081669

  18. Campylobacter jejuni--an emerging foodborne pathogen.

    PubMed

    Altekruse, S F; Stern, N J; Fields, P I; Swerdlow, D L

    1999-01-01

    Campylobacter jejuni is the most commonly reported bacterial cause of foodborne infection in the United States. Adding to the human and economic costs are chronic sequelae associated with C. jejuni infection--Guillian-Barré syndrome and reactive arthritis. In addition, an increasing proportion of human infections caused by C. jejuni are resistant to antimicrobial therapy. Mishandling of raw poultry and consumption of undercooked poultry are the major risk factors for human campylobacteriosis. Efforts to prevent human illness are needed throughout each link in the food chain.

  19. Economic costs of obesity in Thailand: a retrospective cost-of-illness study

    PubMed Central

    2014-01-01

    Background Over the last decade, the prevalence of obesity (BMI ≥ 25 kg/m2) in Thailand has been rising rapidly and consistently. Estimating the cost of obesity to society is an essential step in setting priorities for research and resource use and helping improve public awareness of the negative economic impacts of obesity. This prevalence-based, cost-of-illness study aims to estimate the economic costs of obesity in Thailand. Methods The estimated costs in this study included health care cost, cost of productivity loss due to premature mortality, and cost of productivity loss due to hospital-related absenteeism. The Obesity-Attributable Fraction (OAF) was used to estimate the extent to which the co-morbidities were attributable to obesity. The health care cost of obesity was further estimated by multiplying the number of patients in each disease category attributable to obesity by the unit cost of treatment. The cost of productivity loss was calculated using the human capital approach. Results The health care cost attributable to obesity was estimated at 5,584 million baht or 1.5% of national health expenditure. The cost of productivity loss attributable to obesity was estimated at 6,558 million baht - accounting for 54% of the total cost of obesity. The cost of hospital-related absenteeism was estimated at 694 million baht, while the cost of premature mortality was estimated at 5,864 million baht. The total cost of obesity was then estimated at 12,142 million baht (725.3 million US$PPP, 16.74 baht =1 US$PPP accounting for 0.13% of Thailand’s Gross Domestic Product (GDP). Conclusions Obesity imposes a substantial economic burden on Thai society especially in term of health care costs. Large-scale comprehensive interventions focused on improving public awareness of the cost of and problems associated with obesity and promoting a healthy lifestyle should be regarded as a public health priority. PMID:24690106

  20. 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.

  1. An Outbreak of Foodborne Illness Caused by Enteroaggregative Escherichia coli in a High School in South Korea.

    PubMed

    Shin, Jaeseung; Oh, Sung-Suk; Oh, Kyung-Hwan; Park, Ji-Hyuk; Jang, Eun Jung; Chung, Gyung Tae; Yoo, Cheon-Kwon; Bae, Geun-Ryang; Cho, Seung-Hak

    2015-01-01

    In June 2013, a diarrheal outbreak occurred among high school students in Incheon, South Korea. We investigated the outbreak to identify the pathogen and mode of transmission. A case-control study using a self-administered questionnaire was conducted by local authorities and the Korean Centers for Disease Control and Prevention. Bacterial cultures of stool samples, environmental samples, and samples of preserved food items were prepared. PCR, serotyping, and pulsed-field gel electrophoresis (PFGE) were used to identify and characterize the outbreak-related pathogen. We identified 54 cases of gastroenteritis, with symptoms including diarrhea, abdominal pain, and nausea. None of the food items served in the high school cafeteria were significantly associated with illness, although the odds ratio for kippered trotters mixed with vegetables was relatively high (odds ratio: 2.92, 95% confidence interval: 0.62-13.69). Enteroaggregative Escherichia coli (EAEC) was isolated from this item and the stool samples from 22 symptomatic students and 4 asymptomatic food handlers. The PFGE patterns of EAEC isolated from these sources were indistinguishable. This outbreak was caused by EAEC, and kippered trotters mixed with vegetables, perhaps contaminated by asymptomatic food handlers, were linked to the outbreak. This case-control study highlights the importance of safe food preparation.

  2. Cost of illness for outpatients attending public and private hospitals in Bangladesh.

    PubMed

    Pavel, Md Sadik; Chakrabarty, Sayan; Gow, Jeff

    2016-10-10

    A central aim of Universal Health Coverage (UHC) is protection for all against the cost of illness. In a low income country like Bangladesh the cost burden of health care in tertiary facilities is likely to be significant for most citizens. This cost of an episode of illness is a relatively unexplored policy issue in Bangladesh. The objective of this study was to estimate an outpatient's total cost of illness as result of treatment in private and public hospitals in Sylhet, Bangladesh. The study used face to face interviews at three hospitals (one public and two private) to elicit cost data from presenting outpatients. Other socio-economic and demographic data was also collected. A sample of 252 outpatients were randomly selected and interviewed. The total cost of outpatients comprises direct medical costs, non-medical costs and the indirect costs of patients and caregivers. Indirect costs comprise travel and waiting times and income losses associated with treatment. The costs of illness are significant for many of Bangladesh citizens. The direct costs are relatively minor compared to the large indirect cost burden that illness places on households. These indirect costs are mainly the result of time off work and foregone wages. Private hospital patients have higher average direct costs than public hospital patients. However, average indirect costs are higher for public hospital patients than private hospital patients by a factor of almost two. Total costs of outpatients are higher in public hospitals compared to private hospitals regardless of patient's income, gender, age or illness. Overall, public hospital patients, who tend to be the poorest, bear a larger economic burden of illness and treatment than relatively wealthier private hospital patients. The large economic impacts of illness need a public policy response which at a minimum should include a national health insurance scheme as a matter of urgency.

  3. Assessment of physician knowledge and practices concerning Shiga toxin-producing Escherichia coli infection and enteric illness, 2009, Foodborne Diseases Active Surveillance Network (FoodNet).

    PubMed

    Clogher, Paula; Hurd, Sharon; Hoefer, Dina; Hadler, James L; Pasutti, Lauren; Cosgrove, Shaun; Segler, Suzanne; Tobin-D'Angelo, Melissa; Nicholson, Cindy; Booth, Hillary; Garman, Katie; Mody, Rajal K; Gould, L Hannah

    2012-06-01

    Shiga toxin-producing Escherichia coli (STEC) infections cause acute diarrheal illness and sometimes life-threatening hemolytic uremic syndrome (HUS). Escherichia coli O157 is the most common STEC, although the number of reported non-O157 STEC infections is growing with the increased availability and use of enzyme immunoassay testing, which detects the presence of Shiga toxin in stool specimens. Prompt and accurate diagnosis of STEC infection facilitates appropriate therapy and may improve patient outcomes. We mailed 2400 surveys to physicians in 8 Foodborne Diseases Active Surveillance Network (FoodNet) sites to assess their knowledge and practices regarding STEC testing, treatment, and reporting, and their interpretation of Shiga toxin test results. Of 1102 completed surveys, 955 were included in this analysis. Most (83%) physicians reported often or always ordering a culture of bloody stool specimens; 49% believed that their laboratory routinely tested for STEC O157, and 30% believed that testing for non-O157 STEC was also included in a routine stool culture. Forty-two percent of physicians were aware that STEC, other than O157, can cause HUS, and 34% correctly interpreted a positive Shiga toxin test result. All STEC knowledge-related factors were strongly associated with correct interpretation of a positive Shiga toxin test result. Identification and management of STEC infection depends on laboratories testing for STEC and physicians ordering and correctly interpreting results of Shiga toxin tests. Although overall knowledge of STEC was low, physicians who had more knowledge were more likely to correctly interpret a Shiga toxin test result. Physician knowledge of STEC may be modifiable through educational interventions.

  4. Costs of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin

    PubMed Central

    Kramer, Michael H.; Blair, Kathleen A.; Addiss, David G.; Davis, Jeffrey P.; Haddix, Anne C.

    2003-01-01

    To assess the total medical costs and productivity losses associated with the 1993 waterborne outbreak of cryptosporidiosis in Milwaukee, Wisconsin, including the average cost per person with mild, moderate, and severe illness, we conducted a retrospective cost-of-illness analysis using data from 11 hospitals in the greater Milwaukee area and epidemiologic data collected during the outbreak. The total cost of outbreak-associated illness was $96.2 million: $31.7 million in medical costs and $64.6 million in productivity losses. The average total costs for persons with mild, moderate, and severe illness were $116, $475, and $7,808, respectively. The potentially high cost of waterborne disease outbreaks should be considered in economic decisions regarding the safety of public drinking water supplies. PMID:12702221

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

    PubMed

    Hyun, Kyung-Rae; Kang, Sungwook; Lee, Sunmi

    2014-09-01

    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. 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. 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. 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.

  6. Estimating the employment and earnings costs of mental illness: recent developments in the United States.

    PubMed

    Marcotte, D E; Wilcox-Gök, V

    2001-07-01

    Substantial attention has recently been focused on both the prevalence and consequences of mental illness. Generally, public interest in the costs of mental illness has been limited to the direct costs of treating the mentally ill. In this paper, we consider the magnitude and importance of a major component of the indirect costs of mental illness: employment and earnings losses. We first describe the technical difficulties involved in estimating these costs. We then describe new data and recent advances in the United States that have improved our ability to make such estimates. Our conclusions from the recent research are that each year in the United States 5-6 million workers between the ages of 16 and 54 lose, fail to seek, or cannot find employment as a consequence of mental illness. Among those who do work, we estimate that mental illness decreases annual income by an amount between $3,500 and $6,000. We then discuss an emerging challenge to the traditional method for arriving at such estimates: the friction cost approach. We describe both the conceptual and technical differences between the friction cost method and the traditional human capital approach. We conclude that while economic context has much to do with whether one relies on human capital or friction cost estimates, each can offer useful information about labor market losses due to mental illness.

  7. Perceptions of occupational injury and illness costs by size of organization.

    PubMed

    Haslam, C; Haefeli, K; Haslam, R

    2010-09-01

    Little is known about how organizations perceive and monitor occupational injury and illness costs. To explore perceptions of injury and illness costs, the extent to which organizations monitor their impact, attitudes towards this practice and views on using cost information in health and safety campaigns. Interviews were conducted with 212 representatives from 49 small- and medium-sized enterprises (SMEs) and 80 large organizations from a range of industry sectors. Health and safety investments were driven by a range of factors, of which cost reduction was only one. Human costs were also considered important. Injuries were perceived to represent a substantial business cost by 10% of respondents from SMEs and 56% of those from large organizations. Most were uncertain about the financial impact of work-related illness. No organizations had attempted to monitor occupational illness costs. Injury costs had been assessed within 3 SMEs and 30 large organizations. Only 12% of SME representatives recognized the benefits of costing health and safety failures and around half were unreceptive to the use of cost information in health and safety promotions. Two-thirds of those from large organizations recognized some benefit in measuring costs, and over three-quarters welcomed the provision of industry-specific information. Provision of information that focuses solely on the economic implications of occupational injury and illness may be of limited value and agencies involved in the promotion of health and safety should incorporate a range of information, taking into account the needs and concerns of different sectors.

  8. Rates and costs of respiratory illness in coal mining: a cross-industry comparative analysis.

    PubMed

    Van Houtven, George; Reed, W Randy; Biddle, Elyce A; Volkwein, John C; Clayton, Laurel; Finkelstein, Eric

    2010-06-01

    To estimate the prevalence and costs of respiratory illness for workers in coal mining, compared with other US industries. Using 5 years of insurance claims data for an annual average of 96,240 adult males, we model the probability and costs of respiratory illness as a function of workers' industry and other factors. Controlling for nonindustry factors, workers in coal mining had significantly higher rates of respiratory illness claims (by 2.1% to 3.3% points) compared with other mining, agriculture, construction, and manufacturing. For coal mining workers with respiratory illness, annual medical care costs for these claims were also significantly higher (by $111 to $289). Surprisingly, drug costs were mostly lower (by $17 to $268). Our findings underscore the continued importance and potential cost effectiveness of measures to protect miners from harmful occupational exposures, particularly to coal dust.

  9. [Foodborne disease outbreaks in 2006 report of the National Foodborne Disease Surveillance Network, China].

    PubMed

    Chen, Yan; Guo, Yunchang; Wang, Zhutian; Liu, Xiumei; Liu, Hong; Dai, Yue; Tang, Zhenzhu; Wen, Jian

    2010-05-01

    To study the epidemiological characteristics of foodborne disease outbreaks in China in 2006. The foodborne diseases data collected by the National Foodborne Disease Surveillance Network in 2006 were analyzed. There were 594 outbreaks of foodborne disease reported from 18 provinces in 2006, which caused illness in 13849 persons and death in 67. Among outbreaks for which the etiology was determined, microbial pathogens caused the largest percentage of outbreaks (48.3%) and the largest percentage of cases (63.3%), chemical agents, 24.8% of outbreaks and 15.5% of cases, and animal and plant agents, 23.5% of outbreaks and 17.7% of cases. As discovered by the National Foodborne Disease Surveillance Network, microbial foodborne disease remains a major public health problem in China, and the awareness to report foodborne disease incidents need to be intensified in the future.

  10. Societal Burden of Clinically Anxious Youth Referred for Treatment: A Cost-of-illness Study

    PubMed Central

    Dirksen, Carmen D.; Bögels, 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 (n = 41). To examine the convergent validity, bottom-up acquired costs derived from cost diaries were compared to top-down acquired costs obtained from national registrations. Bottom-up acquired costs measured by means of cost diaries amounted to €2,748 per family of a clinically referred anxious child per annum. Societal costs of families with clinically anxious children were almost 21 times as high compared to families from the general population. With respect to convergent validity, total health care costs using the bottom-up approach from clinically anxious children were quite comparable to those of top-down data of anxious children, although costs within the subcategories differed considerably. Clinical anxiety disorders in childhood cost the Dutch society more than 20 million euros a year. Based on results of discriminate and convergent validity, the cost diary seems a valid method in establishing cost-of-illness in childhood anxiety disorders. PMID:18214667

  11. Societal burden of clinically anxious youth referred for treatment: a cost-of-illness study.

    PubMed

    Bodden, Denise H M; Dirksen, Carmen D; Bögels, Susan M

    2008-05-01

    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 (n = 41). To examine the convergent validity, bottom-up acquired costs derived from cost diaries were compared to top-down acquired costs obtained from national registrations. Bottom-up acquired costs measured by means of cost diaries amounted to Euro 2,748 per family of a clinically referred anxious child per annum. Societal costs of families with clinically anxious children were almost 21 times as high compared to families from the general population. With respect to convergent validity, total health care costs using the bottom-up approach from clinically anxious children were quite comparable to those of top-down data of anxious children, although costs within the subcategories differed considerably. Clinical anxiety disorders in childhood cost the Dutch society more than 20 million euros a year. Based on results of discriminate and convergent validity, the cost diary seems a valid method in establishing cost-of-illness in childhood anxiety disorders.

  12. 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.

  13. 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.

  14. Health sector costs of self-reported food allergy in Europe: a patient-based cost of illness study.

    PubMed

    Fox, Margaret; Mugford, Miranda; Voordouw, Jantine; Cornelisse-Vermaat, Judith; Antonides, Gerrit; de la Hoz Caballer, Belen; Cerecedo, Inma; Zamora, Javier; Rokicka, Ewa; Jewczak, Maciej; Clark, Allan B; Kowalski, Marek L; Papadopoulos, Nikos; Knulst, Anna C; Seneviratne, Suranjith; Belohlavkova, Simona; Asero, Roberto; de Blay, Frederic; Purohit, Ashok; Clausen, Michael; Flokstra de Blok, Bertine; Dubois, Anthony E; Fernandez-Rivas, Montserrat; Burney, Peter; Frewer, Lynn J; Mills, Clare E N

    2013-10-01

    Food allergy is a recognized health problem, but little has been reported on its cost for health services. The EuroPrevall project was a European study investigating the patterns, prevalence and socio-economic cost of food allergy. To investigate the health service cost for food-allergic Europeans and the relationship between severity and cost of illness. Participants recruited through EuroPrevall studies in a case-control study in four countries, and cases only in five countries, completed a validated economics questionnaire. Individuals with possible food allergy were identified by clinical history, and those with food-specific immunoglobulin E were defined as having probable allergy. Data on resource use were used to estimate total health care costs of illness. Mean costs were compared in the case-control cohorts. Regression analysis was conducted on cases from all 9 countries to assess impact of country, severity and age group. Food-allergic individuals had higher health care costs than controls. The mean annual cost of health care was international dollars (I$)2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95% confidence interval I$324-I$1530). A similar result was found for adults in each country, and for children, and was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. Food allergy is associated with higher health care costs. Severity of allergic symptoms is a key explanatory factor.

  15. Willingness to pay and cost of illness for changes in health capital depreciation.

    PubMed

    Ried, W

    1996-01-01

    The paper investigates the relationship between the willingness to pay and the cost of illness approach with respect to the evaluation of economic burden due to adverse health effects. The basic intertemporal framework is provided by Grossman's pure investment model, while effects on individual morbidity are taken to be generated by marginal changes in the rate of health capital depreciation. More specifically, both the simple example of purely temporary changes and the more general case of persistent variations in health capital depreciation are discussed. The analysis generates two principal findings. First, for a class of identical individuals cost as measured by the cost of illness approach is demonstrated to provide a lower bound on the true welfare cost to the individual, i.e. cost as given by the willingness to pay approach. Moreover, the cost of illness is increasing in the size of the welfare loss. Second, if one takes into account the possible heterogeneity of individuals, a clear relationship between the cost values supplied by the two approaches no longer exists. As an example, the impact of variations in either financial wealth or health capital endowment is discussed. Thus, diversity in individual type turns out to blur the link between cost of illness and the true economic cost.

  16. The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review.

    PubMed

    Oliva-Moreno, Juan; Trapero-Bertran, Marta; Peña-Longobardo, Luz Maria; Del Pozo-Rubio, Raúl

    2017-03-01

    There is a growing interest in incorporating informal care in cost-of-illness studies as a relevant part of the economic impact of some diseases. The aim of this paper was to review the recent literature valuating the costs of informal care in a group of selected diseases from 2005 to 2015. We carried out a systematic review on the economic impact of informal care, focusing on six selected diseases: arthritis or osteoarthritis, cancer, dementia, mental diseases, multiple sclerosis and stroke. We selected 91 cost-of-illness articles. The average weight attributed to the informal care cost over the total cost was highly relevant for dementia, stroke, mental diseases, cancer and multiple sclerosis. The most frequent valuation method applied was the opportunity cost method, followed by the proxy good method. The annual cost of informal care presented a high variability depending on the disease and geographic location. Distinguishing by type of illness, the disease with the highest annual value of informal caregiving was dementia, followed by mental illness and multiple sclerosis. The average hourly unit cost was €11.43 (2015 values), varying noticeably depending on the geographic location. This paper identifies several aspects that should be enhanced to promote comparability between studies and countries, and it sends key messages for incorporating informal care costs to adequately measure the economic impact of diseases.

  17. The costs of respiratory illnesses arising from Florida gulf coast Karenia brevis blooms.

    PubMed

    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

    2009-08-01

    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. 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. 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. 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. 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.

  18. The impact on taxpayer costs of a jail diversion program for people with serious mental illness.

    PubMed

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

    2013-12-01

    Mental illness is prevalent among those incarcerated. Jail diversion is one means by which people with mental illness are treated in the community - often with some criminal justice system oversight - instead of being incarcerated. Jail diversion may lead to immediate reductions in taxpayer costs because the person is no longer significantly engaged with the criminal justice system. It may also lead to longer term reductions in costs because effective treatment may ameliorate symptoms, reduce the number of future offenses, and thus subsequent arrests and incarceration. This study estimates the impact on taxpayer costs of a model jail diversion program for people with serious mental illness. Administrative data on criminal justice and treatment events were combined with primary and secondary data on the costs of each event. Propensity score methods and a quasi-experimental design were used to compare treatment and criminal justice costs for a group of people who were diverted to a group of people who were not diverted. Diversion was associated with approximately $2800 lower taxpayer costs per person 2 years after the point of diversion (p<.05). Reductions in criminal justice costs drove this result. Jail diversion for people with mental illness may thus be justified fiscally. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. 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

  20. Iatrogenic high-risk populations and foodborne disease.

    PubMed

    Acheson, David

    2013-09-01

    Certain subsets of the population are at a greater risk of acquiring foodborne infections and have a greater propensity to develop serious complications. Susceptibility to foodborne infection is dependent on numerous factors that largely relate to the status of an individual's defense systems in regard to both preventing and mitigating foodborne illness. Key examples include the increased susceptibility of pregnant women to listeriosis and increased severity of enteric bacterial infections in patients with AIDS. Clinicians must communicate with higher-risk patients about the risks of foodborne illness, and provide patients with information regarding safe food-handling practices.

  1. The impact of firms' adjustments on the indirect cost of illness.

    PubMed

    Jakubczyk, Michał; Koń, Beata

    2017-02-02

    Illness-related absenteeism reduces firms' output, an effect referred to as indirect cost (IC) and often included in cost-of-illness or cost-effectiveness (of health technologies) studies. The companies may foresee this effect and modify hiring or contracting policies. We present a model allowing the estimation of IC with such adjustments. We show that the risk of illness does not change the general shape and properties of the (expected) marginal productivity function. We apply our model to several illustrative examples and show that firm's adjustments impact IC in an ambiguous way, depending on detailed company/market characteristics: in some cases the company reduces the employment (further increasing IC), in another-the opposite happens. Contrary to previous findings, teamwork and shortfall penalties may reduce IC in some settings. Our analysis highlights that IC should be split into the result of companies preparing for and actually experiencing sick leaves.

  2. Burden of epilepsy: a prevalence-based cost of illness study of direct, indirect and intangible costs for epilepsy.

    PubMed

    Gao, Lan; Xia, Li; Pan, Song-Qing; Xiong, Tao; Li, Shu-Chuen

    2015-02-01

    We aimed to gauge the burden of epilepsy in China from a societal perspective by estimating the direct, indirect and intangible costs. Patients with epilepsy and controls were enrolled from two tertiary hospitals in China. Patients were asked to complete a Cost-of-Illness (COI), Willingness-to-Pay (WTP) questionnaires, two utility elicitation instruments and Mini Mental State Examination (MMSE). Healthy controls only completed WTP questionnaire, and utility instruments. Univariate analyses were performed to investigate the differences in cost on the basis of different variables, while multivariate analysis was undertaken to explore the predictors of cost/cost component. In total, 141 epilepsy patients and 323 healthy controls were recruited. The median total cost, direct cost and indirect cost due to epilepsy were US$949.29, 501.34 and 276.72, respectively. Particularly, cost of anti-epileptic drugs (AEDs) (US$394.53) followed by cost of investigations (US$59.34), cost of inpatient and outpatient care (US$9.62) accounted for the majority of the direct medical costs. While patients' (US$103.77) and caregivers' productivity costs (US$103.77) constituted the major component of indirect cost. The intangible costs in terms of WTP value (US$266.07 vs. 88.22) and utility (EQ-5D, 0.828 vs. 0.923; QWB-SA, 0.657 vs. 0.802) were both substantially higher compared to the healthy subjects. Epilepsy is a cost intensive disease in China. According to the prognostic groups, drug-resistant epilepsy generated the highest total cost whereas patients in seizure remission had the lowest cost. AED is the most costly component of direct medical cost probably due to 83% of patients being treated by new generation of AEDs. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Cost of illness due to typhoid fever in five Asian countries.

    PubMed

    Poulos, Christine; Riewpaiboon, Arthorn; Stewart, John F; Clemens, John; Guh, Soyeon; Agtini, Magdarina; Anh, Dang Duc; Baiqing, Dong; Bhutta, Zulfiqar; Sur, Dipika; Whittington, Dale

    2011-03-01

    To generate community-based estimates of the public (paid by the government) and private (paid by households) costs of blood culture-confirmed typhoid fever in Hechi, China; North Jakarta, Indonesia; Kolkata, India; Karachi, Pakistan and Hue, Vietnam. To measure out-of-pocket costs of illness and lost earnings, families with culture-proven cases were surveyed 7, 14 and 90 days after onset of illness. Public costs of treatment were measured at local health facilities using a micro costing (bottom-up) method. The costs of hospitalized cases ranged from USD 129 in Kolkata to USD 432 in North Jakarta (hospitalization rates varied from 2% in Kolkata to 40% in Hechi) and the costs of non-hospitalized cases ranged from USD 13 in Kolkata to USD 67 in Hechi. Where costs were highest (Hechi, North Jakarta and Karachi), the bulk of the costs of hospitalized cases was borne by families, comprising up to 15% of annual household income. Although these estimates may understate true costs due to the fact that higher quality treatment may have been provided earlier-than-usual, this multi-country community-based study contributes to evidence on the public and private costs of typhoid fever in developing countries. These cost estimates were used in a cost-effectiveness analysis of typhoid vaccines and will help policymakers respond to World Health Organization's updated typhoid fever immunization recommendations. © 2011 Blackwell Publishing Ltd.

  4. 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.

  5. Human papillomavirus: burden of illness and treatment cost considerations.

    PubMed

    Fox, Paul A; Tung, Mun-Yee

    2005-01-01

    The monetary and personal costs to society of human papillomavirus (HPV) infection are enormous. In order to make a comparison of different treatment methods we reviewed the entire literature on HPV treatment from January 1966 to December 2003 using MEDLINE, with particular reference to published meta-analyses, randomized controlled and comparative studies. Patient-applied therapies offer patients the possibility of convenient and, on the whole, pain-free treatment. Podofilox (podophyllotoxin) and salicylic acid for genital and extragenital warts, respectively, have the additional advantage of being the most cost-effective treatments and, on this basis, they are to be commended as appropriate first-line agents. The second-line treatment of choice for common warts is cryotherapy. For recalcitrant common warts possible options include inosine pranobex with cryotherapy or electrosurgery, imiquimod with paring and occlusion, intralesional bleomycin, or diphencyprone. Alternative first-line and second-line treatments for genital warts would be either some form of surgical removal or imiquimod. The first option may be the cheapest but this has to be balanced against a degree of post-operative morbidity. Limited data from comparative studies do not show any clear difference in efficacy between cryotherapy, trichloroacetic acid, scissor excision, electrosurgery, and laser surgery in the treatment of genital warts, and the cost effectiveness of these therapies is probably similar to that of imiquimod. Cryotherapy and trichloroacetic acid are relatively expensive and inconvenient for patients and should be reserved as third-line treatments with certain exceptions, such as cryotherapy for meatal warts. The duration of treatment is significantly related to the number of warts present, the area covered by the warts, and the length of time the warts have been present. For recalcitrant anogenital warts third-line treatment options that show promise include surgery in combination

  6. Cost of illness of inflammatory bowel disease in the UK: a single centre retrospective study

    PubMed Central

    Bassi, A; Dodd, S; Williamson, P; Bodger, K

    2004-01-01

    Background and aims: The potentially high costs of care associated with inflammatory bowel disease (IBD) are recognised but we have little knowledge of the scale, profile, or determinants of these costs in the UK. This study aimed to describe costs of illness for a group of IBD patients and determine factors associated with increased healthcare costs. Setting: A university hospital serving a target population of approximately 330 000. Patients and methods: A six month cohort of IBD patients receiving any form of secondary care was identified, comprising 307 cases of ulcerative (or indeterminate) colitis and 172 cases of Crohn’s disease. Demographic and clinical data were abstracted from clinical records and individual resource use was itemised for all attributable costs (including extraintestinal manifestations). Item costs were derived from national and local sources. Cost data were expressed as mean six month costs per patient (with 95% confidence interval (CI)) obtained using non-parametric bootstrapping. Determinants of cost were analysed using generalised linear regression modelling. A postal survey of patients was undertaken to examine indirect costs, out of pocket expenses, and primary care visits. Results: Inpatient services (medical and/or surgical) were required by 67 patients (14%) but accounted for 49% of total secondary care costs. Drug costs accounted for less than a quarter of total costs. Individual patient costs ranged from £73 to £33 254 per six months. Mean (95% CI) six month costs per patient were £1256 (£988, £1721) for colitis and £1652 (£1221, £2239) for Crohn’s disease. Hospitalisation, disease severity grade, and disease extent correlated positively with cost of illness but costs were independent of age or sex. Compared with quiescent cases of IBD, disease relapse was associated with a 2–3-fold increase in costs for non-hospitalised cases and a 20-fold increase in costs for hospitalised cases. Survey data suggested average six

  7. Cost of illness in patients with multiple myeloma in Italy: the CoMiM study.

    PubMed

    Petrucci, Maria Teresa; Calabrese, Elisabetta; Levi, Anna; Federico, Vincenzo; Ceccolini, Michela; Rizzi, Rita; Gozzetti, Alessandro; Falco, Patrizia; Lazzaro, Carlo; Martelli, Elisa; Boccadoro, Mario; Lauria, Francesco; Liso, Vincenzo; Cavo, Michele; Foa, Robert

    2013-01-01

    Multiple myeloma is the second most common hematological cancer. Although it accounts for only a relatively small percentage of all cancer types, the costs associated with managing multiple myeloma are considerable. Available studies are mainly focused on health care costs. The Costo del Mieloma Multiplo (Cost of MM, CoMiM) study investigated the cost of illness of multiple myeloma in Italy during one year of disease management. CoMiM is a retrospective, prevalence-based, multi-center, cross-sectional study based on a stratified sample of patients seen during normal clinical practice (asymptomatic; symptomatic on drugs; symptomatic receiving autologous stem cell transplantation; plateau/remission). Demographics, clinical history, health care and non-health care resource consumption data were collected. Costs were evaluated from the societal viewpoint and expressed in Euro 2008. Data on 236 patients were analyzed (39 asymptomatic, 17%; 29 symptomatic receiving autologous stem-cell transplantation, 12%; 105 symptomatic receiving drugs, 44%; 63 plateau/remission, 27%). The total cost of illness reached € 19,267.1 ± 25,078.6 (asymptomatic, € 959.3 ± 1091.6; symptomatic receiving drugs, € 21,707.8 ± 21,785.3; symptomatic receiving autologous stem-cell transplantation, € 59,243.7 ± 24,214.0; plateau/remission, € 8130.7 ± 15,092.5). The main cost drivers of total cost of illness were drugs and hospital admissions (46.1% and 29.4%, respectively). Antineoplastics and immunomodulators drove the cost of drugs (21.6% and 21.1% of the total cost of illness). Cost of antineoplastics was led by bortezomib (97.4%), whereas the cost driver for immunomodulators was lenalidomide (99.4%). Cost of hospitalization funded by the Italian National Health Service was strongly influenced by transplantation (94.6%), whereas chemotherapy and skeletal fractures did not exceed 1% and 2%, respectively. Despite some limitations, the CoMiM study provides Italian health care decision

  8. 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

  9. 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.

  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. 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…

  12. Cost of illness due to typhoid Fever in pemba, zanzibar, East Africa.

    PubMed

    Riewpaiboon, Arthorn; Piatti, Moritz; Ley, Benedikt; Deen, Jacqueline; Thriemer, Kamala; von Seidlein, Lorenz; Salehjiddawi, Mohammad; Busch, Clara Jana-Lui; Schmied, Wolfgang H; Ali, Said Mohammed; The Typhoid Economic Study Group GiDeok Pak Leon R Ochiai Mahesh K Puri Na Yoon Chang Thomas F Wierzba And John D Clemens

    2014-09-01

    The aim of this study was to estimate the economic burden of typhoid fever in Pemba, Zanzibar, East Africa. This study was an incidence-based cost-of-illness analysis from a societal perspective. It covered new episodes of blood culture-confirmed typhoid fever in patients presenting at the outpatient or inpatient departments of three district hospitals between May 2010 and December 2010. Cost of illness was the sum of direct costs and costs for productivity loss. Direct costs covered treatment, travel, and meals. Productivity costs were loss of income by patients and caregivers. The analysis included 17 episodes. The mean age of the patients, was 23 years (range=5-65, median=22). Thirty-five percent were inpatients, with a mean of 4.75 days of hospital stay (range=3-7, median=4.50). The mean cost for treatment alone during hospital care was US$ 21.97 at 2010 prices (US$ 1=1,430.50 Tanzanian Shilling─TSH). The average societal cost was US$ 154.47 per typhoid episode. The major expenditure was productivity cost due to lost wages of US$ 128.02 (83%). Our results contribute to the further economic evaluation of typhoid fever vaccination in Zanzibar and other sub-Saharan African countries.

  13. Cost of Illness Due to Typhoid Fever in Pemba, Zanzibar, East Africa

    PubMed Central

    Piatti, Moritz; Ley, Benedikt; Deen, Jacqueline; Thriemer, Kamala; von Seidlein, Lorenz; Salehjiddawi, Mohammad; Busch, Clara Jana-Lui; Schmied, Wolfgang H.; Ali, Said Mohammed; The Typhoid Economic Study Group (GiDeok Pak, Leon R. Ochiai, Mahesh K. Puri, Na Yoon Chang, Thomas F. Wierzba, and John D. Clemens)

    2014-01-01

    ABSTRACT The aim of this study was to estimate the economic burden of typhoid fever in Pemba, Zanzibar, East Africa. This study was an incidence-based cost-of-illness analysis from a societal perspective. It covered new episodes of blood culture-confirmed typhoid fever in patients presenting at the outpatient or inpatient departments of three district hospitals between May 2010 and December 2010. Cost of illness was the sum of direct costs and costs for productivity loss. Direct costs covered treatment, travel, and meals. Productivity costs were loss of income by patients and caregivers. The analysis included 17 episodes. The mean age of the patients, was 23 years (range=5-65, median=22). Thirty-five percent were inpatients, with a mean of 4.75 days of hospital stay (range=3-7, median=4.50). The mean cost for treatment alone during hospital care was US$ 21.97 at 2010 prices (US$ 1=1,430.50 Tanzanian Shilling─TSH). The average societal cost was US$ 154.47 per typhoid episode. The major expenditure was productivity cost due to lost wages of US$ 128.02 (83%). Our results contribute to the further economic evaluation of typhoid fever vaccination in Zanzibar and other sub-Saharan African countries. PMID:25395900

  14. 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

    2015-03-02

    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

  15. Systemic lupus erythematosus with neuropsychiatric manifestation incurs high disease costs: a cost-of-illness study in Hong Kong.

    PubMed

    Zhu, Tracy Y; Tam, Lai-Shan; Lee, Vivian W Y; Lee, Kenneth K; Li, Edmund K

    2009-05-01

    To determine the direct and indirect costs of SLE in Hong Kong, and to ascertain the relationship between neuropsychiatric SLE (NPSLE) and disease costs. A retrospective, cross-sectional, non-randomized cost-of-illness study was performed in a tertiary rheumatology specialty centre in Hong Kong. Participants completed questionnaires on sociodemographics, employment status and out-of-pocket expenses. Healthcare resources consumption was recorded by chart review. The occurrence of NPSLE since onset of SLE was determined using the 1999 ACR nomenclature and standard definitions. Mann-Whitney U-test was used to compare disease costs between patients with and without NPSLE. Multiple linear regression was used to determine the predictors of the costs. Three hundred and six Chinese patients were recruited, with a mean age of 41 years and mean disease duration of 9.6 years. A total of 108 NPSLE events were recorded by 83 patients. The most common manifestations were seizure and cardiovascular disease. The mean annual total costs were USD 13,307 per patient. The direct costs dominated the total costs, and the costs of inpatient care contributed 52% of the direct costs. Patients with NPSLE incurred significantly higher direct and indirect costs compared with those without NPSLE. The number of NPSLE events was an independent explanatory variable associated with both direct and indirect costs. The economic impact of SLE in Hong Kong is considerable and patients with NPSLE incur higher disease costs compared with those without NPSLE. Improvement in prevention of end-organ damage, especially neuropsychiatric manifestation, may reduce costs of SLE patients.

  16. Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden

    PubMed Central

    2012-01-01

    Background Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden. Methods The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model. Results 204 (103 women) patients, mean age 48 (SD 11) years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16%) remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389) during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third. Conclusions The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted. PMID:22325050

  17. A societal cost-of-illness study of hemodialysis in Lebanon.

    PubMed

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Salameh, Pascale; Evers, Silvia M A A

    2016-12-01

    Renal failure is a growing public health problem, and is mainly treated by hemodialysis. This study aims to estimate the societal costs of hemodialysis in Lebanon. This was a quantitative, cross-sectional cost-of-illness study conducted alongside the Nutrition Education for Management of Osteodystrophy trial. Costs were assessed with a prevalence-based, bottom-up approach, for the period of June-December 2011. The data of 114 patients recruited from six hospital-based units were collected through a questionnaire measuring healthcare costs, costs to patients and family, and costs in other sectors. Recall data were used for the base-case analysis. Sensitivity analyses employing various sources of resources use and costs were performed. Costs were uprated to 2015US$. Multiple linear regression was conducted to explore the predictors of societal costs. The mean 6-month societal costs were estimated at $9,258.39. The larger part was attributable to healthcare costs (91.7%), while costs to patient and family and costs in other sectors poorly contributed to the total costs (4.2% and 4.1%, respectively). In general, results were robust to sensitivity analyses. Using the maximum value for hospitalization resulted in the biggest difference (+15.5% of the base-case result). Female gender, being widowed/divorced, having hypertension comorbidity, and higher weekly time on dialysis were significantly associated with greater societal costs. Information regarding resource consumption and cost were not readily available. Rather, they were obtained from a variety of sources, with each having its own strengths and limitations. Hemodialysis represents a high societal burden in Lebanon. Using extrapolation, its total annual cost for the Lebanese society is estimated at $61,105,374 and the mean total annual cost ($18,516.7) is 43.70% higher than the gross domestic product per capita forecast for 2015. Measures to reduce the economic burden of hemodialysis should be taken, by promoting

  18. 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

  19. A conceptually based approach to understanding chronically ill patients' responses to medication cost pressures.

    PubMed

    Piette, John D; Heisler, Michele; Horne, Robert; Caleb Alexander, G

    2006-02-01

    Prescription medications enhance the well-being of most chronically ill patients. Many individuals, however, struggle with how to pay for their treatments and as a result experience problems with self-care and health maintenance. Although studies have documented that high out-of-pocket costs are associated with medication non-adherence, little research on prescription cost sharing has been theoretically grounded in knowledge of the more general determinants of patients' self-management behaviors and chronic disease outcomes. We present a conceptual framework for understanding the influence of patient, medication, clinician, and health system factors on individuals' responses to medication costs. We review what is known about how these factors influence medication adherence, identify possible strategies through which clinicians, health systems, and policy-makers may assist patients burdened by their medication costs, and highlight areas in need of further research. Although medication costs represent a burden to chronically ill patients worldwide, most patients report using their medication as prescribed despite the costs, and others report cost-related underuse despite an apparent ability to afford those treatments. The cost-adherence relationship is modified by contextual factors, including patients' characteristics (e.g., age, ethnicity, and attitudes toward medications), the type of medications they are using (e.g., the complexity of dosing and the drug's clinical target), clinician factors (e.g., choice of first-line agent and communication about medication costs), and health system factors (e.g., efforts to influence clinicians' prescribing and to help patients apply for financial assistance programs). Understanding these relationships will enable clinicians and policy-makers to better design pharmacy benefits and assist patients in taking their medication as prescribed. The next generation of studies examining the consequences of prescription drug costs

  20. Mental Health Disorders Associated with Foodborne Pathogens.

    PubMed

    Bolton, Declan J; Robertson, Lucy J

    2016-11-01

    Human infections with foodborne pathogenic organisms are relatively well described in terms of their overt physical symptoms, such as diarrhea, abdominal cramps, vomiting, fever, and associated sequelae. Indeed, some of these are key for diagnosis and treatment, although it should be noted that, for some foodborne pathogens, the physical symptoms might be more diffuse, particularly those associated with some of the foodborne parasites. In contrast, the impact of these pathogens on mental health is less well described, and symptoms such as depression, anxiety, and general malaise are usually ignored when foodborne infections are recorded. Despite this, it is generally accepted that there are several psychiatric disorders of unknown etiology that may be associated with microbial pathogens. Depression, autism, hypochondriasis and anxiety, schizophrenia, and Tourette syndrome probably have multiple contributing causes, among which foodborne pathogens may play a decisive or contributory role, possibly sharing pathophysiological pathways with other environmental triggers. This review focuses on foodborne parasites and bacterial pathogens. Some foodborne parasites, such as metacestodes of Taenia solium and tissue cysts (bradyzoites) of Toxoplasma gondii , may affect mental health by directly infecting the brain. In contrast, bacterial infections and other parasitic infections may contribute to mental illness via the immune system and/or by influencing neurotransmission pathways. Thus, cytokines, for example, have been associated with depression and schizophrenia. However, infectious disease models for psychiatry require a more complete understanding of the relationship between psychiatric disorders and microbial triggers. This article reviews the current state of knowledge on the role of foodborne parasitic and bacterial pathogens in mental illness and identifies some of the gaps that should be addressed to improve diagnosis and treatment of mental health issues that are

  1. Acinetobacter: an underrated foodborne pathogen?

    PubMed

    Amorim, Angelo Maximo Batista de; Nascimento, Janaína Dos Santos

    2017-02-28

    The increasing prevalence of foodborne diseases observed in developing countries has been linked to a rise in the consumption of raw foods. However, unlike the classical pathogens that are commonly implicated in foodborne illnesses, members of the genus Acinetobacter are rarely associated with diarrheal disease, probably because of the difficulty in isolating these Gram-negative bacteria from food sources. Nevertheless, several species of Acinetobacter, especially A. baumannii, possess many of the characteristics associated with successful pathogens and exhibit a prodigious ability to acquire the multiple-drug resistance (MDR) phenotype. In this mini-review, we summarize the epidemiological data relating to MDR Acinetobacter and consider evidence suggesting that contaminated dairy products, along with raw fruit and vegetables, constitute extra-hospital reservoirs of this underrated pathogen, and may represent an increased risk to immunocompromised individuals and young children in healthcare settings.

  2. Household costs of hospitalized dengue illness in semi-rural Thailand.

    PubMed

    Tozan, Yesim; Ratanawong, Pitcha; Sewe, Maquines Odhiambo; Wilder-Smith, Annelies; Kittayapong, Pattamaporn

    2017-09-22

    Dengue-related illness is a leading cause of hospitalization and death in Thailand and other Southeast Asian countries, imposing a major economic burden on households, health systems, and governments. This study aims to assess the economic impact of hospitalized dengue cases on households in Chachoengsao province in eastern Thailand. We conducted a prospective cost-of-illness study of hospitalized pediatric and adult dengue patients at three public hospitals. We examined all hospitalized dengue cases regardless of disease severity. Patients or their legal guardians were interviewed using a standard questionnaire to determine household-level medical and non-medical expenditures and income losses during the illness episode. Between March and September 2015, we recruited a total of 224 hospitalized patients (<5 years, 4%; 5-14 years, 20%, 15-24 years, 36%, 25-34 years, 15%; 35-44 years, 10%; 45+ years, 12%), who were clinically diagnosed with dengue. The total cost of a hospitalized dengue case was higher for adult patients than pediatric patients, and was US$153.6 and US$166.3 for pediatric DF and DHF patients, respectively, and US$171.2 and US$226.1 for adult DF and DHF patients, respectively. The financial burden on households increased with the severity of dengue illness. Although 74% of the households reported that the patient received free medical care, hospitalized dengue illness cost approximately 19-23% of the monthly household income. These results indicated that dengue imposed a substantial financial burden on households in Thailand where a great majority of the population was covered by the Universal Coverage Scheme for health care.

  3. Investigation of rpoS and dps genes in sodium hypochlorite resistance of Salmonella Enteritidis SE86 isolated from foodborne illness outbreaks in southern Brazil.

    PubMed

    Ritter, Ana Carolina; Bacciu, Donatella; Santi, Lucélia; Silva, Walter Orlando Beys da; Vainstein, Marilene Henning; Rubino, Salvatore; Uzzau, Sergio; Tondo, Eduardo Cesar

    2012-03-01

    In Rio Grande do Sul, southern Brazil, Salmonella Enteritidis is one of the principal microorganisms responsible for foodborne disease. The present study was conducted to compare the sodium hypochlorite resistance of Salmonella Enteritidis SE86 with that of other strains of Salmonella Enteritidis isolated from different regions of the world and to investigate the involvement of the rpoS and dps genes in resistance to this disinfectant. We tested five Salmonella Enteritidis wild-type (WT) strains isolated from different countries, two mutant strains of Salmonella Enteritidis SE86, and two tagged (3XFLAG) strains of Salmonella Enteritidis SE86 for their resistance to sodium hypochlorite (200 ppm). The survival of the WT and attenuated strains was determined based on bacterial counts, and tagged proteins (Dps and RpoS) were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting with anti-FLAG antibodies. None of the WT strains of Salmonella Enteritidis were totally inactivated after 20 min. The SE86 strain lacking dps was more sensitive to sodium hypochlorite than was the WT SE86 strain, with a 2-log reduction in counts after 1 min. The RpoS and Dps proteins were actively expressed under the conditions tested, indicating that in Salmonella Enteritidis SE86 these genes, which are expressed when in contact with sodium hypochlorite, are related to oxidative stress.

  4. Surveillance for foodborne disease outbreaks--United States, 2008.

    PubMed

    2011-09-09

    Foodborne agents cause an estimated 48 million illnesses annually in the United States, including 9.4 million illnesses from known pathogens. CDC collects data on foodborne disease outbreaks submitted from all states and territories through the Foodborne Disease Outbreak Surveillance System. During 2008, the most recent year for which data are finalized, 1,034 foodborne disease outbreaks were reported, which resulted in 23,152 cases of illness, 1,276 hospitalizations, and 22 deaths. Among the 479 outbreaks with a laboratory-confirmed single etiologic agent reported, norovirus was the most common, accounting for 49% of outbreaks and 46% of illnesses. Salmonella was the second most common, accounting for 23% of outbreaks and 31% of illnesses. Among the 218 outbreaks attributed to a food vehicle with ingredients from only one of 17 defined food commodities, the top commodities to which outbreaks were attributed were poultry (15%), beef (14%), and finfish (14%), whereas the top commodities to which outbreak-related illnesses were attributed were fruits and nuts (24%), vine-stalk vegetables (23%), and beef (13%). Outbreak surveillance provides insights into the agents that cause foodborne illness, types of implicated foods, and settings where transmission occurs. Public health, regulatory, and food industry professionals can use this information to target prevention efforts against pathogens and foods that cause the most foodborne disease outbreaks.

  5. Health-care cost of diabetes in South India: A cost of illness study

    PubMed Central

    Akari, Sadanandam; Mateti, Uday Venkat; Kunduru, Buchi Reddy

    2013-01-01

    Objective: The objective of this study is to analyze the health-care cost by calculating the direct and indirect costs of diabetes with co-morbidities in south India. Methods: A prospective observational study was conducted at Rohini super specialty hospital (India). Patient data as well as cost details were collected from the patients for a period of 6 months. The study was approved by the hospital committee prior to the study. The diabetic patients of age >18 years, either gender were included in the study. The collected data was analyzed for the average cost incurred in treating the diabetic patients and was calculated based on the total amount spent by the patients to that of total number of patients. Findings: A total of 150 patients were enrolled during the study period. The average costs per diabetic patient with and without co-morbidities were found to be United States dollar (USD) 314.15 and USD 29.91, respectively. The average cost for those with diabetic complications was USD 125.01 for macrovascular complications, USD 90.43 for microvascular complications and USD 142.01 for other infections. Out of USD 314.15, the average total direct medical cost was USD 290.04, the average direct non-medical cost was USD 3.75 and the average total indirect cost was USD 20.34. Conclusion: Our study results revealed that more economic burden was found in male patients (USD 332.06), age group of 51-60 years (USD 353.55) and the patients bearing macrovascular complications (USD 142.01). This information can be a model for future studies of economic evaluations and outcomes research. PMID:24991617

  6. Workers' compensation benefits and shifting costs for occupational injury and illness.

    PubMed

    Leigh, J Paul; Marcin, James P

    2012-04-01

    Whereas national prevalence estimates for workers' compensation benefits are available, incidence estimates are not. Moreover, few studies address which groups in the economy pay for occupational injury and illness when workers' compensation does not. Data on numbers of cases and costs per case were drawn from the Bureau of Labor Statistics and National Council on Compensation Insurance data sets. Costs not covered by workers' compensation were estimated for private and public entities. Total benefits in 2007 were estimated to be $51.7 billion, with $29.8 billion for medical benefits and $21.9 billion for indemnity benefits. For medical costs not covered by workers' compensation, other (non-workers' compensation) insurance covered $14.22 billion, Medicare covered $7.16 billion, and Medicaid covered $5.47 billion. Incidence estimates of national benefits for workers' compensation were generated by combining existing published data. Costs were shifted to workers and their families, non-workers' compensation insurance carriers, and governments.

  7. Novel methods for detection of foodborne viruses

    USDA-ARS?s Scientific Manuscript database

    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...

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

    USDA-ARS?s Scientific Manuscript database

    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...

  9. A cost-of-illness study of spina bifida in Italy

    PubMed Central

    Colombo, Giorgio L; Di Matteo, Sergio; Vinci, Marta; Gatti, Claudia; Pascali, Maria Paola; De Gennaro, Mario; Macrellino, Elena; Mosiello, Giovanni; Redaelli, Tiziana; Schioppa, Francesca; Dieci, Cristina

    2013-01-01

    Introduction Spina bifida (SB) is a congenital malformation of the spinal cord, nerves, and adjacent covering structures, with different levels of severity and functional disability. The economic cost of spina bifida and its prevention using folic acid have never been estimated in Italy. This study was conducted to define the cost of illness of SB in Italy. Methods A retrospective multicenter observational study on the social cost of patients with SB was carried out in three SB centers in Italy. Cost data were collected relating to the 12 months preceding the enrollment time (T0), and subsequently 3 months after the T0 time (±20 days) through a case report form designed to collect the relevant information on the costs incurred during the period considered. The data for all patients were analyzed through multivariate analysis on the main parameters. Results We enrolled 128 patients equally divided between males and females, with a mean age of 13 years (minimum, 0; maximum, 29). Diagnosis was mostly postnatal, with 64 cases diagnosed at birth and 33 cases diagnosed subsequently. The lesion severity levels, as defined in the inclusion criteria, were walking (52 patients); walking with simple orthoses (33 patients); walking with complex orthoses (16 patients); and nonwalking, (25 patients). The anatomic type identified is open SB in most cases (84 patients), followed by closed SB (37 patients) and SB occulta (3 patients). The most significant cost per year was for assistive devices, for a total of 4307.00 €, followed by hospitalization (907.00 €), examinations (592.00 €), and drug therapy (328.00 €). Cost breakdown by age range shows that the highest costs are incurred in the 0–4 age range. The highest cost was for cases of open SB (12,103.00 €). The cost/degree of severity ratio showed that the highest cost was for nonwalking patients (14,323.00 €), followed by patients walking with complex orthoses (13,799.00 €). Conclusion The data from this study

  10. [Cost of illness in Parkinson disease. A retrospective 3-month analysis of direct costs].

    PubMed

    Dodel, R C; Singer, M; Köhne-Volland, R; Selzer, R; Scholz, W; Rathay, B; Oertel, W H

    1997-12-01

    Parkinson's disease (PD) causes significant expense for the national health care system due to its chronic progressive course, the duration of the disease, the high prevalence and the devastating prognosis. In Germany more than DM 320 million are spent for drugs to alleviate parkinsonian symptoms. The aim of this study was to calculate the economic burden of PD by assessing direct medical costs. Forty patients suffering from idiopathic PD were interviewed at an office of neurological specialists and at an outpatient movement disorder clinic about their use of health care resources 3 months prior to the study. The total annual costs reported were DM 14,500, consisting of DM 6500 for drug therapy and DM 8000 for other medical services, including hospital inpatient care (DM 5600), outpatient care (DM 700), medical sundries (DM 1100) and physiotherapy (DM 600). The costs were positively correlated to the extent of the disease (Hoehn and Yahr stage; HY) and the occurrence of motor fluctuations/dyskinesias. We found that both drug-therapy expenses and total medical costs doubled from HYI to HYIV. The rarely employed s.c. therapy with apomorphine additionally increased the costs of drug therapy in HYV. The occurrence of fluctuations/ dyskinesias also increased medical expenses by approximately a factor of two. Indirect burden due to increased days off of work, unemployment and earlier retirement are also significant in Parkinson's disease. This study includes that a treatment which could prevent or retard disease progression as well as a treatment that delays or reduces motor complications would not only ameliorate the situation of patients suffering from PD, but would also lead to significant reductions in cost for the national health care system.

  11. 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

  12. Foodborne disease: the global movement of food and people.

    PubMed

    McEntire, Jennifer

    2013-09-01

    Foodborne illness afflicts people throughout the world. The food safety systems in some countries afford better consumer protection than others. This situation, combined with differing climates and ecologies, results in the association of different types of foodborne illness with different regions of the world. In a global economy, both people and food travel the world. With this travel comes the potential for patients to acquire unexpected diseases. Clinicians need to consider foreign travel as well as the consumption of food from other parts of the world when determining the cause of foodborne disease.

  13. Surveillance for foodborne disease outbreaks --- United States, 2007.

    PubMed

    2010-08-13

    Foodborne agents cause an estimated 76 million illnesses annually in the United States. Outbreak surveillance provides insights into the causes of foodborne illness, types of implicated foods, and settings of foodborne infections that can be used in food safety strategies to prevent and control foodborne disease. CDC collects data on foodborne disease outbreaks submitted from all states and territories. This report summarizes epidemiologic data for the 1,097 reported outbreaks occurring during 2007 (the most recent finalized data), which resulted in 21,244 cases of foodborne illness and 18 deaths. Among the 497 foodborne outbreaks with a laboratory-confirmed single etiologic agent reported, norovirus was the most common cause, followed by Salmonella. Among the 18 reported deaths, 11 were attributed to bacterial etiologies (five Salmonella, three Listeria monocytogenes, two Escherichia coli O157:H7, and one Clostridium botulinum), two to viral etiologies (norovirus), and one to a chemical (mushroom toxin). Four deaths occurred in outbreaks with unknown etiologies. Among the 235 outbreaks attributed to a single food commodity, poultry (17%), beef (16%), and leafy vegetables (14%) were most often the cause of illness. Public health, regulatory, and agricultural professionals can use this information when creating targeted control strategies and to support efforts to promote safe food preparation practices among food employees and the public.

  14. Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

    PubMed Central

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

    2017-01-01

    Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D) and incidence of cardiovascular disease (CVD) following a low glycemic index (GI) or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1) estimate the proportions of individuals who are likely to consume pulses; (2) evaluate the reductions in established risk factors for T2D and CVD; (3) assess the percent reduction in incidences or complications of the diseases of interest; and (4) calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9) to Can$62.4 (95% CI $26–$98.8) and Can$31.6 (95% CI $11.1–$52) to Can$315.5 (95% CI $110.6–$520.4) million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term. PMID:28737688

  15. Estimating the burden of acute gastroenteritis and foodborne illness caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus by using population-based telephone survey data, Miyagi Prefecture, Japan, 2005 to 2006.

    PubMed

    Kubota, Kunihiro; Kasuga, Fumiko; Iwasaki, Emiko; Inagaki, Shunichi; Sakurai, Yoshiharu; Komatsu, Mayumi; Toyofuku, Hajime; Angulo, Frederick J; Scallan, Elaine; Morikawa, Kaoru

    2011-10-01

    Most cases of acute gastroenteritis and foodborne disease are not ascertained by public health surveillance because the ill person does not always seek medical care and submit a stool sample for testing, and the laboratory does not always test for or identify the causative organism. We estimated the total burden of acute gastroenteritis in Miyagi Prefecture, Japan, using data from two 2-week cross-sectional, population-based telephone surveys conducted in 2006 and 2007. To estimate the number of acute gastroenteritis illnesses caused by Campylobacter, Salmonella, and Vibrio parahaemolyticus in Miyagi Prefecture, we determined the number of cases for each pathogen from active laboratory-based surveillance during 2005 to 2006 and adjusted for seeking of medical care and submission of stool specimens by using data from the population-based telephone surveys. Monte Carlo simulation was used to incorporate uncertainty. The prevalence of acute gastroenteritis in the preceding 4 weeks was 3.3% (70 of 2,126) and 3.5% (74 of 2,121) in the winter and summer months, yielding an estimated 44,200 episodes of acute gastroenteritis each year in this region. Among people with acute gastroenteritis, the physician consultation rate was 32.0%, and 10.9% of persons who sought care submitted a stool sample. The estimated numbers of Campylobacter-, Salmonella-, and V. parahaemolyticus -associated episodes of acute gastroenteritis were 1,512, 209, and 100 per 100,000 population per year, respectively, in this region. These estimates are significantly higher than the number of reported cases in surveillance in this region. Cases ascertained from active surveillance were also underrepresented in the present passive surveillance, suggesting that complementary surveillance systems, such as laboratory-based active surveillance in sentinel sites, are needed to monitor food safety in Japan.

  16. 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.

  17. Could EEG Monitoring in Critically Ill Children Be a Cost-effective Neuroprotective Strategy?

    PubMed

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

    2015-12-01

    Electrographic status epilepticus (ESE) in critically ill children is associated with unfavorable functional outcomes, but identifying candidates for ESE management requires resource-intense EEG monitoring. A cost-effectiveness analysis was performed to estimate how much ESE identification and management would need to improve patient outcomes to make EEG monitoring strategies a good value. A decision tree was created to examine the relationships among variables important to deciding whether to perform EEG monitoring. Variable costs were estimated from their component parts, outcomes were estimated in quality-adjusted life-years, and incremental cost-effectiveness ratios were calculated to compare the relative values using four alternative EEG monitoring strategies that varied by monitoring duration. Forty-eight hours of EEG monitoring would be worth its cost if ESE identification and management improved patient outcomes by ≥7%. If ESE identification and management improved patient outcomes by 3% to 6%, then 24 or 48 hours of EEG monitoring would be worth the cost depending on how much decision makers were willing to pay per quality-adjusted life-year gained. If ESE identification and management improved outcomes by as little as 3%, then 24 hours of EEG monitoring would be worth the cost. EEG monitoring has the potential to be cost-effective if ESE identification and management improves patient outcomes by as little as 3%.

  18. Burden of disease and cost of illness of atrial fibrillation in Portugal.

    PubMed

    Gouveia, Miguel; Costa, João; Alarcão, Joana; Augusto, Margarida; Caldeira, Daniel; Pinheiro, Luís; Vaz Carneiro, António; Borges, Margarida

    2015-01-01

    Atrial fibrillation is the most prevalent sustained arrhythmia. This paper estimates the burden and cost of illness attributable to atrial fibrillation in Portugal based on demographic and health statistics. Mortality data by cause of death came from the European Detailed Mortality Database of the World Health Organization (WHO). Hospital data were taken from the Portuguese diagnosis-related groups database. The burden of disease was measured using DALYs (disability-adjusted life years), a metric adopted by the WHO. Costs studied included resource use and lost productivity. The burden and cost of illness are those attributable to atrial fibrillation and its main complication, ischemic stroke. In Portugal, 4070 deaths were attributable to atrial fibrillation in 2010, corresponding to 3.8% of all deaths. In total, the burden of disease attributable to atrial fibrillation was estimated at 23,084 DALYs: 10,521 resulting from premature deaths (1.7% of the total DALYs due to death in 2010 in Portugal), and 12,563 resulting from disability. The total estimated direct costs attributable to atrial fibrillation at 2013 prices were €115 million: €34 million for inpatient care and €81 million for outpatient care. Indirect costs resulting from lost production due to disability were estimated at €25 million. Atrial fibrillation has an important social impact in Portugal due to its associated mortality and morbidity, and was responsible in 2013 for a total cost of €140 million, about 0.08% of gross domestic product. Copyright © 2014. Published by Elsevier España.

  19. Costs of illness in a Russian cohort of patients with Parkinson's disease.

    PubMed

    Winter, Yaroslav; von Campenhausen, Sonja; Popov, Georgy; Reese, Jens P; Klotsche, Jens; Bötzel, Kai; Gusev, Eugene; Oertel, Wolfgang H; Dodel, Richard; Guekht, Alla

    2009-01-01

    The economic burden associated with Parkinson's disease (PD) is increasing as the worldwide population ages. While cost-of-illness studies for PD from developed countries have recently been published, data for Eastern Europe and Asia are still lacking. To prospectively evaluate direct and indirect costs in a cohort of Russian patients with PD in order to identify cost-driving factors. We recruited 100 patients with idiopathic PD who visited the outpatient department for movement disorders of the Russian Medical State University in Moscow between October 2004 and December 2005. The Unified Parkinson's Disease Rating Scale was used to evaluate clinical status. Economic data were collected in a 'bottom-up' approach and evaluated from the societal perspective. Indirect costs were estimated using a human capital approach. Russian currency was converted into euro, year 2005 values, using the purchasing power parity. All costs were then inflated to euro, year 2008 values, using the Medical Care Component of the Consumer Price Index. Independent cost predictors were identified by means of multivariate regression analyses. From the societal perspective, total costs per patient over 6 months amounted to euro2620 (95% CI 2050, 3200), with direct costs accounting for 67% and indirect costs for 33% of the total. Patients' expenditures accounted for 43% of their private income. The primary burden on patients was due to informal care and drugs. Only 10% of home care was provided by the formal service sector. Costs for the nation are estimated at euro1.1 billion per year. The economic burden of PD in Russia is considerable, especially when taking into account low private incomes. Further development of a formal care system and better reimbursement systems for drugs are necessary in Russia.

  20. 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

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

    USDA-ARS?s Scientific Manuscript database

    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,...

  2. Cost-effectiveness of supported housing for homeless persons with mental illness.

    PubMed

    Rosenheck, Robert; Kasprow, Wesley; Frisman, Linda; Liu-Mares, Wen

    2003-09-01

    Supported housing, integrating clinical and housing services, is a widely advocated intervention for homeless people with mental illness. In 1992, the US Department of Housing and Urban Development (HUD) and the US Department of Veterans Affairs (VA) established the HUD-VA Supported Housing (HUD-VASH) program. Homeless veterans with psychiatric and/or substance abuse disorders or both (N = 460) were randomly assigned to 1 of 3 groups: (1) HUD-VASH, with Section 8 vouchers (rent subsidies) and intensive case management (n = 182); (2) case management only, without special access to Section 8 vouchers (n = 90); and (3) standard VA care (n = 188) Primary outcomes were days housed and days homeless. Secondary outcomes were mental health status, community adjustment, and costs from 4 perspectives. During a 3-year follow-up, HUD-VASH veterans had 16% more days housed than the case management-only group and 25% more days housed than the standard care group (P<.001 for both). The case management-only group had only 7% more days housed than the standard care group (P =.29). The HUD-VASH group also experienced 35% and 36% fewer days homeless than each of the control groups (P<.005 for both). There were no significant differences on any measures of psychiatric or substance abuse status or community adjustment, although HUD-VASH clients had larger social networks. From the societal perspective, HUD-VASH was 6200 US dollars (15%) more costly than standard care. Incremental cost-effectiveness ratios suggest that HUD-VASH cost 45 US dollars more than standard care for each additional day housed (95% confidence interval, -19 US dollars to 108 US dollars). Supported housing for homeless people with mental illness results in superior housing outcomes than intensive case management alone or standard care and modestly increases societal costs.

  3. Quality of life and cost of illness in patients with psoriasis in Malaysia: a multicenter study.

    PubMed

    Tang, Min Moon; Chang, Choong Chor; Chan, Lee Chin; Heng, Agnes

    2013-03-01

    Psoriasis is an immune-mediated, chronic, inflammatory skin disease which affects approximately 2% of the world's population. It has a major impact on the patient's quality of life (QoL), influencing career, social activities, family relationships, and all other aspects of life. Many studies have described the various ways in which psoriasis can affect a patient's life. Very little is known, however, about the impact of psoriasis on the QoL of patients treated in Malaysia and the cost of illness in this region. This study aims to describe the extent to which psoriasis affects the QoL of patients treated in government-run dermatology clinics in Malaysia and to estimate the cost of illness. A total of 250 psoriasis patients treated at eight dermatology clinics in government-run hospitals in Malaysia were studied. The severity of psoriasis was assessed by dermatologists. Quality of life was evaluated using the Dermatology Life Quality Index (DLQI) and Version 2 of the 12-Item Short-Form Health Survey (SF-12v2). Scores on the SF-12v2 of healthy subjects and of patients with other medical conditions, such as depression, diabetes mellitus, hypertension, and ischemic heart disease, were also assessed for comparison. The costs of dermatology outpatient consultant fees, medications, investigations, procedures, transportation, over-the-counter medications, and hospitalization were retrospectively estimated using questionnaires. The cohort studied had a median Psoriasis Area Severity Index (PASI) score of 9.9 and a median DLQI score of 10.0. The average SF-12v2 scores were 43.68 (standard deviation [SD] 9.23) and 42.25 (SD 10.7) on the Physical Health Summary and Mental Health Summary, respectively. The impact of disease on QoL was found to be greater in those with more extensive psoriatic lesion involvement, in younger patients, and in those with psoriatic arthropathy. Psoriasis was found to affect QoL in both genders equally. Body mass index had no effect on the severity of

  4. Effect of an enhanced medical home on serious illness and cost of care among high-risk children with chronic illness: a randomized clinical trial.

    PubMed

    Mosquera, Ricardo A; Avritscher, Elenir B C; Samuels, Cheryl L; Harris, Tomika S; Pedroza, Claudia; Evans, Patricia; Navarro, Fernando; Wootton, Susan H; Pacheco, Susan; Clifton, Guy; Moody, Shade; Franzini, Luisa; Zupancic, John; Tyson, Jon E

    Patient-centered medical homes have not been shown to reduce adverse outcomes or costs in adults or children with chronic illness. To assess whether an enhanced medical home providing comprehensive care prevents serious illness (death, intensive care unit [ICU] admission, or hospital stay >7 days) and/or reduces costs among children with chronic illness. Randomized clinical trial of high-risk children with chronic illness (≥3 emergency department visits, ≥2 hospitalizations, or ≥1 pediatric ICU admissions during previous year, and >50% estimated risk for hospitalization) treated at a high-risk clinic at the University of Texas, Houston, and randomized to comprehensive care (n = 105) or usual care (n = 96). Enrollment was between March 2011 and February 2013 (when predefined stopping rules for benefit were met) and outcome evaluations continued through August 31, 2013. Comprehensive care included treatment from primary care clinicians and specialists in the same clinic with multiple features to promote prompt effective care. Usual care was provided locally in private offices or faculty-supervised clinics without modification. Primary outcome: children with a serious illness (death, ICU admission, or hospital stay >7 days), costs (health system perspective). Secondary outcomes: individual serious illnesses, medical services, Medicaid payments, and medical school revenues and costs. In an intent-to-treat analysis, comprehensive care decreased both the rate of children with a serious illness (10 per 100 child-years vs 22 for usual care; rate ratio [RR], 0.45 [95% CI, 0.28-0.73]), and total hospital and clinic costs ($16,523 vs $26,781 per child-year, respectively; cost ratio, 0.58 [95% CI, 0.38-0.88]). In analyses of net monetary benefit, the probability that comprehensive care was cost neutral or cost saving was 97%. Comprehensive care reduced (per 100 child-years) serious illnesses (16 vs 44 for usual care; RR, 0.33 [95% CI, 0.17-0.66]), emergency

  5. Emerging foodborne pathogens

    USDA-ARS?s Scientific Manuscript database

    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...

  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.

  7. 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

  8. Emerging foodborne trematodiasis.

    PubMed

    Keiser, Jennifer; Utzinger, Jürg

    2005-10-01

    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.

  9. Emerging food-borne zoonoses.

    PubMed

    Schlundt, J; Toyofuku, H; Jansen, J; Herbst, S A

    2004-08-01

    Diarrhoeal diseases, almost all of which are caused by food-borne or waterborne microbial pathogens, are leading causes of illness and death in less developed countries, killing an estimated 1.9 million people annually at the global level. Even in developed countries, it is estimated that up to one third of the population are affected by microbiological food-borne diseases each year. The majority of the pathogens causing this significant disease burden are now considered to be zoonotic. The occurrence of some of these zoonotic pathogens seems to have increased significantly over recent years. The factors involved in such increases have not been well studied, but they are generally agreed to include changes in animal production systems and in the food production chain. Both types of changes can cause corresponding changes in patterns of exposure to the pathogens and the susceptibility pattern of the human population. This paper will not attempt a more in-depth analysis of such factors. The authors briefly describe five of the most important emerging food-borne zoonotic pathogens: Salmonella spp., Campylobacter spp., enterohaemorrhagic Escherichia coli, Toxoplasma gondii and Cryptosporidium parvum. The paper does not include a full description of all important emerging food-borne pathogens but instead provides a description of the present situation, as regards these globally more important pathogens. In addition, the authors describe each pathogen according to the new framework of a Food and Agriculture Organization (FAO)/World Health Organization (WHO) microbiological risk assessment, which consists of hazard identification and characterisation, exposure assessment and risk characterisation. Moreover, the authors provide a brief account of attempts at risk mitigation, as well as suggestions for risk management for some of these pathogens, based on thorough international FAO/WHO risk assessments. The authors emphasise the importance of science-based programmes for

  10. Cost-effectiveness evaluation of three approaches to case management for homeless mentally ill clients.

    PubMed

    Wolff, N; Helminiak, T W; Morse, G A; Calsyn, R J; Klinkenberg, W D; Trusty, M L

    1997-03-01

    In this study the authors compared the cost-effectiveness of three approaches to case management for individuals with severe mental illness who were at risk for homelessness: assertive community treatment alone, assertive community treatment with community workers, and brokered case management (purchase of services). Individuals were randomly assigned to the three treatment conditions and followed for 18 months. Eligibility requirements included a severe DSM-III axis I diagnosis, such as schizophrenia, and either current homelessness or risk for homelessness based on prior history of homelessness. Participants were recruited from the emergency rooms and inpatient units of local psychiatric hospitals. Data on 85 people were available for analyses: 28 in assertive community treatment alone, 35 in assertive community treatment with community workers, and 22 receiving brokered case management (purchase of services). Clients assigned to the two assertive community treatment conditions had more contact with their treatment programs, experienced greater reductions in psychiatric symptoms, and were more satisfied with their treatment than clients in the brokered condition. There was no statistically significant difference between treatment conditions in terms of the total costs of treating the participants. However, the assertive community treatment conditions spent less money on inpatient services than brokered case management, but more on case management services and maintenance (i.e., food stamps, housing subsidies, and Supplemental Security Income payments). Assertive community treatment has better client outcomes at no greater cost and is, therefore, more cost-effective than brokered case management.

  11. [Checklist for the Development and Assessment of Cost-of-Illness Studies].

    PubMed

    Müller, Dirk; Stock, Stephanie; Dintsios, Charalabos-Markos; Chernyak, Nadja; Gerber-Grote, Andreas; Gloede, Tristan Daniel; Hermann, Benita; Huppertz, Eduard; Jülich, Fabian; Mostardt, Sarah; Köberlein-Neu, Juliane; Prenzler, Anne; Salize, Hans-Joachim; Santos, Sara; Scheckel, Benjamin; Seidl, Astrid; Wahlers, Katharina; Icks, Andrea

    2017-05-18

    Background Cost-of-illness (CoI) studies are important instruments for estimating the socioeconomic burden of specified diseases. CoI studies provide important information about the cost structure of a disease, the resulting research need, approaches to improve aspects of care and, monetary consequences from different perspectives. This information can be useful for healthcare research and health policy. Due to heterogeneity of available Cost-of-Illness studies, the working group 'Health Economics' of the German Network for Healthcare Research (DNVF) in accordance with the German Society for Health Economics (DGGÖ) developed an instrument for the planning, conduct and assessment of CoI studies. Methods The checklist was developed based on a systematic literature search of published national and international checklists as well as guidelines and recommendations for development and assessment of CoI studies and health economic evaluations. Structure and subject matter of the generic checklist was designed, approved and, finally, examined in a pretest by the working group. Results Based on the results of the literature search (n=2 454), 58 articles were used for the identification of relevant criteria for the checklist. With respect to the results of the pretest, 6 dimensions were included in the checklist: (i) general aspects, (ii) identification of resources, (iii) description and quantification of resource consumption, (iv) valuation of resources (v) analysis and presentation of results and (vi) discussion and conclusion. In total, the 6 dimensions were operationalized through 37 items. Conclusion This checklist is an initial approach to improve transparency and understanding of CoI studies in terms of the extent, structure and development of the socioeconomic burden of diseases. The checklist supports the comparability of different studies and facilitates study conception. © Georg Thieme Verlag KG Stuttgart · New York.

  12. [Direct and indirect costs associated with respiratory allergic diseases in Italy. A probabilistic cost of illness study].

    PubMed

    Marcellusi, Andrea; Viti, Raffaella; Incorvaia, Cristoforo; Mennini, Francesco Saverio

    2015-10-01

    The respiratory allergies, including allergic rhinitis and allergic asthma, represent a substantial medical and economic burden worldwide. Despite their dimension and huge economic-social burden, no data are available on the costs associated with the management of respiratory allergic diseases in Italy. The objective of this study was to estimate the average annual cost incurred by the National Health Service (NHS), as well as society, due to respiratory allergies and their main co-morbidities in Italy. A probabilistic prevalence-based cost of illness model was developed to estimate an aggregate measure of the economic burden associated with respiratory allergies and their main co-morbidities in terms of direct and indirect costs. A systematic literature review was performed in order to identify both the cost per case (expressed in present value) and the number of affected patients, by applying an incidence-based estimation method. Direct costs were estimated multiplying the hospitalization, drugs and management costs derived by the literature with the Italian epidemiological data. Indirect costs were calculated based on lost productivity according to the human capital approach. Furthermore, a one-way and probabilistic sensitivity analysis with 5,000 Monte Carlo simulations were performed, in order to test the robustness of the results and define the proper 95% Confidence Interval (CI). Overall, the total economic burden associated with respiratory allergies and their main co-morbidities was € 7.33 billion (95% CI: € 5.99-€ 8.82). A percentage of 27.5% was associated with indirect costs (€ 2.02; 95% CI: € 1.72-€ 2.34 billion) and 72.5% with direct costs (€ 5.32; 95% CI: € 4.04-€ 6.77 billion). In allergic asthma, allergic rhinitis, combined allergic rhinitis and asthma, turbinate hypertrophy and allergic conjunctivitis, the model estimate an average annual economic burden of € 1,35 (95% CI: € 1,14-€ 1,58) billion, € 1,72 (95% CI: € 1

  13. Estimated Costs of Sporadic Gastrointestinal Illness Associated with Surface Water Recreation: A Combined Analysis of Data from NEEAR and CHEERS Studies

    EPA Science Inventory

    BACKGROUND: The ·burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost. attributable disease burden estimates can be useful for environmental management decisions. OBJECTIVES: We characteriz...

  14. Use of Multiple Data Sources to Estimate the Economic Cost of Dengue Illness in Malaysia

    PubMed Central

    Shepard, Donald S.; Undurraga, Eduardo A.; Lees, Rosemary Susan; Halasa, Yara; Lum, Lucy Chai See; Ng, Chiu Wan

    2012-01-01

    Dengue represents a substantial burden in many tropical and sub-tropical regions of the world. We estimated the economic burden of dengue illness in Malaysia. Information about economic burden is needed for setting health policy priorities, but accurate estimation is difficult because of incomplete data. We overcame this limitation by merging multiple data sources to refine our estimates, including an extensive literature review, discussion with experts, review of data from health and surveillance systems, and implementation of a Delphi process. Because Malaysia has a passive surveillance system, the number of dengue cases is under-reported. Using an adjusted estimate of total dengue cases, we estimated an economic burden of dengue illness of US$56 million (Malaysian Ringgit MYR196 million) per year, which is approximately US$2.03 (Malaysian Ringgit 7.14) per capita. The overall economic burden of dengue would be even higher if we included costs associated with dengue prevention and control, dengue surveillance, and long-term sequelae of dengue. PMID:23033404

  15. 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

  16. [Cost evaluation of a model for integrated care of seriously mentally ill patients].

    PubMed

    Fischer, F; Hoffmann, K; Mönter, N; Walle, M; Beneke, R; Negenborn, S; Weinmann, S; Willich, S N; Berghöfer, A

    2014-02-01

    The model for integrated care (IC) of those seriously mentally ill patients insured with the DAK-Gesundheit health insurance and various Betriebskrankenkassen (members of the VAG Mitte) from the regions Berlin, Brandenburg, Lower Saxony and Bremen allows a complex treatment in the outpatient setting which consists of psychiatrists, general practitioners and clinicians, psychiatric nursing, sociotherapy (only in Berlin), internal medicine quality circles, orientation on treatment guidelines and conceptual consensus with the relevant care clinics. The aim of the evaluation is to illustrate the health economic effects of IC. In the period from 2006 to 2010 insured members of the DAK-Gesundheit and other involved health insurance companies with a serious mental illness, a significant impairment of social functioning and the need to be treated to avoid or substitute an in-hospital stay were included in the integrated care. The cost perspective was that of the statutory health insurance companies. For the health economic evaluation, the utilisation of continuous IC over 18 months was compared to the last 18 months prior to the inclusion in IC. The clinical findings were gathered quarterly during the IC using CGI (Clinical Global Impressions) and GAF (Global Assessment of Functioning Scale). A total of 1 364 patients receiving IC in 66 doctor's practices were documented (of those, 286 had diagnoses of ICD-10 F2, 724 ICD-10 F32-F39). The median age was 48.8 years, 69% were female. 24% had their own source of income, 40% were on the pension, and the rest of the patients were receiving transfer benefits in some form. In 54% of the cases IC was used to avoid an in-hospital stay, in 46% of the cases to substitute an in-hospital stay. The degree of the CGI was 5.5 on average at the time of inclusion and the GAF score was 36.5 on average. The 226 patients with continuous documentation over 18 months were included in the health economic analysis. The number of days spent in

  17. Costs of Illness Due to Cholera, Costs of Immunization and Cost-Effectiveness of an Oral Cholera Mass Vaccination Campaign in Zanzibar

    PubMed Central

    Schaetti, Christian; Weiss, Mitchell G.; Ali, Said M.; Chaignat, Claire-Lise; Khatib, Ahmed M.; Reyburn, Rita; Duintjer Tebbens, Radboud J.; Hutubessy, Raymond

    2012-01-01

    Background The World Health Organization (WHO) recommends oral cholera vaccines (OCVs) as a supplementary tool to conventional prevention of cholera. Dukoral, a killed whole-cell two-dose OCV, was used in a mass vaccination campaign in 2009 in Zanzibar. Public and private costs of illness (COI) due to endemic cholera and costs of the mass vaccination campaign were estimated to assess the cost-effectiveness of OCV for this particular campaign from both the health care provider and the societal perspective. Methodology/Principal Findings Public and private COI were obtained from interviews with local experts, with patients from three outbreaks and from reports and record review. Cost data for the vaccination campaign were collected based on actual expenditure and planned budget data. A static cohort of 50,000 individuals was examined, including herd protection. Primary outcome measures were incremental cost-effectiveness ratios (ICER) per death, per case and per disability-adjusted life-year (DALY) averted. One-way sensitivity and threshold analyses were conducted. The ICER was evaluated with regard to WHO criteria for cost-effectiveness. Base-case ICERs were USD 750,000 per death averted, USD 6,000 per case averted and USD 30,000 per DALY averted, without differences between the health care provider and the societal perspective. Threshold analyses using Shanchol and assuming high incidence and case-fatality rate indicated that the purchase price per course would have to be as low as USD 1.2 to render the mass vaccination campaign cost-effective from a health care provider perspective (societal perspective: USD 1.3). Conclusions/Significance Based on empirical and site-specific cost and effectiveness data from Zanzibar, the 2009 mass vaccination campaign was cost-ineffective mainly due to the relatively high OCV purchase price and a relatively low incidence. However, mass vaccination campaigns in Zanzibar to control endemic cholera may meet criteria for cost

  18. Foodborne Illness Reduction Act of 2011

    THOMAS, 112th Congress

    Sen. Gillibrand, Kirsten E. [D-NY

    2011-09-08

    Senate - 09/08/2011 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  19. 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 ( ...

  20. Foodborne Illness Reduction Act of 2011

    THOMAS, 112th Congress

    Sen. Gillibrand, Kirsten E. [D-NY

    2011-06-08

    Senate - 06/08/2011 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  1. Barbecue Basics: Tips to Prevent Foodborne Illness

    MedlinePlus Videos and Cool Tools

    ... Wash hands well and often, with soap and water for at least 20 seconds, especially after using ... an outdoor setting with no bathroom, use a water jug, some soap, and paper towels. Consider carrying ...

  2. Towards universal coverage: examining costs of illness, payment, and coping strategies to different population groups in southeast Nigeria.

    PubMed

    Ezeoke, Ogochukwu P; Onwujekwe, Obinna E; Uzochukwu, Benjamin S

    2012-01-01

    This study investigated the costs of illness to households in different socio-economic status (SES) groups and geographic places of abode in addition to the mechanisms that the different population groups used to pay for health services and cope with payments. A cross-sectional descriptive study of 3,200 households selected from six communities in two states was conducted using interviewer-administered pre-tested questionnaires. An SES index was used to divide the households into quartiles, and χ(2) analysis was used to determine the relationship of SES and geographic abode of households with cost of illness, payment mechanism, and coping strategies. The results show that malaria was the illness that most people had. The average cost of transportation for malaria was 86 Naira ($0.6 US), and the total cost of treatment was 2,819.9 Naira ($20 US); of this cost, drug costs alone contributed more than 90%. Out of pocket was the main method of payment. Treatment costs differed by geographic location and socio-economic status. Policy measures should establish targeted mechanisms to protect the general population, especially rural dwellers and poorer households, against the financial burden of direct healthcare payments.

  3. Foodborne outbreaks of shigellosis in the USA, 1998–2008

    PubMed Central

    Nygren, B. L.; Schilling, K. A.; Blanton, E. M.; Silk, B. J.; Cole, D. J.; Mintz, E. D.

    2015-01-01

    SUMMARY We examined reported outbreaks of foodborne shigellosis in the USA from 1998 to 2008 and summarized demographic and epidemiological characteristics of 120 confirmed outbreaks resulting in 6208 illnesses. Most reported foodborne shigellosis outbreaks (n=70, 58%) and outbreak-associated illnesses (n=3383, 54%) were restaurant-associated. The largest outbreaks were associated with commercially prepared foods distributed in multiple states and foods prepared in institutional settings. Foods commonly consumed raw were implicated in 29 (24%) outbreaks and infected food handlers in 28 (23%) outbreaks. Most outbreaks (n=86, 72%) were caused by Shigella sonnei. Targeted efforts to reduce contamination during food handling at multiple points in the food processing and distribution system, including food preparation in restaurants and institutional settings, could prevent many foodborne disease outbreaks and outbreak-related illnesses including those due to Shigella. PMID:22361246

  4. Effect of asthma on falling into poverty: the overlooked costs of illness.

    PubMed

    Callander, Emily J; Schofield, Deborah J

    2015-05-01

    Studies on the indirect costs of asthma have taken a narrow view of how the condition affects the living standards of patients by examining only the association with employment and income. To build on the current cost-of-illness literature and identify whether having asthma is associated with an increased risk of poverty, thus giving a more complete picture of the costs of asthma to individuals and society. Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian survey to estimate the relative risk of income poverty, multidimensional poverty, and long-term multidimensional poverty between 2007 and 2012 and population attributable risk method to estimate the proportion of poverty between 2007 and 2012 directly attributable to asthma. No significant difference was found in the risk of falling into income poverty between those with and without asthma (P = .07). Having asthma increased the risk of falling into multidimensional poverty by 1.35 (95% confidence interval [CI], 1.01-1.83) and the risk of falling into chronic multidimensional poverty by 2.22 (95% CI, 1.20-4.10). Between 2007 and 2012, a total of 5.2% of income poverty cases (95% CI, 5.1%-5.4%), 7.8% of multidimensional poverty cases (95% CI, 7.7%-8.0%), and 19.6% of chronic multidimensional poverty cases (95% CI, 19.2%-20.0%) can be attributed to asthma. Asthma is associated with an increased risk of falling into poverty. This should be taken into consideration when considering the suitability of different treatment options for patients with asthma. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  5. Cost of illness studies on reproductive, maternal, newborn, and child health: a systematic literature review

    PubMed Central

    2013-01-01

    Background The term “reproductive, maternal, newborn, and child health (RMNCH)” describes an integrated continuum of health states which is central to Millennium Development Goals 4 and 5. While the burden of mortality and morbidity associated with RMNCH is well known, knowledge is still limited about the economic burden of RMNCH. Concrete evidence of cost of illness (COI) of RMNCH may help policy makers in supporting investment in RMNCH. Methods A systematic literature search of COI studies was performed in electronic databases. The time frame for the analysis was January 1990 – April 2011. The databases checked were Medline (Pubmed), Embase and ECONbase, EconLit, the Cumulative Index to Nursing and Allied Health (CINAHL), the National Bureau of Economic Research, the Latin American and Caribbean Literature on Health Sciences Database (LILACS), and Popline. Furthermore, we searched working papers and reference lists of selected articles. Results All the studies investigated address particular complications and issues of RMNCH, e.g., preterm birth, non-exclusive breastfeeding, and sexually transmitted diseases (STDs), but not RMNCH as an entire continuum. Most of the studies were conducted in high income countries, with limited data on low and middle income countries. The burden of disease is very high even for single complications. For example, the disease burden related to non-exclusive breastfeeding was given as 14.39 billion international dollars (ID) (2012, purchasing power parity) per year in the USA. Methodological differences in study design, costing approach, perspective of analysis, and time frame make it difficult to compare different studies. Conclusion The continuum of RMNCH covers a large portion of the lifespan from birth through the reproductive age. From a methodological perspective, an ideal COI study would clearly describe the perspective of analysis and, hence, the cost items (direct or indirect), cost collection procedure, discounting

  6. Cost of illness of oral lichen planus in a U.K. population--a pilot study.

    PubMed

    Ni Riordain, Richeal; Christou, Joanna; Pinder, Denise; Squires, Vanessa; Hodgson, Tim

    2016-05-01

    To assess the economic burden of oral lichen planus (OLP) from the perspective of the healthcare provider in a U.K. population. This prevalence-based cost-of-illness analysis was carried out via a cross-sectional study conducted in the Oral Medicine Unit of the Eastman Dental Hospital. This study was conducted in three phases - phase 1 involved framing of the cost-of-illness analysis, development of the cost inventory and design of the patient questionnaire for ease of data collection. Data collected from patients were inputted during phase 2, and costings were determined. The final phase consisted of the calculation of the cost of illness of OLP. One hundred patients were enrolled in the study, 30 males and 70 females, with an average age of 59.9 years (±13.4 years). The average OLP patient, based on our cohort, attends the oral medicine unit 2.64 times per year, their general medical practitioner 1.13 times annually, their general dental practitioner 0.82 times in a year and fills on average 3.37 prescriptions annually. This leads to an average annual cost of £398.58 (€541.16) per patient per year from the perspective of the healthcare provider. The annual average cost of OLP to the healthcare provider in the U.K. is substantial. The prevalence-based cost-of-illness data generated in this study will facilitate comparison with other chronic oral mucosal diseases and with chronic diseases managed in allied medical specialties. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. 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

  8. Costs of rheumatoid arthritis during the period 1990-2010: a register-based cost-of-illness study in Sweden.

    PubMed

    Kalkan, Almina; Hallert, Eva; Bernfort, Lars; Husberg, Magnus; Carlsson, Per

    2014-01-01

    The objectives of this study were to analyse the total socio-economic impact of RA in Sweden during the period 1990-2010 and to analyse possible changes in costs during this period. The period was deliberately chosen to cover 10 years before and 10 years after the introduction of biologic drugs. A prevalence-based cost-of-illness study was conducted based on data from national and regional registries. There was a decrease in the utilization of RA-related inpatient care as well as sick leave and disability pension during 1990-2010 in Sweden. Total costs for RA are presented in current prices as well as inflation-adjusted with the consumer price index (CPI) and a healthcare price index. The total fixed cost of RA was €454 million in 1990, adjusted to the price level of 2010 with the CPI. This cost increased to €600 million in 2010 and the increase was mainly due to the substantially increasing costs for pharmaceuticals. Of the total costs, drug costs increased from 3% to 33% between 1990 and 2010. Consequently the portion of total costs accounting for indirect costs for RA is lowered from 75% in 1990 to 58% in 2010. By inflation adjusting with the CPI, which is reasonable from a societal perspective, there was a 32% increase in the total fixed cost of RA between 1990 and 2010. This suggests that decreased hospitalization and indirect costs have not fallen enough to offset the increasing cost of drug treatment.

  9. Cost-effectiveness of dalteparin vs unfractionated heparin for the prevention of venous thromboembolism in critically ill patients.

    PubMed

    Fowler, Robert A; Mittmann, Nicole; Geerts, William; Heels-Ansdell, Diane; Gould, Michael K; Guyatt, Gordon; Krahn, Murray; Finfer, Simon; Pinto, Ruxandra; Chan, Brian; Ormanidhi, Orges; Arabi, Yaseen; Qushmaq, Ismael; Rocha, Marcelo G; Dodek, Peter; McIntyre, Lauralyn; Hall, Richard; Ferguson, Niall D; Mehta, Sangeeta; Marshall, John C; Doig, Christopher James; Muscedere, John; Jacka, Michael J; Klinger, James R; Vlahakis, Nicholas; Orford, Neil; Seppelt, Ian; Skrobik, Yoanna K; Sud, Sachin; Cade, John F; Cooper, Jamie; Cook, Deborah

    2014-11-26

    Venous thromboembolism (VTE) is a common complication of acute illness, and its prevention is a ubiquitous aspect of inpatient care. A multicenter blinded, randomized trial compared the effectiveness of the most common pharmocoprevention strategies, unfractionated heparin (UFH) and the low-molecular-weight heparin (LMWH) dalteparin, finding no difference in the primary end point of leg deep-vein thrombosis but a reduced rate of pulmonary embolus and heparin-induced thrombocytopenia among critically ill medical-surgical patients who received dalteparin. To evaluate the comparative cost-effectiveness of LMWH vs UFH for prophylaxis against VTE in critically ill patients. Prospective economic evaluation concurrent with the Prophylaxis for Thromboembolism in Critical Care Randomized Trial (May 2006 to June 2010). The economic evaluation adopted a health care payer perspective and in-hospital time horizon; derived baseline characteristics and probabilities of intensive care unit and in-hospital events; and measured costs among 2344 patients in 23 centers in 5 countries and applied these costs to measured resource use and effects of all enrolled patients. Costs, effects, incremental cost-effectiveness of LMWH vs UFH during the period of hospitalization, and sensitivity analyses across cost ranges. Hospital costs per patient were $39,508 (interquartile range [IQR], $24,676 to $71,431) for 1862 patients who received LMWH compared with $40,805 (IQR, $24,393 to $76,139) for 1862 patients who received UFH (incremental cost, -$1297 [IQR, -$4398 to $1404]; P = .41). In 78% of simulations, a strategy using LMWH was most effective and least costly. In sensitivity analyses, a strategy using LMWH remained least costly unless the drug acquisition cost of dalteparin increased from $8 to $179 per dose and was consistent among higher- and lower-spending health care systems. There was no threshold at which lowering the acquisition cost of UFH favored prophylaxis with UFH. From a

  10. Lower respiratory tract illness in the first two years of life: epidemiologic patterns and costs in a suburban pediatric practice.

    PubMed Central

    McConnochie, K M; Hall, C B; Barker, W H

    1988-01-01

    The epidemiologic patterns and the economic impact of acute lower respiratory tract illness (LRTI) in children under age two were studied using data collected from November 1, 1971-August 30, 1975 in a suburban pediatric practice in Monroe County, New York. LRTI was responsible for 23 illness episodes per 100 child-years among children in their first two years of life. This indicates that a cohort of 100 children might be anticipated to have 46 LRTI episodes from birth until their second birthday. The majority of episodes correlated with the presence of four viruses in the community, most commonly respiratory syncytial virus. The minimal, estimated direct cost of LRTI in the first two years of life based on 1984 cost data was equivalent to $35.14 for every child and was comprised of hospitalization cost ($19.68) and ambulatory care cost ($15.46). Hospitalization costs attributable to LRTI comprised at least 2.5 per cent of all hospitalization costs in this age group. Immunization against the four most common respiratory viruses, at a reasonable cost per child immunized, would appear to be cost beneficial. PMID:3337302

  11. 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.

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

    USDA-ARS?s Scientific Manuscript database

    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 ...

  13. The cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders: A cost-of-illness study.

    PubMed

    Demarré, Liesbet; Verhaeghe, Sofie; Annemans, Lieven; Van Hecke, Ann; Grypdonck, Maria; Beeckman, Dimitri

    2015-07-01

    The economic impact of pressure ulcer prevention and treatment is high. The results of cost-of-illness studies can assist the planning, allocation, and priority setting of healthcare expenditures to improve the implementation of preventive measures. Data on the cost of current practice of pressure ulcer prevention or treatment in Flanders, a region of Belgium, is lacking. To examine the cost of pressure ulcer prevention and treatment in an adult population in hospitals and nursing homes from the healthcare payer perspective. A cost-of-illness study was performed using a bottom-up approach. Hospitals and nursing homes in Flanders, a region of Belgium. Data were collected in a series of prospective multicentre cross-sectional studies between 2008 and 2013. Data collection included data on risk assessment, pressure ulcer prevalence, preventive measures, unit cost of materials for prevention and treatment, nursing time measurements for activities related to pressure ulcer prevention and treatment, and nursing wages. The cost of pressure ulcer prevention and treatment in hospitals and nursing homes was calculated as annual cost for Flanders, per patient, and per patient per day. The mean (SD) cost for pressure ulcer prevention was €7.88 (8.21) per hospitalised patient at risk per day and €2.15 (3.10) per nursing home resident at risk per day. The mean (SD) cost of pressure ulcer prevention for patients and residents identified as not at risk for pressure ulcer development was €1.44 (4.26) per day in hospitals and €0.50 (1.61) per day in nursing homes. The main cost driver was the cost of labour, responsible for 79-85% of the cost of prevention. The mean (SD) cost of local treatment per patient per day varied between €2.34 (1.14) and €77.36 (35.95) in hospitals, and between €2.42 (1.15) and €16.18 (4.93) in nursing homes. Related to methodological differences between studies, the cost of pressure ulcer prevention and treatment in hospitals and nursing

  14. Reducing the burden of suffering from eating disorders: Unmet treatment needs, cost of illness, and the quest for cost-effectiveness.

    PubMed

    Striegel Weissman, Ruth; Rosselli, Francine

    2017-01-01

    Eating disorders are serious mental disorders as reflected in significant impairments in health and psychosocial functioning and excess mortality. Despite the clear evidence of clinical significance and despite availability of evidence-based, effective treatments, research has shown a paradox of elevated health services use and, yet, infrequent treatment specifically targeting the eating disorder (i.e., high unmet treatment need). This review paper summarizes key studies conducted in collaboration with G. Terence Wilson and offers an update of the research literature published since 2011 in three research areas that undergirded our collaborative research project: unmet treatment needs, cost of illness, and cost-effectiveness of treatments. In regards to unmet treatment needs, epidemiological studies find that the number of individuals with an eating disorder who do not receive disorder-specific treatment continues to remain high. Cost-of-illness show that eating disorders are associated with substantial financial burdens for individuals, their family, and society, yet comprehensive examination of costs across public sectors is lacking. Cost measures vary widely, making it difficult to draw firm conclusions. Hospitalization is a major driver of medical costs incurred by individuals with an eating disorder. Only a handful of cost-effectiveness studies have been conducted, leaving policy makers with little information on which to base decisions about allocation of resources to help reduce the burden of suffering attributable to eating disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Potential Influence of Advance Care Planning and Palliative Care Consultation on ICU Costs for Patients With Chronic and Serious Illness.

    PubMed

    Khandelwal, Nita; Benkeser, David C; Coe, Norma B; Curtis, J Randall

    2016-08-01

    To estimate the potential ICU-related cost savings if in-hospital advance care planning and ICU-based palliative care consultation became standard of care for patients with chronic and serious illness. Decision analysis using literature estimates and inpatient administrative data from Premier. Patients with chronic, life-limiting illness admitted to a hospital within the Premier network. None. Using Premier data (2008-2012), ICU resource utilization and costs were tracked over a 1-year time horizon for 2,097,563 patients with chronic life-limiting illness. Using a Markov microsimulation model, we explored the potential cost savings from the hospital system perspective under a variety of scenarios by varying the interventions' efficacies and availabilities. Of 2,097,563 patients, 657,825 (31%) used the ICU during the 1-year time horizon; mean ICU spending per patient was 11.3k (SD, 17.6k). In the base-case analysis, if in-hospital advance care planning and ICU-based palliative care consultation were systematically provided, we estimated a mean reduction in ICU costs of 2.8k (SD, 14.5k) per patient and an ICU cost saving of 25%. Among the simulated patients who used the ICU, the receipt of both interventions could have resulted in ICU cost savings of 1.9 billion, representing a 6% reduction in total hospital costs for these patients. In-hospital advance care planning and palliative care consultation have the potential to result in significant cost savings. Studies are needed to confirm these findings, but our results provide guidance for hospitals and policymakers.

  16. 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

  17. Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care

    PubMed Central

    Basu, Anirban; Kee, Romina; Buchanan, David; Sadowski, Laura S

    2012-01-01

    Objective To assess the costs of a housing and case management program in a novel sample—homeless adults with chronic medical illnesses. Data Source The study used data from multiple sources: (1) electronic medical records for hospital, emergency room, and ambulatory medical and mental health visits; (2) institutional and regional databases for days in respite centers, jails, or prisons; and (3) interviews for days in nursing homes, shelters, substance abuse treatment centers, and case manager visits. Total costs were estimated using unit costs for each service. Study Design Randomized controlled trial of 407 homeless adults with chronic medical illnesses enrolled at two hospitals in Chicago, Illinois, and followed for 18 months. Principal Findings Compared to usual care, the intervention group generated an average annual cost savings of (−)$6,307 per person (95 percent CI: −16,616, 4,002; p = .23). Subgroup analyses of chronically homeless and those with HIV showed higher per person, annual cost savings of (−)$9,809 and (−)$6,622, respectively. Results were robust to sensitivity analysis using unit costs. Conclusion The findings of this comprehensive, comparative cost analyses demonstrated an important average annual savings, though in this underpowered study these savings did not achieve statistical significance. PMID:22098257

  18. Long-term consequences of foodborne infections.

    PubMed

    Batz, Michael B; Henke, Evan; Kowalcyk, Barbara

    2013-09-01

    Foodborne infections with Campylobacter, E. coli O157:H7, Listeria monocytogenes, Salmonella, Shigella, Toxoplasma gondii, and other pathogens can result in long-term sequelae to numerous organ systems. These include irritable bowel syndrome, inflammatory bowel disease, reactive arthritis, hemolytic uremic syndrome, chronic kidney disease, Guillain-Barré Syndrome, neurological disorders from acquired and congenital listeriosis and toxoplasmosis, and cognitive and developmental deficits due to diarrheal malnutrition or severe acute illness. A full understanding of the long-term sequelae of foodborne infection is important both for individual patient management by clinicians, as well as to inform food safety and public health decision making. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Foodborne botulism in the Republic of Georgia.

    PubMed

    Varma, Jay K; Katsitadze, Guram; Moiscrafishvili, Maia; Zardiashvili, Tamar; Chikheli, Maia; Tarkashvili, Natalia; Jhorjholiani, Ekaterina; Chubinidze, Maia; Kukhalashvili, Teimuraz; Khmaladze, Irakli; Chakvetadze, Nelli; Imnadze, Paata; Sobel, Jeremy

    2004-09-01

    Foodborne botulism is a potentially fatal, paralytic illness that can cause large outbreaks. A possible increase in botulism incidence during 2001 in the Republic of Georgia prompted this study. We reviewed surveillance data and abstracted records of patients with botulism who were hospitalized from 1980 to 2002. During this period, 879 botulism cases were detected. The median annual incidence increased from 0.3 per 100,000 during 1980 to 1990 to 0.9 per 100,000 during 1991 to 2002. For 706 botulism patients hospitalized from 1980 to 2002, 80% of their cases were attributed to home-preserved vegetables. Surveillance evaluation verified that botulism incidence varied greatly by region. Georgia has the highest nationally reported rate of foodborne botulism in the world. A strategy addressing individual behaviors in the home is needed to improve food safety; developing this strategy requires a deeper understanding of why botulism has increased and varies by region.

  20. Foodborne Botulism in the Republic of Georgia

    PubMed Central

    Katsitadze, Guram; Moiscrafishvili, Maia; Zardiashvili, Tamar; Chokheli, Maia; Tarkhashvili, Natalia; Jhorjholiani, Ekaterina; Chubinidze, Maia; Kukhalashvili, Teimuraz; Khmaladze, Irakli; Chakvetadze, Nelli; Imnadze, Paata; Sobel, Jeremy

    2004-01-01

    Foodborne botulism is a potentially fatal, paralytic illness that can cause large outbreaks. A possible increase in botulism incidence during 2001 in the Republic of Georgia prompted this study. We reviewed surveillance data and abstracted records of patients with botulism who were hospitalized from 1980 to 2002. During this period, 879 botulism cases were detected. The median annual incidence increased from 0.3 per 100,000 during 1980 to 1990 to 0.9 per 100,000 during 1991 to 2002. For 706 botulism patients hospitalized from 1980 to 2002, 80% of their cases were attributed to home-preserved vegetables. Surveillance evaluation verified that botulism incidence varied greatly by region. Georgia has the highest nationally reported rate of foodborne botulism in the world. A strategy addressing individual behaviors in the home is needed to improve food safety; developing this strategy requires a deeper understanding of why botulism has increased and varies by region. PMID:15498162

  1. Systematic review of studies on rotavirus disease cost-of-illness and productivity loss in Latin America and the Caribbean.

    PubMed

    Takemoto, Maíra Libertad Soligo; Bahia, Luciana; Toscano, Cristiana M; Araujo, Denizar Vianna

    2013-07-02

    Rotavirus is the most common cause of severe acute diarrhea among children in both developed and developing countries. Vaccination can reduce the disease burden and its incorporation into health care systems should consider future costs and benefits. To systematically review studies on costs due to rotavirus infection in Latin America and Caribbean (LAC) region, considering their methods and results. A search of relevant databases including the Cochrane Central Register of Controlled Trials, Embase, MEDLINE via PubMed, the Latin American and Caribbean Health Sciences Literature database (LILACS), and the Brazilian Thesis Databank was performed. Inclusion criteria for studies were: (a) economic evaluation or cost-of-illness studies; (b) conducted in the LAC region; (c) assess economic burden of rotavirus disease or the economic impact of rotavirus vaccination programs. Two authors independently screened the studies for eligibility. Of 444 studies initially retrieved, 21 met the eligibility criteria and were included (14 cost-effectiveness analyses of vaccination programs and 7 cost-of-illness studies). Direct medical costs were assessed in all 21 studies, but only 10 also investigated indirect and non-medical direct costs. The most commonly observed methods for cost estimation were retrospective database analysis and hospital-based surveillance study. Only one study was a household-based survey.A wide cost range was identified (e.g., inpatient care US$79.91 to US$858.40 and outpatient care US$13.06 to US$64.10), depending on the methods, study perspective, and type of costs included. Rotavirus-associated costs were assessed in 21 studies across the Latin America and Caribbean region. The majority of studies were made alongside economic evaluations of vaccination programs. Methods are broadly different among studies but administrative databases seem to be the most employed source of data. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Cost of illness in patients with mandibular fracture following road traffic crash and its socioeconomic implications in KANO STATE, NIGERIA.

    PubMed

    Akhiwu, B I; Suleiman, H H; Muktar, M; Amole, I O

    2015-01-01

    The Upward trend in facial injuries following road traffic crashes has been attributed to increasing urbanization and industrialization. This study was conducted to determine the cost of illness for mandibular fractures and its socioeconomic implications. All the consecutive patients with mandibular fractures following road traffic crashes that presented to the Aminu Kano Teaching hospital in Kano State were recruited over one year. A total of 50 patients were managed during the study period with 58% in the age range 21-30 years with mean of 27.9 ± 8.1 years, motorcycle-related road traffic crashes constituted the commonest aetiology. The cost of illness for mandibular fractures was N89, 312.20 ($488) per person. Cost of managing mandibular fractures was equivalent to 8.4% of the health care budget of the state and also equivalent to 15.2 % of the GDP per capita of the year of study surpassing the cost of illness for hypertension and diabetes. These findings highlight the need for policies that would ensure safe driving, enforce the use of safety gadgets, protocols for efficient fracture management and reduced hospital stay.

  3. Estimating the burden of foodborne disease, South Korea, 2008-2012.

    PubMed

    Park, Myoung Su; Kim, Yong Soo; Lee, Soon Ho; Kim, Soon Han; Park, Ki Hwan; Bahk, Gyung Jin

    2015-03-01

    Estimating the actual occurrence of foodborne illness is challenging because only a small proportion of foodborne illnesses are confirmed and reported. Many studies have attempted to accurately estimate the overall number of cases of foodborne illness, but none have attempted to estimate the burden of foodborne disease in South Korea. This study used data from the Health Insurance Review and Assessment Service (HIRA), a public health surveillance system in South Korea, to calculate the number of cases and hospitalizations due to 18 specific pathogens and unspecified agents commonly transmitted through contaminated food between 2008 and 2012 in South Korea while accounting for uncertainty in the estimate. The estimated annual occurrences of foodborne illness were 336,138 (90% credible interval [CrI]: 258,379-430,740), with inpatient stays (hospitalizations), outpatient visits (foodborne disease infections), and patients' experiences (without visiting physicians) accounting for 2.3% (n=7809 [90% CrI: 7016-8616]), 14.4% (n=48,267 [90% CrI: 45,883-50,695]) and 83.3% (n=280,062 [90% CrI: 201,795-374,091]), respectively. Escherichia coli, including enterohemorrhagic E. coli, caused most illnesses, followed by nontyphoidal Salmonella spp., Staphylococcus aureus, hepatitis A virus, and norovirus. These results will be useful to food safety policymakers for the prevention and control of foodborne pathogens in South Korea.

  4. Detection of Foodborne Bacterial Pathogens from Individual Filth Flies

    PubMed Central

    Pava-Ripoll, Monica; Pearson, Rachel E.G.; Miller, Amy K.; Ziobro, George C.

    2015-01-01

    There is unanimous consensus that insects are important vectors of foodborne pathogens. However, linking insects as vectors of the pathogen causing a particular foodborne illness outbreak has been challenging. This is because insects are not being aseptically collected as part of an environmental sampling program during foodborne outbreak investigations and because there is not a standardized method to detect foodborne bacteria from individual insects. To take a step towards solving this problem, we adapted a protocol from a commercially available PCR-based system that detects foodborne pathogens from food and environmental samples, to detect foodborne pathogens from individual flies.Using this standardized protocol, we surveyed 100 wild-caught flies for the presence of Cronobacter spp., Salmonella enterica, and Listeria monocytogenes and demonstrated that it was possible to detect and further isolate these pathogens from the body surface and the alimentary canal of a single fly. Twenty-two percent of the alimentary canals and 8% of the body surfaces from collected wild flies were positive for at least one of the three foodborne pathogens. The prevalence of Cronobacter spp. on either body part of the flies was statistically higher (19%) than the prevalence of S. enterica (7%) and L.monocytogenes (4%). No false positives were observed when detecting S. enterica and L. monocytogenes using this PCR-based system because pure bacterial cultures were obtained from all PCR-positive results. However, pure Cronobacter colonies were not obtained from about 50% of PCR-positive samples, suggesting that the PCR-based detection system for this pathogen cross-reacts with other Enterobacteriaceae present among the highly complex microbiota carried by wild flies. The standardized protocol presented here will allow laboratories to detect bacterial foodborne pathogens from aseptically collected insects, thereby giving public health officials another line of evidence to find out how

  5. Detection of foodborne bacterial pathogens from individual filth flies.

    PubMed

    Pava-Ripoll, Monica; Pearson, Rachel E G; Miller, Amy K; Ziobro, George C

    2015-02-13

    There is unanimous consensus that insects are important vectors of foodborne pathogens. However, linking insects as vectors of the pathogen causing a particular foodborne illness outbreak has been challenging. This is because insects are not being aseptically collected as part of an environmental sampling program during foodborne outbreak investigations and because there is not a standardized method to detect foodborne bacteria from individual insects. To take a step towards solving this problem, we adapted a protocol from a commercially available PCR-based system that detects foodborne pathogens from food and environmental samples, to detect foodborne pathogens from individual flies.Using this standardized protocol, we surveyed 100 wild-caught flies for the presence of Cronobacter spp., Salmonella enterica, and Listeria monocytogenes and demonstrated that it was possible to detect and further isolate these pathogens from the body surface and the alimentary canal of a single fly. Twenty-two percent of the alimentary canals and 8% of the body surfaces from collected wild flies were positive for at least one of the three foodborne pathogens. The prevalence of Cronobacter spp. on either body part of the flies was statistically higher (19%) than the prevalence of S. enterica (7%) and L.monocytogenes (4%). No false positives were observed when detecting S. enterica and L. monocytogenes using this PCR-based system because pure bacterial cultures were obtained from all PCR-positive results. However, pure Cronobacter colonies were not obtained from about 50% of PCR-positive samples, suggesting that the PCR-based detection system for this pathogen cross-reacts with other Enterobacteriaceae present among the highly complex microbiota carried by wild flies. The standardized protocol presented here will allow laboratories to detect bacterial foodborne pathogens from aseptically collected insects, thereby giving public health officials another line of evidence to find out how

  6. Water-Borne Diseases, Cost of Illness and Willingness to Pay for Diseases Interventions in Rural Communities of Developing Countries

    PubMed Central

    Malik, A; Yasar, A; Tabinda, AB; Abubakar, M

    2012-01-01

    Background Almost one third of the global population is living in developing South Asia where disease occurrence is high especially in rural areas and people are unaware of water-borne diseases and cost of illness. Methods: The quantitative approach involved questionnaire based study (n=50 households). The community awareness, the occurrence of water-borne diseases with related cost of illness and community participation for the introduction of health interventions for water-borne diseases were evaluated through cross-tabulations, correlations, and ANOVA. Results: Majority (40%) of the community had no knowledge of water-borne diseases except some had little knowledge of diarrhea and typhoid. Diarrhea followed by stomach diseases was widespread in the community. Population below poverty level was bearing the cost of illness around US$ 0.6—1.2 (Rs 50—100) per day followed by low and average income level with direct cost of US$ 2.3 (Rs 200) per day. The indirect cost of illness had showed increasing trend between US$ 2.3—4.7 (Rs 200–400) per day with increase in income levels. Maximum willingness to pay (WTP) for water supply and sewerage system was US$ 3.6 (Rs 300) and US$ 1.2 (Rs 100) per month respectively. Income and water supply demand was strongly correlated with acceptability to pay for the facilities (r = 0.319, 0.307; P< 0.05). Income had a strong influence on WTP for water and sewerage system (r = 0.805, 0.797; P< 0.05). Conclusion: To maintain rural health, water-borne diseases can be reduced by introducing health interventions like proper water and sanitation facilities. PMID:23113192

  7. 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

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

    PubMed

    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.

  9. Incidences and Costs of Illness for Diarrhea and Acute Respiratory Infections for Children < 5 Years of Age in Rural Bangladesh.

    PubMed

    Halder, Amal K; Luby, Stephen P; Akhter, Shamima; Ghosh, Probir K; Johnston, Richard B; Unicomb, Leanne

    2017-02-06

    Understanding illness costs associated with diarrhea and acute respiratory infections (ARI) could guide prevention and treatment strategies. This study aimed to determine incidence of childhood diarrhea and ARI and costs of homecare, hospitalization, and outpatient treatment by practitioner type in rural Bangladesh. From each of 100 randomly selected population clusters we sampled 17 households with at least one child < 5 years of age. Childhood diarrhea incidence was 3,451 and ARI incidence was 5,849/1,000 child-years. For diarrhea and ARI outpatient care per 1,000 child-years, parents spent more on unqualified ($2,361 and $4,822) than qualified health-care practitioners ($113 and $947). For outpatient care, visits to unqualified health-care practitioners were at least five times more common than visits to qualified practitioners. Costs for outpatient care treatment by unqualified health-care practitioners per episode of illness were similar to those for qualified health-care practitioners. Homecare costs ($0.16 and $0.24), as well as hospitalization costs per episode, were similar for diarrhea and ARI, respectively. On average, rural Bangladeshi households with children < 5 years of age spent 1.3% ($12 of $915) of their annual income managing diarrhea and ARI for those children. The majority of childhood illness management cost comprised visits to unqualified health-care practitioners. Policy makers should consider strategies to increase the skills of unqualified health-care practitioners, use community health workers to provide referral, and promote homecare for diarrhea and ARI. Incentives to motivate existing qualified physicians who are interested to work in rural Bangladesh could also be considered.

  10. Comorbidities, treatment patterns and cost-of-illness of acromegaly in Sweden: a register-linkage population-based study.

    PubMed

    Lesén, Eva; Granfeldt, Daniel; Houchard, Aude; Dinet, Jérôme; Berthon, Anthony; Olsson, Daniel S; Björholt, Ingela; Johannsson, Gudmundur

    2017-02-01

    Acromegaly is a complex endocrine disease with multiple comorbidities. Treatment to obtain biochemical remission includes surgery, medical therapy and radiation. We aimed to describe comorbidities, treatment patterns and cost-of-illness in patients with acromegaly in Sweden. A nationwide population-based study. Patients with acromegaly were identified and followed in national registers in Sweden. Longitudinal treatment patterns were assessed in patients diagnosed between July 2005 and December 2013. The cost-of-illness during 2013 was estimated from a societal perspective among patients diagnosed between 1987 and 2013. Among 358 patients with acromegaly (48% men, mean age at diagnosis 50.0 (s.d. 15.3) years) at least one comorbidity was reported in 81% (n = 290). The most common comorbidities were hypertension (40%, n = 142), neoplasms outside the pituitary (30%, n = 109), hypopituitarism (22%, n = 80) and diabetes mellitus (17%, n = 61). Acromegaly treatment was initiated on average 3.7 (s.d. 6.9) months after diagnosis. Among the 301 treated patients, the most common first-line treatments were surgery (60%, n = 180), somatostatin analogues (21%, n = 64) and dopamine agonists (14%, n = 41). After primary surgery, 24% (n = 44) received somatostatin analogues. The annual per-patient cost was €12 000; this was €8700 and €16 000 if diagnosed before or after July 2005, respectively. The cost-of-illness for acromegaly and its comorbidities was 77% from direct costs and 23% from production loss. The prevalence of comorbidity is high in patients with acromegaly. The most common first-line treatment in acromegalic patients was surgery followed by somatostatin analogues. The annual per-patient cost of acromegaly and its comorbidities was €12 000. © 2017 European Society of Endocrinology.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  12. 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

  13. Radiation inactivation of foodborne pathogens on frozen seafood products

    USDA-ARS?s Scientific Manuscript database

    Food-borne illness due to consumption of contaminated seafood is, unfortunately, a regular occurrence in the United States. Ionizing (gamma) irradiation can effectively inactivate microorganisms and extend the shelf-life of seafood. In this study, the ability of gamma irradiation to inactivate food-...

  14. Economic consequences of accidents to hands and forearms by log splitters and circular saws: cost of illness study.

    PubMed

    Eriksson, Martin; Karlsson, Johan; Carlsson, Katarina Steen; Dahlin, Lars B; Rosberg, Hans-Eric

    2011-02-01

    We estimated costs associated with injuries to hands from log splitters and circular saws used to cut up firewood and assessed the value of prevention. The study was carried out as a cost of illness study with an incidence approach based on 57 consecutive patients (median age 51; range 8-81) with injuries to the hand or forearm. Twenty-six of the 57 had an amputation which required microsurgery and 31/57 had various injuries. Median Hand Injury Severity Score (HISS) reflecting the severity of all injuries was 67 (range 6-332). Median DASH score after 2-7 years was 12.5 (0-73.3). Total cost (direct costs, costs of lost productivity, and lost quality of life) was estimated to roughly EUR 14 million (EUR 2.8 million/year), where the cost of lost quality of life is 82% of the total cost and loss of productivity and direct costs are 9% each. Injuries sustained from log splitters and circular saws account for considerable costs, but first and foremost human suffering.

  15. [Food-borne botulism].

    PubMed

    Nakamura, Yuko; Sawada, Mikio; Ikeguchi, Kunihiko; Nakano, Imaharu

    2012-08-01

    Botulism is a neuroparalytic disease caused by neurotoxins produced by Clostridium botulinum, and classically presents as palsies of cranial nerves and acute descending flaccid paralysis. Food-borne botulism is the most common form of botulism, and caused by preformed neurotoxins produced by Clostridium botulinum. Electrophysiological studies play an important role in the early diagnosis. Confirmation of the diagnosis is based on the detection of botulinum toxins in the patient's serum or stool. In Japan, decades ago, botulism type E occurred, though only sporadically, almost every year, but in recent years, has dramatically decreased in frequency. Botulism is a curable disease when treated early and adequately. Differential diagnosis of cranial nerves and limb muscle palsies with rapid exacerbation should include food-borne botulism.

  16. 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.

  17. 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

  18. Cost-of-illness in patients with moderate to severe psoriasis: a cross-sectional survey in Hungarian dermatological centres.

    PubMed

    Balogh, Orsolya; Brodszky, Valentin; Gulácsi, László; Herédi, Emese; Herszényi, Krisztina; Jókai, Hajnalka; Kárpáti, Sarolta; Baji, Petra; Remenyik, Éva; Szegedi, Andrea; Holló, Péter

    2014-05-01

    Despite the widespread availability of biological drugs in psoriasis, there is a shortage of disease burden studies. To assess the cost-of-illness and quality of life of patients with moderate to severe psoriasis in Hungary. Consecutive patients with Psoriasis Area and Severity Index (PASI) > 10 and Dermatology Life Quality Index (DLQI) > 10, or treated with traditional systemic (TST) or biological systemic treatment (BST) were included. Demographic data, clinical characteristics, psoriasis related medication, health care utilizations and employment status in the previous 12 months were recorded. Costing was performed from the societal perspective applying the human capital approach. Quality of life was assessed using DLQI and EQ-5D measures. Two-hundred patients were involved (females 32%) with a mean age of 51 (SD 13) years, 103 (52%) patients were on BST. Mean PASI, DLQI and EQ-5D scores were 8 (SD 10), 6 (SD 7) and 0.69 (SD 0.3), respectively. The mean total cost was €9,254/patient/year (SD 8,502) with direct costs accounting for 86%. The main cost driver was BST (mean €7,339/patient/year). Total costs differed significantly across treatment subgroups, mean (SD): no systemic therapy €2,186 (4,165), TST €2,388 (4,106) and BST €15,790 (6,016) (p < 0,001). Patients with BST had better PASI and DLQI scores (p < 0.01) than the other two subgroups. Patients with biological treatment have a significantly better quality of life and higher total costs than patients with or without traditional systemic treatment. Our study is the largest in Europe and the first in the CEE region that provides cost-of-illness data in psoriasis involving patients with BST.

  19. Direct healthcare cost of obesity in brazil: an application of the cost-of-illness method from the perspective of the public health system in 2011.

    PubMed

    de Oliveira, Michele Lessa; Santos, Leonor Maria Pacheco; da Silva, Everton Nunes

    2015-01-01

    Obesity is a global public health problem and a risk factor for several diseases that financially impact healthcare systems. To estimate the direct costs attributable to obesity (body mass index {BMI} ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged ≥ 20 incurred by the Brazilian public health system in 2011. Public hospitals and outpatient care. A cost-of-illness method was adopted using a top-down approach based on prevalence. The proportion of the cost of each obesity-associated comorbidity was calculated and obesity prevalence was used to calculate attributable risk. Direct healthcare cost data (inpatient care, bariatric surgery, outpatient care, medications and diagnostic procedures) were extracted from the Ministry of Health information systems, available on the web. Direct costs attributable to obesity totaled US$ 269.6 million (1.86% of all expenditures on medium- and high-complexity health care). The cost of morbid obesity accounted for 23.8% (US$ 64.2 million) of all obesity-related costs despite being 18 times less prevalent than obesity. Bariatric surgery costs in Brazil totaled US$ 17.4 million in 2011. The cost of morbid obesity in women was five times higher than it was in men. The cost of morbid obesity was found to be proportionally higher than the cost of obesity. If the current epidemic were not reversed, the prevalence of obesity in Brazil will increase gradually in the coming years, as well as its costs, having serious implications for the financial sustainability of the Brazilian public health system.

  20. Direct Healthcare Cost of Obesity in Brazil: An Application of the Cost-of-Illness Method from the Perspective of the Public Health System in 2011

    PubMed Central

    2015-01-01

    Background Obesity is a global public health problem and a risk factor for several diseases that financially impact healthcare systems. Objective To estimate the direct costs attributable to obesity (body mass index {BMI} ≥ 30 kg/m2) and morbid obesity (BMI ≥ 40 kg/m2) in adults aged ≥ 20 incurred by the Brazilian public health system in 2011. Settings Public hospitals and outpatient care. Methods A cost-of-illness method was adopted using a top-down approach based on prevalence. The proportion of the cost of each obesity-associated comorbidity was calculated and obesity prevalence was used to calculate attributable risk. Direct healthcare cost data (inpatient care, bariatric surgery, outpatient care, medications and diagnostic procedures) were extracted from the Ministry of Health information systems, available on the web. Results Direct costs attributable to obesity totaled US$ 269.6 million (1.86% of all expenditures on medium- and high-complexity health care). The cost of morbid obesity accounted for 23.8% (US$ 64.2 million) of all obesity-related costs despite being 18 times less prevalent than obesity. Bariatric surgery costs in Brazil totaled US$ 17.4 million in 2011. The cost of morbid obesity in women was five times higher than it was in men. Conclusion The cost of morbid obesity was found to be proportionally higher than the cost of obesity. If the current epidemic were not reversed, the prevalence of obesity in Brazil will increase gradually in the coming years, as well as its costs, having serious implications for the financial sustainability of the Brazilian public health system. PMID:25830909

  1. Current pathogenic Escherichia coli foodborne outbreak cases and therapy development.

    PubMed

    Yang, Shih-Chun; Lin, Chih-Hung; Aljuffali, Ibrahim A; Fang, Jia-You

    2017-08-01

    Food contamination by pathogenic microorganisms has been a serious public health problem and a cause of huge economic losses worldwide. Foodborne pathogenic Escherichia coli (E. coli) contamination, such as that with E. coli O157 and O104, is very common, even in developed countries. Bacterial contamination may occur during any of the steps in the farm-to-table continuum from environmental, animal, or human sources and cause foodborne illness. To understand the causes of the foodborne outbreaks by E. coli and food-contamination prevention measures, we collected and investigated the past 10 years' worldwide reports of foodborne E. coli contamination cases. In the first half of this review article, we introduce the infection and symptoms of five major foodborne diarrheagenic E. coli pathotypes: enteropathogenic E. coli (EPEC), Shiga toxin-producing E. coli/enterohemorrhagic E. coli (STEC/EHEC), Shigella/enteroinvasive E. coli (EIEC), enteroaggregative E. coli (EAEC), and enterotoxigenic E. coli (ETEC). In the second half of this review article, we introduce the foodborne outbreak cases caused by E. coli in natural foods and food products. Finally, we discuss current developments that can be applied to control and prevent bacterial food contamination.

  2. Epidemiology of foodborne norovirus outbreaks, United States, 2001-2008.

    PubMed

    Hall, Aron J; Eisenbart, Valerie G; Etingüe, Amy Lehman; Gould, L Hannah; Lopman, Ben A; Parashar, Umesh D

    2012-10-01

    Noroviruses are the leading cause of foodborne illness in the United States. To better guide interventions, we analyzed 2,922 foodborne disease outbreaks for which norovirus was the suspected or confirmed cause, which had been reported to the Foodborne Disease Outbreak Surveillance System of the Centers for Disease Control and Prevention during 2001-2008. On average, 365 foodborne norovirus outbreaks were reported annually, resulting in an estimated 10,324 illnesses, 1,247 health care provider visits, 156 hospitalizations, and 1 death. In 364 outbreaks attributed to a single commodity, leafy vegetables (33%), fruits/nuts (16%), and mollusks (13%) were implicated most commonly. Infected food handlers were the source of 53% of outbreaks and may have contributed to 82% of outbreaks. Most foods were likely contaminated during preparation and service, except for mollusks, and occasionally, produce was contaminated during production and processing. Interventions to reduce the frequency of foodborne norovirus outbreaks should focus on food workers and production of produce and shellfish.

  3. The direct costs of epilepsy in Russia. A prospective cost-of-illness study from a single center in Moscow.

    PubMed

    Guekht, Alla; Mizinova, Maria; Kaimovsky, Igor; Danilenko, Oksana; Bianchi, Elisa; Beghi, Ettore

    2016-11-01

    The objective of this study was to investigate prospectively the direct costs of epilepsy in Russia, taking a patient perspective and a bottom-up approach. The study was conducted in adolescents and adults with epilepsy seen in the ambulatory services of a city hospital in Moscow. Patients were assigned to different prognostic categories: newly diagnosed epilepsy; epilepsy in remission for 2+years; epilepsy in remission for <2years or with occasional seizures; active, nondrug-resistant epilepsy; drug-resistant epilepsy; and drug-resistant epilepsy in surgical candidates. Patients were followed prospectively for 12months. Demographic and clinical features at admission were collected and correlated with costs. Cost estimates were based on the Russian National Health Service perspective and its implementation in Moscow. Cost items included drugs and laboratory/instrumental tests. The costs per patient were calculated for the entire sample and for each prognostic category separately. Univariate and multivariate analyses were performed. Included were 738 patients (393 men, 345 women aged 14-85years). The median annual cost/patient was €955 (IQR 521-2134; range 51-10,904). The median cost of drugs was €643 (IQR 288-1866; range 0-9960), and the median cost of laboratory/instrumental testing was €202 (IQR 160-270; range 20-1217). Mean costs varied across prognostic categories ranging from €782 in newly diagnosed patients to €3777 in patients with drug-resistant epilepsy. Mean (SD) hospital costs ranged from €646.7 (109.0) in patients with occasional seizures to €950.0 (28.3) in surgical candidates. Independent predictors of total costs were younger age at diagnosis, disability status, generalized seizures, multiple seizure types, seizure severity, and etiology. The cost of epilepsy in Moscow varies significantly depending on disease characteristics and response to drug treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The Cost-Effectiveness of Independent Housing for the Chronically Mentally Ill: Do Housing and Neighborhood Features Matter?

    PubMed Central

    Harkness, Joseph; Newman, Sandra J; Salkever, David

    2004-01-01

    Objective To determine the effects of housing and neighborhood features on residential instability and the costs of mental health services for individuals with chronic mental illness (CMI). Data Sources Medicaid and service provider data on the mental health service utilization of 670 individuals with CMI between 1988 and 1993 were combined with primary data on housing attributes and costs, as well as census data on neighborhood characteristics. Study participants were living in independent housing units developed under the Robert Wood Johnson Foundation Program on Chronic Mental Illness in four of nine demonstration cities between 1988 and 1993. Study Design Participants were assigned on a first-come, first-served basis to housing units as they became available for occupancy after renovation by the housing providers. Multivariate statistical models are used to examine the relationship between features of the residential environment and three outcomes that were measured during the participant's occupancy in a study property: residential instability, community-based service costs, and hospital-based service costs. To assess cost-effectiveness, the mental health care cost savings associated with some residential features are compared with the cost of providing housing with these features. Data Collection/Extraction Methods Health service utilization data were obtained from Medicaid and from state and local departments of mental health. Non-mental-health services, substance abuse services, and pharmaceuticals were screened out. Principal Findings Study participants living in newer and properly maintained buildings had lower mental health care costs and residential instability. Buildings with a richer set of amenity features, neighborhoods with no outward signs of physical deterioration, and neighborhoods with newer housing stock were also associated with reduced mental health care costs. Study participants were more residentially stable in buildings with fewer units

  5. Cost-effectiveness of seasonal influenza vaccination in pregnant women, health care workers and persons with underlying illnesses in Belgium.

    PubMed

    Blommaert, Adriaan; Bilcke, Joke; Vandendijck, Yannick; Hanquet, Germaine; Hens, Niel; Beutels, Philippe

    2014-10-21

    Risk groups with increased vulnerability for influenza complications such as pregnant women, persons with underlying illnesses as well as persons who come into contact with them, such as health care workers, are currently given priority (along with other classic target groups) to receive seasonal influenza vaccination in Belgium. We aimed to evaluate this policy from a health care payer perspective by cost-effectiveness analysis in the three specific target groups above, while accounting for effects beyond the target group. Increasing the coverage of influenza vaccination is likely to be cost-effective for pregnant women (median €6589 per quality-adjusted life-year (QALY) gained [€4073-€10,249]) and health care workers (median €24,096/QALY gained [€16,442-€36,342]), if this can be achieved without incurring additional administration costs. Assuming an additional physician's consult is charged to administer each additional vaccine dose, the cost-effectiveness of vaccinating pregnant women depends strongly on the extent of its impact on the neonate's health. For health care workers, the assumed number of preventable secondary infections has a strong influence on the cost-effectiveness. Vaccinating people with underlying illnesses is likely highly cost-effective above 50 years of age and borderline cost-effective for younger persons, depending on relative life expectancy and vaccine efficacy in this risk group compared to the general population. The case-fatality ratios of the target group, of the secondary affected groups and vaccine efficacy are key sources of uncertainty.

  6. [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.

  7. An economic perspective on childhood obesity: recent findings on cost of illness and cost effectiveness of interventions.

    PubMed

    John, Jürgen; Wolfenstetter, Silke B; Wenig, Christina M

    2012-09-01

    This review aims to put an economic perspective on childhood and adolescent obesity by providing an overview on the latest literature on obesity-related costs and the cost effectiveness of interventions to prevent or manage the problem. The review is based on a comprehensive PubMed/Medline search performed in October 2011. Findings on the economic burden of childhood obesity are inconclusive. Considering the different cost components and age groups, most but not all studies found excess health care costs for obese compared with normal-weight peers. The main limitations relate to short study periods and the strong focus on health care costs, neglecting other components of the economic burden of childhood obesity. The results of the economic evaluations of childhood and adolescent obesity programs support the expectation that preventive and management interventions with acceptable cost effectiveness do exist. Some interventions may even be cost saving. However, owing to the differences in various methodologic aspects, it is difficult to compare preventive and treatment approaches in their cost effectiveness or to determine the most cost-effective timing of preventive interventions during infancy and adolescence. To design effective public policies against the obesity epidemic, a better understanding and a more precise assessment of the health care costs and the broader economic burden are necessary but, critically, depend on the collection of additional longitudinal data. The economic evaluation of childhood obesity interventions poses various methodologic challenges, which should be addressed in future research to fully use the potential of economic evaluation as an aid to decision making. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Cost-of-illness of neck pain in The Netherlands in 1996.

    PubMed

    Borghouts, J A; Koes, B W; Vondeling, H; Bouter, L M

    1999-04-01

    The prevalence of neck pain in the general population ranges from 10 to 15%. The complaints can result in substantial medical consumption, absenteeism from work and disability. In this study we investigated the costs of neck pain in the Netherlands in 1996 to assess the financial burden to society. The study was based on prevalence data. Data sources included national registries, reports of research institutes and health care authorities. Direct health care costs were estimated for hospital care, general practice care and paramedical care. These costs were calculated using fees. Calculation of indirect costs (absenteeism and disability) was based on the Human Capital Method (HCM). As an alternative approach the Friction Cost Method (FCM) was used. The total cost of neck pain in The Netherlands in 1996 was estimated to be US $686 million. The share of these costs was about 1% of total health care expenditures and 0.1 % of the Gross Domestic Product (GDP) in 1996. Direct costs were $160 million (23%). Paramedical care accounted for largest proportion of direct costs (84%). When applying the HCM for calculating indirect costs, these costs amounted to $527 million (77%). The total number of sick days related to neck pain were estimated to be 1.4 million with a total cost of $185.4 million in 1996. Disability for neck pain accounted for the largest proportion (50%) of the total costs related to neck pain in 1996 ($341). When applying the FCM for calculating the indirect costs, these costs were reduced to $96 million. The costs related to neck pain in 1996 in The Netherlands were substantial. Some caution should be taken in interpretation, as a number of assumptions had to be made in order to estimate the total costs. The cost structure shown in this study, with high indirect costs, has also been found in other studies. From an economical point of view it seems to be important to prevent patients from having to take sick leave and disability. One way in achieving this

  9. Cost Estimates for Designing and Implementing a Novel Team Care Model for Chronically Ill Patients.

    PubMed

    Panattoni, Laura; Dillon, Ellis; Hurlimann, Lily; Durbin, Meg; Tai-Seale, Ming

    2017-09-25

    Little is known about the cost of implementing chronic care models. We estimate the human resource cost of implementing a novel team-based chronic care model "Champion," at a large multispecialty group practice. We used activity-based costing to calculate costs from development through rollout and stabilization in 1 clinic with 12 000 chronic care patients. Data analyzed included Microsoft Outlook meeting metadata, supporting documents, and 2014 employee wages. Implementation took more than 29 months, involved 168 employees, and cost the organization $2 304 787. Payers may need to consider a mixed-payment model to support the both implementation and maintenance costs of team-based chronic care.

  10. Estimates of Foodborne Illness in the United States -- Burden of Foodborne Illness: Findings

    MedlinePlus

    ... 965,958 192,316–2,483,309 10 Campylobacter spp . 845,024 337,031–1,611,083 ... Norovirus 14,663 8,097–23,323 26 Campylobacter spp . 8,463 4,300–15,227 15 ... 0–733 19 Norovirus 149 84–237 11 Campylobacter spp. 76 0–332 6 Subtotal 88 References ...

  11. 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

  12. 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…

  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. The Chikungunya Epidemic on La Réunion Island in 2005–2006: A Cost-of-Illness Study

    PubMed Central

    Soumahoro, Man-Koumba; Boelle, Pierre-Yves; Gaüzere, Bernard-Alex; Atsou, Kokuvi; Pelat, Camille; Lambert, Bruno; La Ruche, Guy; Gastellu-Etchegorry, Marc; Renault, Philippe; Sarazin, Marianne; Yazdanpanah, Yazdan; Flahault, Antoine; Malvy, Denis; Hanslik, Thomas

    2011-01-01

    Background This study was conducted to assess the impact of chikungunya on health costs during the epidemic that occurred on La Réunion in 2005–2006. Methodology/Principal Findings From data collected from health agencies, the additional costs incurred by chikungunya in terms of consultations, drug consumption and absence from work were determined by a comparison with the expected costs outside the epidemic period. The cost of hospitalization was estimated from data provided by the national hospitalization database for short-term care by considering all hospital stays in which the ICD-10 code A92.0 appeared. A cost-of-illness study was conducted from the perspective of the third-party payer. Direct medical costs per outpatient and inpatient case were evaluated. The costs were estimated in Euros at 2006 values. Additional reimbursements for consultations with general practitioners and drugs were estimated as €12.4 million (range: €7.7 million–€17.1 million) and €5 million (€1.9 million–€8.1 million), respectively, while the cost of hospitalization for chikungunya was estimated to be €8.5 million (€5.8 million–€8.7 million). Productivity costs were estimated as €17.4 million (€6 million–€28.9 million). The medical cost of the chikungunya epidemic was estimated as €43.9 million, 60% due to direct medical costs and 40% to indirect costs (€26.5 million and €17.4 million, respectively). The direct medical cost was assessed as €90 for each outpatient and €2,000 for each inpatient. Conclusions/Significance The medical management of chikungunya during the epidemic on La Réunion Island was associated with an important economic burden. The estimated cost of the reported disease can be used to evaluate the cost/efficacy and cost/benefit ratios for prevention and control programmes of emerging arboviruses. PMID:21695162

  15. Cost of preventing workplace heat-related illness through worker breaks and the benefit of climate-change mitigation

    NASA Astrophysics Data System (ADS)

    Takakura, Jun'ya; Fujimori, Shinichiro; Takahashi, Kiyoshi; Hijioka, Yasuaki; Hasegawa, Tomoko; Honda, Yasushi; Masui, Toshihiko

    2017-06-01

    The exposure of workers to hot environments is expected to increase as a result of climate change. In order to prevent heat-related illness, it is recommended that workers take breaks during working hours. However, this would lead to reductions in worktime and labor productivity. In this study, we estimate the economic cost of heat-related illness prevention through worker breaks associated with climate change under a wide range of climatic and socioeconomic conditions. We calculate the worktime reduction based on the recommendation of work/rest ratio and the estimated future wet bulb glove temperature, which is an index of heat stresses. Corresponding GDP losses (cost of heat-related illness prevention through worker breaks) are estimated using a computable general equilibrium model throughout this century. Under the highest emission scenario, GDP losses in 2100 will range from 2.6 to 4.0% compared to the current climate conditions. On the other hand, GDP losses will be less than 0.5% if the 2.0 °C goal is achieved. The benefit of climate-change mitigation for avoiding worktime loss is comparable to the cost of mitigation (cost of the greenhouse gas emission reduction) under the 2.0 °C goal. The relationship between the cost of heat-related illness prevention through worker breaks and global average temperature rise is approximately linear, and the difference in economic loss between the 1.5 °C goal and the 2.0 °C goal is expected to be approximately 0.3% of global GDP in 2100. Although climate mitigation and socioeconomic development can limit the vulnerable regions and sectors, particularly in developing countries, outdoor work is still expected to be affected. The effectiveness of some adaptation measures such as additional installation of air conditioning devices or shifting the time of day for working are also suggested. In order to reduce the economic impacts, adaptation measures should also be implemented as well as pursing ambitious climate change

  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.

  17. [Food-borne botulism].

    PubMed

    Nakamura, Yuko; Sawada, Mikio; Ikeguchi, Kunihiko; Nakano, Imaharu

    2011-09-01

    Botulism is a neuroparalytic disease caused by neurotoxins produced by Clostridium botulinum. Food-borne botulism is a kind of exotoxin-caused food intoxication. Although this disease is rarely reported in Japan now, it is a cause of great concern because of its high mortality rate, and botulism cases should be treated as a public health emergency. Botulism classically presents as acute symmetrical descending flaccid paralysis. Its diagnosis is based on the detection of botulinum toxins in the patient's serum or stool specimens. Electrophysiologic tests of such patients show reduced compound muscle action potentials (CMAPs), low amplitudes and short durations of motor unit potentials (MUPs), and mild waning in repetitive low-frequency stimulations. Single fiber electromyography (EMG) is particularly useful for the diagnosis of botulism. We report a case of food-borne botulism that we had encountered. An 83-year-old man with rapidly progressive diplopia, dysphagia, and tetraplegia was hospitalized; he required intensive care, including artificial ventilatory support. Electrophysiologic tests yielded findings compatible with botulism. We made a clinical diagnosis of food-borne botulism and administered antitoxin on the seventh disease day. The patient's motor symptoms started ameliorating several days after the antitoxin injection. Subsequently, botulinum toxin type A was detected in the patient's serum specimen by using a bioassay, and the type A gene and silent B gene were detected in his serum specimen by using polymerase chain reaction (PCR). C. botulinum was also obtained from stool culture on the 17th and 50th disease days. Botulism is a curable disease if treated early. Although it is a rare condition, it should always be considered in the differential diagnosis of patients with rapid onset of cranial nerve and limb muscle palsies.

  18. [Juvenile obesity and comorbidity type 2 diabetes mellitus (T2 DM) in Germany: development and cost-of-illness analysis].

    PubMed

    Wolfenstetter, S B

    2006-10-01

    Obesity and type 2 diabetes mellitus (T2 DM) among children have increased in the last years and developed into a major public health problem in Germany. Obesity and T2 DM are important causes of morbidity among young people associated with high costs for the health system. The objective of this paper is to estimate the number of obese and diabetic children and adolescents and the associated economic burden of illness in Germany now (2003) and in the future. Cost assessments of obesity in adulthood and studies of obese children in Germany are based on English and German scientific publications and internet sources. Cost calculations are based on the top-down approach and the prevalence method. Direct costs of illness are derived from aggregate statistical data (ICD 10: obesity E 65-68; T2 DM E 11) and various scientific publications and telephone interviews. Except for T2 DM, other comorbidities of obesity are neglected in this analysis. In 1999, 1.3 million children were overweight and 594,000 were obese in Germany. The highest prevalence of obesity was in children aged 14 to 17 years. The prevalence for overweight children has risen from 8.9 % to 15.7 % and for obese children from 10.1 % to 13.1 % over the period from 1994 to 1999/1998. Approximately 1 % of these were type 2 diabetics. During 2003, the mean annual direct costs of obesity were euro 44 million, with euro 36.4 million for rehabilitation, euro 3.6 million for hospital care and euro 3.9 million for special medical programs. The costs of juvenile T2 DM were euro 1.4 million (hospital care and rehabilitation). Mean costs per treated obese child added up to euro 3484.00 and to euro 8539.00 per treated obese child with T2 DM. The incremental costs are euro 2489.00 for obese children and euro 7544.00 for obese children with T2 DM compared to the average costs of illness of a child aged 5 to 20 years in Germany. Future annual attributable costs of obesity could be up to euro 6.4 million, 7.3-10.1 % of all

  19. Integrating animal health and foodborne disease surveillance.

    PubMed

    Berman, E M; Shimshony, A

    2013-08-01

    The control of foodborne diseases from an animal source has become an important part of public health policy. Since the agents that cause these diseases originate in animals, Veterinary Services, as well as Public Health Services, must be involved in their control. Control programmes should be established either through cooperation between the two Services or by the consolidation of all those involved into a single food control agency. Surveillance is an important part of these control programmes. The following questions must be addressed when planning an effective surveillance programme. What is the relative incidence, morbidity, mortality and economic cost of the foodborne disease in humans? Is the animal population the exclusive or a significant source of the human foodborne infection? What kind of surveillance is needed to identify the disease-causing agent in the animal population? Are we interested in identifying all cases of a disease in order to eradicate it or is our aim to reduce its incidence in the animal population? Do we have the ability to control the disease in the animal population? What disease detection tests are available? What are the sensitivity, specificity and cost of these diagnostic tests? Finally, does the country, region or agency involved have the legal, financial and educational resources to carry out this surveillance and follow it up with appropriate action? After these questions have been resolved,the veterinary and public health sectors must jointly decide if surveillance and control are feasible. If so, they can then begin to develop an appropriate programme.

  20. The burden of norovirus gastroenteritis: an important foodborne and healthcare-related infection.

    PubMed

    Belliot, G; Lopman, B A; Ambert-Balay, K; Pothier, P

    2014-08-01

    Human norovirus (NoV) is now recognized as one of the most important causative agents of gastroenteritis in all age groups worldwide. During the course of NoV infection, symptoms are usually mild and disappear within 48 h after onset. The incidence of NoV infection is high, with hundreds of cases per 10 000 of the population, although the number of infections is still underestimated. Epidemiological surveys conducted in Europe and North America have shown that NoV infections constitute a major disease burden, especially for young children and the elderly, in whom NoV infection leads to high rates of hospitalization and mortality. NoV infections are also of concern in hospitals, where viral infections can be persistent in immunocompromised patients. Although the cost of NoV infection in the hospital community has not yet been clearly established, it appears that NoV infections could cost hundreds of thousands of euros in terms of unit closure, and NoV-related sickness in patients and health workers. Besides their clinical burden, NoVs, as foodborne pathogens, also cause to millions of dollars of losses for the healthcare system and the food industry. Recent estimates in the USA showed that, annually, NoV illness cost $2 billion and led to a loss of approximately 5000 quality-adjusted life-years, making NoV one of the top five pathogens causing enteric illnesses. The highest cost among 14 foodborne pathogens is also attributed to human NoV in The Netherlands. This accumulation of evidence underlines the enormous impact of NoV on populations.

  1. An outbreak of foodborne botulism in Ontario

    PubMed Central

    Loutfy, Mona R; Austin, John W; Blanchfield, Burke; Fong, Ignatius W

    2003-01-01

    Botulism is a rare paralytic illness resulting from a potent neurotoxin produced by Clostridium botulinum. Botulism in Canada is predominately due to C botulinum type E and affects mainly the First Nations and Inuit populations. The most recent outbreak of botulism in Ontario was in Ottawa in 1991 and was caused by C botulinum type A. We report an outbreak of foodborne type B botulism in Ontario, which implicated home-canned tomatoes. The outbreak was characterized by mild symptoms in two cases and moderately severe illness in one case. The investigation shows the importance of considering the diagnosis of botulism in patients presenting with cranial nerve and autonomic dysfunction, especially when combined with gastrointestinal complaints; it also highlights the importance of proper home canning technique. PMID:18159458

  2. 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

  3. The global economic burden of diabetes in adults aged 20-79 years: a cost-of-illness study.

    PubMed

    Bommer, Christian; Heesemann, Esther; Sagalova, Vera; Manne-Goehler, Jennifer; Atun, Rifat; Bärnighausen, Till; Vollmer, Sebastian

    2017-06-01

    Differences in methods and data used in past studies have limited comparisons of the cost of illness of diabetes across countries. We estimate the full global economic burden of diabetes in adults aged 20-79 years in 2015, using a unified framework across all countries. Our objective was to highlight patterns of diabetes-associated costs as well as to identify the need for further research in low-income regions. Epidemiological and economic data for 184 countries were used to estimate the global economic burden of diabetes, regardless of diabetes type. Direct costs were derived using a top-down approach based on WHO general health expenditure figures and prevalence data from the 2015 International Diabetes Federation Diabetes Atlas. Indirect costs were assessed using a human-capital approach, including diabetes-associated morbidity and premature mortality. We estimate the global cost of diabetes for 2015 was US$1·31 trillion (95% CI 1·28-1·36) or 1·8% (95% CI 1·8-1·9) of global gross domestic product (GDP). Notably, indirect costs accounted for 34·7% (95% CI 34·7-35·0) of the total burden, although substantial variations existed both in the share and the composition of indirect costs across countries. North America was the most affected region relative to GDP and also the largest contributor to global absolute costs. However, on average, the economic burden as percentage of GDP was larger in middle-income countries than in high-income countries. Our results suggest a substantial global economic burden of diabetes. Although limited data were available for low-income and middle-income countries, our findings suggest that large diabetes-associated costs are not only a problem in high-income settings but also affect poorer world regions. None. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Comparative cost of illness analysis and assessment of health care burden of Duchenne and Becker muscular dystrophies in Germany.

    PubMed

    Schreiber-Katz, Olivia; Klug, Constanze; Thiele, Simone; Schorling, Elisabeth; Zowe, Janet; Reilich, Peter; Nagels, Klaus H; Walter, Maggie C

    2014-12-18

    Our study aimed to determine the burden of illness in dystrophinopathy type Duchenne (DMD) and Becker (BMD), both leading to progressive disability, reduced working capacity and high health care utilization. A micro-costing method was used to examine the direct, indirect and informal care costs measuring the economic burden of DMD in comparison to BMD on patients, relatives, payers and society in Germany and to determine the health care burden of these diseases. Standardized questionnaires were developed based on predefined structured interview guidelines to obtain data directly from patients and caregivers using the German dystrophinopathy patient registry. The health-related quality of life (HRQOL) was analyzed using PedsQL™ Measurement Model. In total, 363 patients with genetically confirmed dystrophinopathies were enrolled. Estimated annual disease burden including direct medical/non-medical, indirect and informal care costs of DMD added up to € 78,913 while total costs in BMD were € 39,060. Informal care costs, indirect costs caused by loss of productivity and absenteeism of patients and caregivers as well as medical costs of rehabilitation services and medical aids were identified as the most important cost drivers. Total costs notably increased with disease progression and were consistent with the clinical severity; however, patients' HRQOL declined with disease progression. In conclusion, early assessments of economic aspects and the disease burden are essential to gain extensive knowledge of a distinct disease and above all play an important role in funding drug development programs for rare diseases. Therefore, our results may help to accelerate payer negotiations such as the pricing and reimbursement of new therapies, and will hopefully contribute to facilitating the efficient translation of innovations from clinical research over marketing authorization to patient access to a causative treatment.

  5. 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.

  6. 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.

  7. Research needs and strategies to establish best practices and cost effective models for chronic critical illness.

    PubMed

    Carson, Shannon S

    2012-06-01

    Past research in chronic critical illness has been effective in defining the population and identifying unique aspects of their outcomes and resource needs, but there has been little research focused on interventions to improve outcomes. This review discusses some research priorities that could have immediate impact on patient outcomes. General topics include prevention or limiting the incidence of chronic critical illness; specific topics related to patient management, such as interventions for weaning, rehabilitation, nutrition or infections; and methods to enhance communication and end-of-life care. In addition to specific patient management interventions, further comparative effectiveness research on care settings is indicated, considering the expected growth in the patient population and the substantial resource needs. 2012 Daedalus Enterprises

  8. Cost of Illness and Comorbidities in Adults Diagnosed With Attention-Deficit/Hyperactivity Disorder: A Retrospective Analysis

    PubMed Central

    Montejano, Leslie; Sasané, Rahul; Huse, Dan

    2011-01-01

    Objective: This retrospective study assessed the cost of illness and medical and psychiatric comorbidities in adults with attention-deficit/hyperactivity disorder (ADHD) compared with adults without ADHD (matched 1:3) and adults with depression (1:1). Individuals with depression were included as a benchmark against which the burden of ADHD could be measured. Method: Measures of health care and employment–related costs were compared to generate estimates of medical expenditures, workplace absences, and comorbidities in adults with ADHD (using ICD-9-CM codes) who were enrolled in employer-sponsored health plans throughout 2006. Individuals with ADHD (31,752) were matched with 95,256 non-ADHD controls. The majority of individuals with ADHD (n = 29,965) were also matched with an equal number of individuals with a depression diagnosis (using ICD-9-CM codes). Results: In this adult population with ADHD enrolled in an employer-sponsored health plan, medical and psychiatric comorbidities were the primary drivers of health care utilization and cost. Of note, depression was significantly prevalent among those with ADHD compared to matched non-ADHD controls (14% vs 3.2%; P ≤ .0001). Subgroup analysis demonstrated that ADHD patients with depression had a significantly higher number of medical and other psychiatric comorbid illnesses including diabetes, hypertension, asthma, irritable bowel syndrome, bipolar disorder, anxiety, alcohol abuse, and substance abuse compared to those with ADHD alone (P ≤ .0001). Patients with ADHD incurred higher total annual health care expenditures than control subjects ($4,306 vs $2,418); approximately 15% of costs were paid by the patient. The total annual costs associated with productivity losses were also higher (driven by differences in short-term disability costs) in the ADHD group compared with controls ($4,403 vs $4,209). Conclusions: Medical and psychiatric comorbidities were primary drivers of the direct health care cost associated

  9. Burden of illness, annual healthcare utilization, and costs associated with commercially insured patients with Cushing disease in the United States.

    PubMed

    Broder, Michael S; Neary, Maureen P; Chang, Eunice; Cherepanov, Dasha; Ludlam, William H

    2015-01-01

    To describe the burden of illness, healthcare utilization, and costs associated with Cushing disease (CD), a rare disorder resulting from adrenocorticotropic hormone-secreting pituitary tumors, in commercially insured patients in the U. S. Patients with CD were identified in 2010 in the IMS Health PharMetrics and Truven Health Analytics MarketScan claims databases. Because there is no diagnosis code for CD, patients were identified with a claim for Cushing syndrome and either benign pituitary adenoma or hypophysectomy. We estimated total and CD-related utilization and costs using pharmacy and medical claims. We identified 685 CD patients (81% female; mean age, 41.7 years; mean Charlson comorbidity index, 1.6; mean number of chronic conditions, 4.2); 30.5% of the patients had diabetes, 22.5% had psychiatric disturbances, 21% had infections, 8.6% had osteoporosis, 8% had cardiovascular disease/stroke, 5.5% had kidney stones, and 0.7% had compression fracture of a vertebra. Patients had a mean of 19.8 office visits per year; 38.4% had inpatient hospitalizations and 34.2% visited the emergency department (ED). Patients had a mean of 3.2 CD-related office visits per year; 26.9% had CD-related hospitalizations, 0.9% had CD-related ED visits, and 36.8% had CD treatments. Mean annual total costs were $34,992 (pharmacy, $3,597; medical costs, $31,395). CD-related costs accounted for $14,310 of total costs (CD treatment costs, $9,353; other CD-related costs, $4,957). CD patients have a high burden of illness. Among CD patients in this study, 30.5% had diabetes, 22.5% had psychiatric disturbances, 21% had infections, 8.6% had osteoporosis, 8% had cardiovascular disease/stroke, and 5.5% had kidney stones. Patients had 19.8 office visits per year, and >34% of patients were hospitalized. Mean total cost of care was approximately $35,000 per year.

  10. Costs of illness and care in Parkinson's disease: an evaluation in six countries.

    PubMed

    von Campenhausen, Sonja; Winter, Yaroslav; Rodrigues e Silva, Antonio; Sampaio, Christina; Ruzicka, Evzen; Barone, Paolo; Poewe, Werner; Guekht, Alla; Mateus, Céu; Pfeiffer, Karl-P; Berger, Karin; Skoupa, Jana; Bötzel, Kai; Geiger-Gritsch, Sabine; Siebert, Uwe; Balzer-Geldsetzer, Monika; Oertel, Wolfgang H; Dodel, Richard; Reese, Jens P

    2011-02-01

    We investigated the costs of Parkinson's Disease (PD) in 486 patients based on a survey conducted in six countries. Economic data were collected over a 6-month period and presented from the societal perspective. The total mean costs per patient ranged from EUR 2620 to EUR 9820. Direct costs totalled about 60% to 70% and indirect costs about 30% to 40% of total costs. The proportions of costs components of PD vary notably; variations were due to differences in country-specific health system characteristics, macro economic conditions, as well as frequencies of resource use and price differences. However, inpatient care, long-term care and medication were identified as the major expenditures in the investigated countries.

  11. 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.

  12. The cost of illness of atrial fibrillation: a systematic review of the recent literature.

    PubMed

    Wolowacz, S E; Samuel, M; Brennan, V K; Jasso-Mosqueda, J-G; Van Gelder, I C

    2011-10-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia, its prevalence increasing markedly with age. Atrial fibrillation is strongly associated with increased risk of morbidity, including stroke and thromboembolism. There is growing awareness of the economic burden of AF due to ageing populations and constrained public finances. A systematic review was performed (1990-2009). Cost studies for AF or atrial flutter were included; acute-onset and post-operative AF were excluded. Total, direct, and indirect costs were extracted. Of 875 records retrieved, 37 studies were included. The cost of managing individual AF patients is high. Direct-cost estimates ranged from $2000 to 14,200 per patient-year in the USA and from €450 to 3000 in Europe. This is comparable with other chronic conditions such as diabetes. The direct cost of AF represented 0.9-2.4% of the UK health-care budget in 2000 and had almost doubled over the previous 5 years. Inpatient care accounted for 50-70% of annual direct costs. In the USA, AF hospitalizations alone cost ∼$6.65 billion in 2005. In this first systematic review of the economic burden of AF, hospitalizations consistently represented the major cost driver. Costs and hospitalizations attributable to AF have increased markedly over recent decades and are expected to increase in future due to ageing populations.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  14. Food safety and foodborne disease in 21st century homes.

    PubMed

    Scott, Elizabeth

    2003-09-01

    Over the past decade there has been a growing recognition of the involvement of the home in several public health and hygiene issues. Perhaps the best understood of these issues is the role of the home in the transmission and acquisition of foodborne disease. The incidence of foodborne disease is increasing globally. Although foodborne disease data collection systems often miss the mass of home-based outbreaks of sporadic infection, it is now accepted that many cases of foodborne illness occur as a result of improper food handling and preparation by consumers in their own kitchens. Some of the most compelling evidence has come from the international data on Salmonella species and Campylobacter species infections.By its very nature, the home is a multifunctional setting and this directly impacts upon the need for better food safety in the home. In particular, the growing population of elderly and other immnocompromised individuals living at home who are likely to be more vulnerable to the impact of foodborne disease is an important aspect to consider. In addition, some developed nations are currently undergoing a dramatic shift in healthcare delivery, resulting in millions of patients nursed at home. Other aspects of the home that are unique in terms of food safety are the use of the home as a daycare centre for preschool age children, the presence of domestic animals in the home and the use of the domestic kitchen for small-scale commercial catering operations. At the global level, domestic food safety issues for the 21st century include the continued globalization of the food supply, the impact of international travel and tourism, and the impact of foodborne disease on developing nations.A number of countries have launched national campaigns to reduce the burden of foodborne disease, including alerting consumers to the need to practice food safety at home. Home hygiene practice and consumer hygiene products are being refined and targeted to areas of risk

  15. The Cost of Responding to an Acinetobacter Outbreak in Critically Ill Surgical Patients.

    PubMed

    Jiang, Yushan; Resch, Stephen; Liu, Xiaoxia; Rogers, Selwyn O; Askari, Reza; Klompas, Michael; Jayaraman, Sudha P

    2016-02-01

    Our institution had an outbreak of multi-drug-resistant Acinetobacter (MDRA) in 2011. We analyzed the costs of responding to this outbreak from the hospital's perspective. We estimated retrospectively the excess costs associated with an MDRA outbreak response at a major academic medical center, including the costs of staffing, supplies, administrative time, deep cleaning, and environmental testing. Differences in mean costs before and during the 2011 MDRA outbreak were analyzed using the Student t-test. The overall excess cost incurred during the outbreak response was $371,079 in 2011 U.S. dollars. The largest contributors were the extra resources needed to staff and clean the two intensive care units (ICUs) (78%). In the general surgery ICU, the mean weekly cost of nursing during the outbreak was $13,276 more for regular hours (+15%; p < 0.01) than in the pre-outbreak period and $2,682 more for overtime hours (+86%; p = 0.02). In the trauma ICU, the cost was $20,746 more for regular hours (+24%; p < 0.01) and $3,445 more for overtime hours (+124%; p < 0.01). The costs of supplies ($13,036; +30%; p = 0.03) and gloves ($2,572; +48%; p = 0.01) also were greater during the outbreak. Administrative time, consumables, use of a surge pod, and environmental testing accounted for the remainder of the extra costs. Our institution incurred $371,079 in excess costs as a result of an MDRA outbreak. This figure does not include the costs related to treatment of the infections, loss of reimbursement because of hospital-acquired infection, legal services, or changes in staff morale, patient satisfaction, or hospital reputation. Strategies to prevent and control such outbreaks better have substantial value.

  16. Costs of Caring for Persons with Long-Term Mental Illness in Alternative Residential Settings.

    ERIC Educational Resources Information Center

    Galster, George C.; And Others

    1994-01-01

    Costs for caring for severely mentally disabled persons receiving housing subsidies and/or case management services or who were in a state hospital were compared in two Ohio counties. Comparisons for 82 persons found differences among community-based group settings, but the state hospital costs at least 3 times higher. (SLD)

  17. Cost of Illness for Patients with Arthritis Receiving Multidisciplinary Rehabilitation Care

    PubMed Central

    Grotle, Margreth; Hagen, Kåre Birger; Uhlig, Till; Aas, Eline

    2011-01-01

    Purpose. To describe healthcare consumption and costs prior to, during, and after multidisciplinary rehabilitation due to arthritis. Methods. 306 patients (age 18–75 years) with arthritis scheduled for multidisciplinary rehabilitation care in 9 rehabilitation centres and 4 rheumatology hospital departments were included and followed for 6 months. Costs were estimated in Euros (€) for the total sample and five clinical subgroups. Results. Healthcare costs ranged from €3,033 to €91,336 and were significantly higher at hospital departments compared to rehabilitation centres: €9,722 (SD 5,406) and €4,250 (SD 1,040). While total costs prior to and after rehabilitation were stable for those receiving rehabilitation at a hospital, there was a significant increase in costs for those being at a rehabilitation centre. Total mean costs were more than doubled when including social costs: from €32,410 (95% CI 20,074–37,017) to €51,491 (95% CI 49,055–61,657). Conclusions. Healthcare and social costs for arthritis rehabilitation were substantial both before and after a rehabilitation stay. It is important to explore methods to reduce the length of rehabilitation stay and production loss connected to rehabilitation of patients with rheumatic disease. PMID:22110975

  18. Out-of-pocket costs and other determinants of access to healthcare for children with febrile illnesses: a case-control study in rural Tanzania.

    PubMed

    Castellani, Joëlle; Mihaylova, Borislava; Evers, Silvia M A A; Paulus, Aggie T G; Mrango, Zakayo E; Kimbute, Omari; Shishira, Joseph P; Mulokozi, Francis; Petzold, Max; Singlovic, Jan; Gomes, Melba

    2015-01-01

    To study private costs and other determinants of access to healthcare for childhood fevers in rural Tanzania. A case-control study was conducted in Tanzania to establish factors that determine access to a health facility in acute febrile illnesses in children less than 5 years of age. Carers of eligible children were interviewed in the community; cases were represented by patients who went to a facility and controls by those who did not. A Household Wealth Index was estimated using principal components analysis. A multivariable logistic regression analysis was performed to understand the factors which influenced attendance of healthcare facility including severity of the illness and household wealth/socio-demographic indicators. To complement the data on costs from community interviews, a hospital-based study obtained details of private expenditures for hospitalised children under the age of 5. Severe febrile illness is strongly associated with health facility attendance (OR: 35.76, 95%CI: 3.68-347.43, p = 0.002 compared with less severe febrile illness). Overall, the private costs of an illness for patients who went to a hospital were six times larger than private costs of controls ($5.68 vs. $0.90, p<0.0001). Household wealth was not significantly correlated with total costs incurred. The separate hospital based cost study indicated that private costs were three times greater for admissions at the mission versus public hospital: $13.68 mission vs. $4.47 public hospital (difference $ 9.21 (95% CI: 7.89 -10.52), p<0.0001). In both locations, approximately 50% of the cost was determined by the duration of admission, with each day in hospital increasing private costs by about 12% (95% CI: 5% - 21%). The more severely ill a child, the higher the probability of attending hospital. We did not find association between household wealth and attending a health facility; nor was there an association between household wealth and private cost.

  19. Foodborne Disease Outbreaks in Correctional Institutions-United States, 1998-2014.

    PubMed

    Marlow, Mariel A; Luna-Gierke, Ruth E; Griffin, Patricia M; Vieira, Antonio R

    2017-07-01

    To present the first update on the epidemiology of US foodborne correctional institution outbreaks in 20 years. We analyzed data from the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System to describe correctional institution outbreaks from 1998 to 2014 and compare them with other foodborne outbreaks. Two hundred foodborne outbreaks in correctional institutions were reported, resulting in 20 625 illnesses, 204 hospitalizations, and 5 deaths. Median number of outbreak-associated illnesses per 100 000 population per year was 45 (range = 11-141) compared with 7 (range = 4-10) for other outbreaks. These outbreaks accounted for 6% (20 625 of 358 330) of outbreak-associated foodborne illnesses. Thirty-seven states reported at least 1 outbreak in a correctional institution. Clostridium perfringens (28%; 36 of 128) was the most frequently reported single etiology. The most frequently reported contributing factor was food remaining at room temperature (37%; 28 of 76). Incarcerated persons suffer a disproportionate number of outbreak-associated foodborne illnesses. Better food safety oversight and regulation in correctional food services could decrease outbreaks. Public Health Implications. Public health officials, correctional officials, and food suppliers can work together for food safety. Clearer jurisdiction over regulation of correctional food services is needed.

  20. 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

  1. Estimating the Burden of Acute Gastrointestinal Illness in Grenada

    PubMed Central

    Glasgow, Lindonne M.; Antoine, Samuel C.; Pérez, Enrique; Indar, Lisa

    2013-01-01

    This is the first study conducted in Grenada, with a population of approximately 108,000, to quantify the magnitude, distribution, and burden of self-reported acute gastroenteritis (AGE). A retrospective population survey was conducted in October 2008 and April 2009 and a laboratory survey from October 2008 to September 2009. The estimated monthly prevalence of AGE was 10.7% (95% CI 9.0-12.6; 1.4 episodes/person-year), with a median of 3 days of illness. Of those who reported AGE, 31% sought medical care (stool samples were requested from 12.5%); 10% took antibiotics; 45% took non-prescribed medication; and 81% reported restricted activity. Prevalence of AGE was significantly higher among children aged <5 years (23.5%, p<0.001). Of the AGE stool samples submitted to the laboratory for analysis, 12.1% were positive for a foodborne pathogen. Salmonella enteritidis was the most common foodborne pathogen associated with AGE-related illness. The estimated percentage of underreporting of syndromic AGE to the Ministry of Health was 69%. In addition, for every laboratory-confirmed foodborne/AGE pathogen, it was estimated that there were 316 additional cases occurring in the population. The minimum estimated cost associated with treatment for AGE was US$ 703,950 each year, showing that AGE has a potentially significant economic impact in Grenada.

  2. Estimating the burden of acute gastrointestinal illness in Grenada.

    PubMed

    Glasgow, Lindonne M; Forde, Martin S; Antoine, Samuel C; Pérez, Enrique; Indar, Lisa

    2013-12-01

    This is the first study conducted in Grenada, with a population of approximately 108,000, to quantify the magnitude, distribution, and burden of self-reported acute gastroenteritis (AGE). A retrospective population survey was conducted in October 2008 and April 2009 and a laboratory survey from October 2008 to September 2009. The estimated monthly prevalence of AGE was 10.7% (95% CI 9.0-12.6; 1.4 episodes/ person-year), with a median of 3 days of illness. Of those who reported AGE, 31% sought medical care (stool samples were requested from 12.5%); 10% took antibiotics; 45% took non-prescribed medication; and 81% reported restricted activity. Prevalence of AGE was significantly higher among children aged <5 years (23.5%, p < 0.001). Of the AGE stool samples submitted to the laboratory for analysis, 12.1% were positive for a foodborne pathogen. Salmonella enteritidis was the most common foodborne pathogen associated with AGE-related illness. The estimated percentage of underreporting of syndromic AGE to the Ministry of Health was 69%. In addition, for every laboratory-confirmed foodborne/AGE pathogen, it was estimated that there were 316 additional cases occurring in the population. The minimum estimated cost associated with treatment for AGE was US$ 703,950 each year, showing that AGE has a potentially significant economic impact in Grenada.

  3. 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

  4. Drivers of uncertainty in estimates of foodborne gastroenteritis incidence.

    PubMed

    Glass, Kathryn; Ford, Laura; Kirk, Martyn D

    2014-12-01

    Estimates of the incidence of foodborne illness are increasingly used at national and international levels to quantify the burden of disease and advocate for improvements in food safety. The calculation of such estimates involves multiple datasets and several disease multipliers, applied to dozens of pathogens. Unsurprisingly, this process often produces wide interval estimates. Using a model of foodborne gastroenteritis in Australia, we calculate the contribution of both data and multipliers to the width of the interval. We then compare pathogen-specific estimates of the proportion of gastroenteritis that is foodborne from national-level studies conducted in Canada, Greece, France, the Netherlands, New Zealand, the United Kingdom, and the United States. Overall, we estimate that 74% (range 63-92%) of the interval width for foodborne gastroenteritis in Australia is a result of uncertainty in the proportion of gastroenteritis that is due to contaminated food. Across national studies, we find considerable variability in point estimates and the width of interval estimates for the foodborne proportion for relatively common pathogens such as Salmonella spp., Campylobacter spp., and norovirus. While some uncertainty in estimates of gastroenteritis incidence is inevitable, an understanding of the drivers of this uncertainty can help to focus further research. In particular, this work highlights the value of studies quantifying the routes of transmission for common pathogens.

  5. The long-term impact of employment on mental health service use and costs for persons with severe mental illness.

    PubMed

    Bush, Philip W; Drake, Robert E; Xie, Haiyi; McHugo, Gregory J; Haslett, William R

    2009-08-01

    Stable employment promotes recovery for persons with severe mental illness by enhancing income and quality of life, but its impact on mental health costs has been unclear. This study examined service cost over ten years among participants in a co-occurring disorders study. Latent-class growth analysis of competitive employment identified trajectory groups. The authors calculated annual costs of outpatient services and institutional stays for 187 participants and examined group differences in ten-year utilization and cost. A steady-work group (N=51) included individuals whose work hours increased rapidly and then stabilized to average 5,060 hours per person over ten years. A late-work group (N=57) and a no-work group (N=79) did not differ significantly in utilization or cost outcomes, so they were combined into a minimum-work group (N=136). More education, a bipolar disorder diagnosis (versus schizophrenia or schizoaffective disorder), work in the past year, and lower scores on the expanded Brief Psychiatric Rating Scale predicted membership in the steady-work group. These variables were controlled for in the outcomes analysis. Use of outpatient services for the steady-work group declined at a significantly greater rate than it did for the minimum-work group, while institutional (hospital, jail, or prison) stays declined for both groups without a significant difference. The average cost per participant for outpatient services and institutional stays for the minimum-work group exceeded that of the steady-work group by $166,350 over ten years. Highly significant reductions in service use were associated with steady employment. Given supported employment's well-established contributions to recovery, evidence of long-term reductions in the cost of mental health services should lead policy makers and insurers to promote wider implementation.

  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

    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.

  8. 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.

  9. Foodborne protozoan parasites.

    PubMed

    Dawson, David

    2005-08-25

    This report addresses Cryptosporidium, Giardia, Cyclospora, and more briefly, Toxoplasma as the main parasitic protozoa of concern to food production worldwide. Other parasitic protozoa may be spread in food or water but are not considered as great a risk to food manufacture. The protozoan parasites Cryptosporidium, Giardia, and Cyclospora have proven potential to cause waterborne and foodborne disease. Toxoplasma gondii has been considered a risk in specific cases, but humans are not its primary host. Cryptosporidium and Giardia are widespread in the environment, particularly the aquatic environment, and major outbreaks of cryptosporidiosis and giardiasis have occurred as a result of contaminated drinking water. Large outbreaks of waterborne cyclosporiasis have not been identified. Cryptosporidium, Giardia, and Cyclospora have potential significance in the preparation and consumption of fresh produce and in catering practice, in which ready-to-eat foods may be served that have not received heat treatment. None of the three organisms Cryptosporidium, Giardia, and Cyclospora has been shown to be a problem for heat processed food or tap water that has undergone appropriate treatment at a water treatment works. All three are sensitive to standard pasteurisation techniques. Although humans are not a primary host for T. gondii, the potential exists for both waterborne and foodborne toxoplasmosis. Parasitic protozoa do not multiply in foods, but they may survive in or on moist foods for months in cool, damp environments. Their ecology makes control of these parasites difficult. For general control of parasitic protozoa in the food chain, the following steps are necessary: - Follow good hygienic practice in food service and catering industries.- Minimise dissemination of cysts and oocysts in the farming environment and via human waste management.- Include these microorganisms in Hazard Analysis Critical Control Point (HACCP) plans of water suppliers, industries or sectors

  10. Burden of illness: direct and indirect costs among persons with hemophilia A in the United States.

    PubMed

    Zhou, Zheng-Yi; Koerper, Marion A; Johnson, Kathleen A; Riske, Brenda; Baker, Judith R; Ullman, Megan; Curtis, Randall G; Poon, Jiat-Ling; Lou, Mimi; Nichol, Michael B

    2015-06-01

    To examine the direct and indirect costs of hemophilia care among persons with hemophilia A in the US. Observational data were obtained from HUGS-Va, a multi-center study from six federally supported hemophilia treatment centers (HTCs). Eligible individuals completed a standardized initial questionnaire and were followed regularly for 2 years to obtain information on work or school absenteeism, time spent arranging hemophilia care, and unpaid hemophilia-related support from caregivers. Data from 1-year healthcare utilization records and 2-year clotting factor dispensing records measured direct medical costs. Indirect costs were imputed using the human capital approach, which uses wages as a proxy measure of work time output. A total of 222 patients with complete data were included in the analysis. Two-thirds had severe hemophilia and the mean age was 21.1 years. The use of prophylaxis in severe hemophilia patients is associated with statistically significant reduction in the numbers of emergency department (ED) visits and bleeding episodes compared with those who were treated episodically. From the societal perspective, mild hemophilia costs $59,101 (median: $7519) annually per person, $84,363 (median: $61,837) for moderate hemophilia, $201,471 (median: $143,431) for severe hemophilia using episodic treatment, and $301,392 (median: $286,198) for severe hemophilia receiving prophylaxis. Clotting factor contributed from 54% of total costs in mild hemophilia to a maximum of 94% for patients with severe hemophilia receiving prophylaxis. Hemophilia is a costly disorder not only because of its high medical expenses, but also due to the high indirect costs incurred.

  11. Costs of treating patients with schizophrenia who have illness-related crisis events.

    PubMed

    Zhu, Baojin; Ascher-Svanum, Haya; Faries, Douglas E; Peng, Xiaomei; Salkever, David; Slade, Eric P

    2008-08-26

    Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37,329), persons with prior

  12. Costs of treating patients with schizophrenia who have illness-related crisis events

    PubMed Central

    Zhu, Baojin; Ascher-Svanum, Haya; Faries, Douglas E; Peng, Xiaomei; Salkever, David; Slade, Eric P

    2008-01-01

    Background Relatively little is known about the relationship between psychosocial crises and treatment costs for persons with schizophrenia. This naturalistic prospective study assessed the association of recent crises with mental health treatment costs among persons receiving treatment for schizophrenia. Methods Data were drawn from a large multi-site, non-interventional study of schizophrenia patients in the United States, conducted between 1997 and 2003. Participants were treated at mental health treatment systems, including the Department of Veterans Affairs (VA) hospitals, community mental health centers, community and state hospitals, and university health care service systems. Total costs over a 1-year period for mental health services and component costs (psychiatric hospitalizations, antipsychotic medications, other psychotropic medications, day treatment, emergency psychiatric services, psychosocial/rehabilitation group therapy, individual therapy, medication management, and case management) were calculated for 1557 patients with complete medical information. Direct mental health treatment costs for patients who had experienced 1 or more of 5 recent crisis events were compared to propensity-matched samples of persons who had not experienced a crisis event. The 5 non-mutually exclusive crisis event subgroups were: suicide attempt in the past 4 weeks (n = 18), psychiatric hospitalization in the past 6 months (n = 240), arrest in the past 6 months (n = 56), violent behaviors in the past 4 weeks (n = 62), and diagnosis of a co-occurring substance use disorder (n = 413). Results Across all 5 categories of crisis events, patients who had a recent crisis had higher average annual mental health treatment costs than patients in propensity-score matched comparison samples. Average annual mental health treatment costs were significantly higher for persons who attempted suicide ($46,024), followed by persons with psychiatric hospitalization in the past 6 months ($37

  13. Illness Mapping: a time and cost effective method to estimate healthcare data needed to establish community-based health insurance

    PubMed Central

    2012-01-01

    Background Most healthcare spending in developing countries is private out-of-pocket. One explanation for low penetration of health insurance is that poorer individuals doubt their ability to enforce insurance contracts. Community-based health insurance schemes (CBHI) are a solution, but launching CBHI requires obtaining accurate local data on morbidity, healthcare utilization and other details to inform package design and pricing. We developed the “Illness Mapping” method (IM) for data collection (faster and cheaper than household surveys). Methods IM is a modification of two non-interactive consensus group methods (Delphi and Nominal Group Technique) to operate as interactive methods. We elicited estimates from “Experts” in the target community on morbidity and healthcare utilization. Interaction between facilitator and experts became essential to bridge literacy constraints and to reach consensus. The study was conducted in Gaya District, Bihar (India) during April-June 2010. The intervention included the IM and a household survey (HHS). IM included 18 women’s and 17 men’s groups. The HHS was conducted in 50 villages with1,000 randomly selected households (6,656 individuals). Results We found good agreement between the two methods on overall prevalence of illness (IM: 25.9% ±3.6; HHS: 31.4%) and on prevalence of acute (IM: 76.9%; HHS: 69.2%) and chronic illnesses (IM: 20.1%; HHS: 16.6%). We also found good agreement on incidence of deliveries (IM: 3.9% ±0.4; HHS: 3.9%), and on hospital deliveries (IM: 61.0%. ± 5.4; HHS: 51.4%). For hospitalizations, we obtained a lower estimate from the IM (1.1%) than from the HHS (2.6%). The IM required less time and less person-power than a household survey, which translate into reduced costs. Conclusions We have shown that our Illness Mapping method can be carried out at lower financial and human cost for sourcing essential local data, at acceptably accurate levels. In view of the good fit of results

  14. Violence and the costs of caring for a family member with severe mental illness.

    PubMed

    Thompson, Maxine Seaborn

    2007-09-01

    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 noncompliance are included in a series of multivariate regression models predicting caregiver financial burden that include measures for disruptive behaviors, personal needs, social supports, and caregiver characteristics. The findings show that violent perpetration and violent victimization increase the number of financial contributions and perceived financial strain. Nonviolent victimization, in contrast, decreases caregiver financial burden. Number of financial contributions and perceived financial strain are greatest when the family member is violent and extremely disruptive or needs assistance with personal care. Neither substance use nor medication noncompliance contributed to caregiver financial burden. Co-residence, female sex, parenthood, and instrumental social support were also associated with financial burden.

  15. Costs of hospitalization with respiratory syncytial virus illness among children aged <5 years and the financial impact on households in Bangladesh, 2010

    PubMed Central

    Bhuiyan, Mejbah Uddin; Luby, Stephen P; Alamgir, Nadia Ishrat; Homaira, Nusrat; Sturm–Ramirez, Katharine; Gurley, Emily S.; Abedin, Jaynal; Zaman, Rashid Uz; Alamgir, ASM; Rahman, Mahmudur; Ortega–Sanchez, Ismael R.; Azziz–Baumgartner, Eduardo

    2017-01-01

    Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged <5 years with laboratory–confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case–patients’ homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non–medical costs (costs for food, lodging and transportation); indirect costs (caregivers’ productivity loss), and coping strategies used by families to pay for treatment. We used WHO–Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost–per–episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43–101), indirect cost was US$ 19 (IQR = 11–29) and total cost was US$ 94 (IQR = 67–127). The median out–of–pocket cost was 24% of monthly household income of affected families (US$ 143), and >50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV–associated hospitalization in children

  16. 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

  17. Socioeconomic costs and health-related quality of life in juvenile idiopathic arthritis: a cost-of-illness study in the United Kingdom.

    PubMed

    Angelis, Aris; Kanavos, Panos; López-Bastida, Julio; Linertová, Renata; Serrano-Aguilar, Pedro

    2016-08-02

    Juvenile idiopathic arthritis (JIA) refers to a number of rare chronic inflammatory diseases. Although JIA imposes a significant societal burden, limited data are available on the cost of JIA. The study's objective is to quantify the socioeconomic burden of JIA patients in the United Kingdom (UK), along with their health-related quality of life (HRQoL). A bottom-up, cross-sectional, cost-of-illness analysis of 23 patients was carried out. To collect data on demographic characteristics, health resource utilization, informal care, productivity losses and HRQoL, questionnaires were administered to and completed by patients or their caregivers. The EuroQol five dimensions (EQ-5D) instrument was used to measure HRQoL. This study found that the average annual cost for a JIA patient was €31,546, with direct health care costs equalling €14,509 (46.0 % of total costs), direct non-health care costs amounting to €8,323 (26.4 %) and productivity losses being €8,715 (27.6 %). This was calculated using unit costs for 2012. The largest expenditures on average were accounted for by early retirement (27.0 %), followed by informal care (24.1 %), medications (21.1 %), outpatient and primary health care visits (13.2 %) and diagnostic tests (7.9 %). Important differences existed between JIA patients in need of caregiver assistance and those with no need (€39,469 vs. €25,452 respectively). Among adult JIA patients, mean EQ-5D index scores and visual analogue scale (VAS) scores were found to be 0.26 and 49.00 respectively; the same scores among caregivers were 0.66 and 67.14 respectively. JIA poses a significant cost burden on the UK society. Over half of the total average costs (54 %) are related to non-health care and productivity losses. HRQoL of JIA patients is considerably worse than the UK general population.

  18. Surveillance for foodborne disease outbreaks - United States, 1998-2008.

    PubMed

    Gould, L Hannah; Walsh, Kelly A; Vieira, Antonio R; Herman, Karen; Williams, Ian T; Hall, Aron J; Cole, Dana

    2013-06-28

    Foodborne diseases cause an estimated 48 million illnesses each year in the United States, including 9.4 million caused by known pathogens. Foodborne disease outbreak surveillance provides valuable insights into the agents and foods that cause illness and the settings in which transmission occurs. CDC maintains a surveillance program for collection and periodic reporting of data on the occurrence and causes of foodborne disease outbreaks in the United States. This surveillance system is the primary source of national data describing the numbers of illnesses, hospitalizations, and deaths; etiologic agents; implicated foods; contributing factors; and settings of food preparation and consumption associated with recognized foodborne disease outbreaks in the United States. 1998-2008. The Foodborne Disease Outbreak Surveillance System collects data on foodborne disease outbreaks, defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food. Public health agencies in all 50 states, the District of Columbia, U.S. territories, and Freely Associated States have primary responsibility for identifying and investigating outbreaks and use a standard form to report outbreaks voluntarily to CDC. During 1998-2008, reporting was made through the electronic Foodborne Outbreak Reporting System (eFORS). During 1998-2008, CDC received reports of 13,405 foodborne disease outbreaks, which resulted in 273,120 reported cases of illness, 9,109 hospitalizations, and 200 deaths. Of the 7,998 outbreaks with a known etiology, 3,633 (45%) were caused by viruses, 3,613 (45%) were caused by bacteria, 685 (5%) were caused by chemical and toxic agents, and 67 (1%) were caused by parasites. Among the 7,724 (58%) outbreaks with an implicated food or contaminated ingredient reported, 3,264 (42%) could be assigned to one of 17 predefined commodity categories: fish, crustaceans, mollusks, dairy, eggs, beef, game, pork, poultry, grains/beans, oils

  19. Foodborne (1973-2013) and Waterborne (1971-2013) Disease Outbreaks - United States.

    PubMed

    Dewey-Mattia, Daniel; Roberts, Virginia A; Vieira, Antonio; Fullerton, Kathleen E

    2016-10-14

    CDC collects data on foodborne and waterborne disease outbreaks reported by all U.S. states and territories through the Foodborne Disease Outbreak Surveillance System (FDOSS) (http://www.cdc.gov/foodsafety/fdoss/surveillance/index.html) and the Waterborne Disease and Outbreak Surveillance System (WBDOSS) http://www.cdc.gov/healthywater/surveillance), respectively. These two systems are the primary source of national data describing the number of reported outbreaks; outbreak-associated illnesses, hospitalizations, and deaths; etiologic agents; water source or implicated foods; settings of exposure; and other factors associated with recognized foodborne and waterborne disease outbreaks in the United States.

  20. 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…

  1. A Cost-Sharing Exemption Program for Patients With Mental Illness in Taiwan: Who Enrolls?

    PubMed

    Huang, Hsin-Hui; Chen, Chuan-Yu; Chou, Yiing-Jenq; Huang, Nicole

    2015-11-01

    The purpose of this study was to identify patient and provider characteristics associated with enrollment in a cost-sharing exemption program among people newly diagnosed as having schizophrenia. The study used a nationally representative sample from Taiwan's National Health Insurance (NHI) program. Enrollment in a cost-sharing exemption program among 1,824 individuals with schizophrenia was observed for one year and three years after the individuals received a diagnosis of schizophrenia for the first time. Generalized estimating equations were applied to estimate the effect of various patient and physician characteristics on the odds of enrollment. The one-year and three-year program enrollment rates were 52% and 58%, respectively. People ages 35 or older were significantly more likely to enroll compared with younger people. People with low incomes and people who were hospitalized for schizophrenia were significantly more likely to enroll. Regarding provider characteristics, patients cared for by psychiatrists (adjusted odds ratio [AOR]=1.10) or by psychiatric institutions (AOR=1.10) were significantly more likely to enroll in the cost-sharing exemption program within the first year of diagnosis. The results suggest that enrollment in the NHI's cost-sharing exemption program by people newly diagnosed as having schizophrenia was relatively low. The role of providers must not be overlooked. Effective strategies targeting high-risk subgroups for nonparticipation are necessary in addressing mental health parity.

  2. 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

  3. 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

  4. Effectiveness and cost-effectiveness of a cardiovascular risk prediction algorithm for people with severe mental illness (PRIMROSE).

    PubMed

    Zomer, Ella; Osborn, David; Nazareth, Irwin; Blackburn, Ruth; Burton, Alexandra; Hardoon, Sarah; Holt, Richard Ian Gregory; King, Michael; Marston, Louise; Morris, Stephen; Omar, Rumana; Petersen, Irene; Walters, Kate; Hunter, Rachael Maree

    2017-09-05

    To determine the cost-effectiveness of two bespoke severe mental illness (SMI)-specific risk algorithms compared with standard risk algorithms for primary cardiovascular disease (CVD) prevention in those with SMI. Primary care setting in the UK. The analysis was from the National Health Service perspective. 1000 individuals with SMI from The Health Improvement Network Database, aged 30-74 years and without existing CVD, populated the model. Four cardiovascular risk algorithms were assessed: (1) general population lipid, (2) general population body mass index (BMI), (3) SMI-specific lipid and (4) SMI-specific BMI, compared against no algorithm. At baseline, each cardiovascular risk algorithm was applied and those considered high risk (> 10%) were assumed to be prescribed statin therapy while others received usual care. Quality-adjusted life years (QALYs) and costs were accrued for each algorithm including no algorithm, and cost-effectiveness was calculated using the net monetary benefit (NMB) approach. Deterministic and probabilistic sensitivity analyses were performed to test assumptions made and uncertainty around parameter estimates. The SMI-specific BMI algorithm had the highest NMB resulting in 15 additional QALYs and a cost saving of approximately £53 000 per 1000 patients with SMI over 10 years, followed by the general population lipid algorithm (13 additional QALYs and a cost saving of £46 000). The general population lipid and SMI-specific BMI algorithms performed equally well. The ease and acceptability of use of an SMI-specific BMI algorithm (blood tests not required) makes it an attractive algorithm to implement in clinical settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Evidence summary: what 'cost of illness' evidence is there about cross-infection related infections in dental practice?

    PubMed

    Fox, Chris

    2010-07-24

    Since August 2009, members of the Primary Care Dentistry Research Forum (http://www.dentistryresearch.org) have taken part in an online vote to identify questions in day-to-day practice that they felt most needed to be answered with conclusive research. The question which receives the most votes each month forms the subject of a critical appraisal of the relevant literature. Each month a new round of voting takes place to decide which further questions will be reviewed. Dental practitioners and dental care professionals are encouraged to take part in the voting and submit their own questions to be included in the vote by joining the website.The paper below details a summary of the findings of the seventh critical appraisal. In conclusion, the critical appraisal identified no evidence on the epidemiological scale of cross-infection caused in dental practices and therefore also of the cost impact of cross-infection caused in primary dental practices. As a result, no 'cost of illness', or cost-benefit assessment, exists or is feasible at this time.

  6. Use of Bayesian Markov Chain Monte Carlo methods to model cost-of-illness data.

    PubMed

    Cooper, Nicola J; Sutton, Alex J; Mugford, Miranda; Abrams, Keith R

    2003-01-01

    It is well known that the modeling of cost data is often problematic due to the distribution of such data. Commonly observed problems include 1) a strongly right-skewed data distribution and 2) a significant percentage of zero-cost observations. This article demonstrates how a hurdle model can be implemented from a Bayesian perspective by means of Markov Chain Monte Carlo simulation methods using the freely available software WinBUGS. Assessment of model fit is addressed through the implementation of two cross-validation methods. The relative merits of this Bayesian approach compared to the classical equivalent are discussed in detail. To illustrate the methods described, patient-specific non-health-care resource-use data from a prospective longitudinal study and the Norfolk Arthritis Register (NOAR) are utilized for 218 individuals with early inflammatory polyarthritis (IP). The NOAR database also includes information on various patient-level covariates.

  7. 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

  8. Estimated Costs of Sporadic Gastrointestinal Illness Associated with Surface Water Recreation: A Combined Analysis of Data from NEEAR and CHEERS Studies

    PubMed Central

    DeFlorio-Barker, Stephanie; Wade, Timothy J.; Jones, Rachael M.; Friedman, Lee S.; Wing, Coady; Dorevitch, Samuel

    2016-01-01

    Background: The burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost, attributable disease burden estimates can be useful for environmental management decisions. Objectives: We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation. Methods: Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U.S. states, and CHEERS, which evaluated illness after incidental-contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI. Results: Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338–$1,681) and $1,676 for swimming/wading (range $425–2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs. Conclusions: Our estimates suggest gastrointestinal illness attributed to surface water recreation at urban waterways, lakes, and coastal marine beaches is responsible for costs that should be accounted for when considering the monetary impact of efforts to improve water quality. The COI provides more information than the frequency of illness, as it takes into account disease incidence, health care utilization, and lost productivity. Use of monetized disease severity information should be included in future studies of water quality and health. Citation: DeFlorio-Barker S, Wade TJ, Jones RM

  9. Estimated Costs of Sporadic Gastrointestinal Illness Associated with Surface Water Recreation: A Combined Analysis of Data from NEEAR and CHEERS Studies.

    PubMed

    DeFlorio-Barker, Stephanie; Wade, Timothy J; Jones, Rachael M; Friedman, Lee S; Wing, Coady; Dorevitch, Samuel

    2017-02-01

    The burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost, attributable disease burden estimates can be useful for environmental management decisions. We characterize the disease burden attributable to water recreation using data from two cohort studies using a cost of illness (COI) approach and estimate the largest drivers of the disease burden of water recreation. Data from the NEEAR study, which evaluated swimming and wading in marine and freshwater beaches in six U.S. states, and CHEERS, which evaluated illness after incidental-contact recreation (boating, canoeing, fishing, kayaking, and rowing) on waterways in the Chicago area, were used to estimate the cost per case of gastrointestinal illness and costs attributable to water recreation. Data on health care and medication utilization and missed days of work or leisure were collected and combined with cost data to construct measures of COI. Depending on different assumptions, the cost of gastrointestinal symptoms attributable to water recreation are estimated to be $1,220 for incidental-contact recreation (range $338-$1,681) and $1,676 for swimming/wading (range $425-2,743) per 1,000 recreators. Lost productivity is a major driver of the estimated COI, accounting for up to 90% of total costs. Our estimates suggest gastrointestinal illness attributed to surface water recreation at urban waterways, lakes, and coastal marine beaches is responsible for costs that should be accounted for when considering the monetary impact of efforts to improve water quality. The COI provides more information than the frequency of illness, as it takes into account disease incidence, health care utilization, and lost productivity. Use of monetized disease severity information should be included in future studies of water quality and health. Citation: DeFlorio-Barker S, Wade TJ, Jones RM, Friedman LS, Wing C, Dorevitch S. 2017. Estimated costs of

  10. Societal cost-of-illness in patients with borderline personality disorder one year before, during and after dialectical behavior therapy in routine outpatient care.

    PubMed

    Wagner, Till; Fydrich, Thomas; Stiglmayr, Christian; Marschall, Paul; Salize, Hans-Joachim; Renneberg, Babette; Fleßa, Steffen; Roepke, Stefan

    2014-10-01

    Societal cost-of-illness in a German sample of patients with borderline personality disorder (BPD) was calculated for 12 months prior to an outpatient Dialectical Behavior Therapy (DBT) program, during a year of DBT in routine outpatient care and during a follow-up year. We retrospectively assessed resource consumption and productivity loss by means of a structured interview. Direct costs were calculated as opportunity costs and indirect costs were calculated according to the Human Capital Approach. All costs were expressed in Euros for the year 2010. Total mean annual BPD-related societal cost-of-illness was €28026 (SD = €33081) during pre-treatment, €18758 (SD = €19450) during the DBT treatment year for the 47 DBT treatment completers, and €14750 (SD = €18592) during the follow-up year for the 33 patients who participated in the final assessment. Cost savings were mainly due to marked reductions in inpatient treatment costs, while indirect costs barely decreased. In conclusion, our findings provide evidence that the treatment of BPD patients with an outpatient DBT program is associated with substantial overall cost savings. Already during the DBT treatment year, these savings clearly exceed the additional treatment costs of DBT and are further extended during the follow-up year. Correspondingly, outpatient DBT has the potential to be a cost-effective treatment for BPD patients. Efforts promoting its implementation in routine care should be undertaken. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Least Wanted Foodborne Pathogens

    MedlinePlus

    ... HOW TO AVOID THEM Campylobacter - Second most common bacterial cause of diarrhea in the United States; Sources: raw and undercooked poultry and other meat, raw milk and untreated water. Clostridium botulinum - This organism produces a toxin which causes botulism, a life-threatening illness that ...

  12. Assertive community treatment for people with severe mental illness: the effect on hospital use and costs.

    PubMed

    Salkever, D; Domino, M E; Burns, B J; Santos, A B; Deci, P A; Dias, J; Wagner, H R; Faldowski, R A; Paolone, J

    1999-06-01

    To determine the effect of the Program for Assertive Community Treatment (PACT) model on psychiatric inpatient service use in a population of non-emergency psychiatric patients with severe chronic mental illness, and to test for variations in this effect with program staffing levels and patient characteristics such as race and age. Data are taken from a randomized trial of PACT in Charleston, South Carolina for 144 patients recruited from August 1989 through July 1991. Subjects were randomly assigned either to one of two PACT programs or to usual care at a local mental health center. Effects on hospital use were measured over an 18-month follow-up period via multiple regression analysis. Data were obtained from Medicaid claims, chart reviews, subject, case manager, and family interviews; searches of the computerized patient and financial databases of the South Carolina Department of Mental Health and relevant hospitals; and searches of the hard copy and computerized financial databases of the two major local hospitals providing inpatient psychiatric care. PACT participants were about 40 percent less likely to be hospitalized during the follow-up period. The effect was stronger for older patients. Lower PACT client/staff ratios also reduced the risk of hospitalization. No evidence of differential race effects was found. Given some hospital use, PACT did not influence the number of days of use. Controlling for other covariates, PACT significantly reduces hospitalizations but the size of this effect varies with patient and program characteristics. This study shows that previous results on PACT can be applied to non-emergency patients even when the control condition is an up-to-date CMHC office-based case management program.

  13. Assertive community treatment for people with severe mental illness: the effect on hospital use and costs.

    PubMed Central

    Salkever, D; Domino, M E; Burns, B J; Santos, A B; Deci, P A; Dias, J; Wagner, H R; Faldowski, R A; Paolone, J

    1999-01-01

    OBJECTIVE: To determine the effect of the Program for Assertive Community Treatment (PACT) model on psychiatric inpatient service use in a population of non-emergency psychiatric patients with severe chronic mental illness, and to test for variations in this effect with program staffing levels and patient characteristics such as race and age. DATA SOURCES/STUDY SETTING: Data are taken from a randomized trial of PACT in Charleston, South Carolina for 144 patients recruited from August 1989 through July 1991. STUDY DESIGN: Subjects were randomly assigned either to one of two PACT programs or to usual care at a local mental health center. Effects on hospital use were measured over an 18-month follow-up period via multiple regression analysis. DATA COLLECTION METHODS: Data were obtained from Medicaid claims, chart reviews, subject, case manager, and family interviews; searches of the computerized patient and financial databases of the South Carolina Department of Mental Health and relevant hospitals; and searches of the hard copy and computerized financial databases of the two major local hospitals providing inpatient psychiatric care. PRINCIPAL FINDINGS: PACT participants were about 40 percent less likely to be hospitalized during the follow-up period. The effect was stronger for older patients. Lower PACT client/staff ratios also reduced the risk of hospitalization. No evidence of differential race effects was found. Given some hospital use, PACT did not influence the number of days of use. CONCLUSIONS: Controlling for other covariates, PACT significantly reduces hospitalizations but the size of this effect varies with patient and program characteristics. This study shows that previous results on PACT can be applied to non-emergency patients even when the control condition is an up-to-date CMHC office-based case management program. PMID:10357291

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

    USDA-ARS?s Scientific Manuscript database

    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...

  15. Foodborne Campylobacter: Infections, Metabolism, Pathogenesis and Reservoirs

    PubMed Central

    Epps, Sharon V. R.; Harvey, Roger B.; Hume, Michael E.; Phillips, Timothy D.; Anderson, Robin C.; Nisbet, David J.

    2013-01-01

    Campylobacter species are a leading cause of bacterial-derived foodborne illnesses 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 a serious public health threat. Campylobacter jejuni and Campylobacter coli are considered to be the most important enteropathogens of this genus and their ability to colonize and survive in a wide variety of animal species and habitats make them extremely difficult to control. This article reviews the historical and emerging importance of this bacterial group and addresses aspects of the human infections they cause, their metabolism and pathogenesis, and their natural reservoirs in order to address the need for appropriate food safety regulations and interventions. PMID:24287853

  16. Foodborne pathogens and their toxins.

    PubMed

    Martinović, Tamara; Andjelković, Uroš; Gajdošik, Martina Šrajer; Rešetar, Dina; Josić, Djuro

    2016-09-16

    Foodborne pathogens, mostly bacteria and fungi, but also some viruses, prions and protozoa, contaminate food during production and processing, but also during storage and transport before consuming. During their growth these microorganisms can secrete different components, including toxins, into the extracellular environment. Other harmful substances can be also liberated and can contaminate food after disintegration of food pathogens. Some bacterial and fungal toxins can be resistant to inactivation, and can survive harsh treatment during food processing. Many of these molecules are involved in cellular processes and can indicate different mechanisms of pathogenesis of foodborne organisms. More knowledge about food contaminants can also help understand their inactivation. In the present review the use of proteomics, peptidomics and metabolomics, in addition to other foodomic methods for the detection of foodborne pathogenic fungi and bacteria, is overviewed. Furthermore, it is discussed how these techniques can be used for discovering biomarkers for pathogenicity of foodborne pathogens, determining the mechanisms by which they act, and studying their resistance upon inactivation in food of animal and plant origin. Comprehensive and comparative view into the genome and proteome of foodborne pathogens of bacterial or fungal origin and foodomic, mostly proteomic, peptidomic and metabolomic investigation of their toxin production and their mechanism of action is necessary in order to get further information about their virulence, pathogenicity and survival under stress conditions. Furthermore, these data pave the way for identification of biomarkers to trace sources of contamination with food-borne microorganisms and their endo- and exotoxins in order to ensure food safety and prevent the outbreak of food-borne diseases. Therefore, detection of pathogens and their toxins during production, transport and before consume of food produce, as well as protection against

  17. Attributing the human disease burden of foodborne infections to specific sources.

    PubMed

    Pires, Sara M; Evers, Eric G; van Pelt, Wilfrid; Ayers, Tracy; Scallan, Elaine; Angulo, Frederick J; Havelaar, Arie; Hald, Tine

    2009-05-01

    Foodborne diseases are an important cause of human illness worldwide. Humans acquire these infections from a variety of sources and routes of transmission. Many efforts have been made in the last decades to prevent and control foodborne diseases, particularly foodborne zoonoses. However, information on the impact of these interventions is limited. To identify and prioritize successful food safety interventions, it is important to attribute the burden of human illness to the specific sources. Defining scientific concepts and harmonizing terminology for "source attribution" is essential for understanding and improving attribution methodologies and for sharing knowledge within the scientific community. We propose harmonized nomenclature, and describe the various approaches for human illness source attribution and their usefulness to address specific public health questions.

  18. The management of small area burns and unexpected illness after burn in children under five years of age - A costing study in the English healthcare setting.

    PubMed

    Kandiyali, R; Sarginson, J H; Hollén, L I; Spickett-Jones, F; Young, A E R

    2017-08-17

    The objective of this economic study was to evaluate the resource use and cost associated with the management of small area burns, including the additional costs associated with unexpected illness after burn in children of less than five years of age. This study was conducted as a secondary analysis of a multi-centre prospective observational cohort study investigating the physiological response to burns in children. 452 children were included in the economic analysis (median age=1.60years, 61.3% boys, median total burn surface area [TBSA]=1.00%) with a mean length of stay of 0.69 days. Of these children, 21.5% re-presented to medical care with an unexpected illness within fourteen days of injury. The cost of managing a burn of less than 10% TBSA in a child less than five years of age was £785. The additional cost associated with the management of illness after burn was £1381. A generalised linear regression model was used to determine the association between an unexpected illness after burn, presenting child characteristics and NHS cost. Our findings may be of value to those planning economic evaluations of novel technologies in burn care. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  19. Household costs of dengue illness: secondary outcomes from a randomised controlled trial of dengue prevention in Guerrero state, Mexico.

    PubMed

    Legorreta-Soberanis, José; Paredes-Solís, Sergio; Morales-Pérez, Arcadio; Nava-Aguilera, Elizabeth; Serrano-de Los Santos, Felipe René; Dimas-Garcia, Diana Lisseth; Ledogar, Robert J; Cockcroft, Anne; Andersson, Neil

    2017-05-30

    Dengue is a serious public health problem with an important economic impact. This study used data from a cluster randomised controlled trial of community mobilisation for dengue prevention to estimate the household costs of treatment of dengue illness. It examined the economic impact of the trial intervention in the three coastal regions of Mexico's Guerrero State. The 2010 baseline survey covered households in a random sample of 90 clusters in the coastal regions; the clusters were randomly allocated to intervention or control and re-surveyed in 2012. The surveys asked about dengue cases in the last 12 months, expenditures on their treatment, and work or school days lost by patients and care givers. We did not assign monetary value to days lost, since a lost day to a person of low earning power is of equal or higher value to that person than to one who earns more. The 12,312 households in 2010 reported 1020 dengue cases in the last 12 months (1.9% of the sample population). Most (78%) were ambulatory cases, with a mean cost of USD 51 and 10.8 work/school days, rising to USD 96 and 11.4 work/school days if treated by a private physician. Hospitalised cases cost USD 28-94 in government institutions and USD 392 in private hospitals (excluding additional inpatient charges), as well as 9.6-17.3 work/school days. Dengue cases cost households an estimated 412,825 work/school days throughout the three coastal regions. In the follow up survey, 6.1% (326/5349) of households in intervention clusters and 7.9% (405/5139) in control clusters reported at least one dengue case. The mean of days lost per case was similar in intervention and control clusters, but the number of days lost from dengue and all elements of costs for dengue cases per 1000 population were lower in intervention clusters. If the total population of the three coastal regions had received the intervention, some 149,401 work or school days lost per year could have been prevented. The economic effect of

  20. Out-of-Pocket Costs and Other Determinants of Access to Healthcare for Children with Febrile Illnesses: A Case-Control Study in Rural Tanzania

    PubMed Central

    Castellani, Joëlle; Mihaylova, Borislava; Evers, Silvia M. A. A.; Paulus, Aggie T. G.; Mrango, Zakayo E.; Kimbute, Omari; Shishira, Joseph P.; Mulokozi, Francis; Petzold, Max; Singlovic, Jan; Gomes, Melba

    2015-01-01

    Objectives To study private costs and other determinants of access to healthcare for childhood fevers in rural Tanzania. Methods A case-control study was conducted in Tanzania to establish factors that determine access to a health facility in acute febrile illnesses in children less than 5 years of age. Carers of eligible children were interviewed in the community; cases were represented by patients who went to a facility and controls by those who did not. A Household Wealth Index was estimated using principal components analysis. A multivariable logistic regression analysis was performed to understand the factors which influenced attendance of healthcare facility including severity of the illness and household wealth/socio-demographic indicators. To complement the data on costs from community interviews, a hospital-based study obtained details of private expenditures for hospitalised children under the age of 5. Results Severe febrile illness is strongly associated with health facility attendance (OR: 35.76, 95%CI: 3.68-347.43, p = 0.002 compared with less severe febrile illness). Overall, the private costs of an illness for patients who went to a hospital were six times larger than private costs of controls ($5.68 vs. $0.90, p<0.0001). Household wealth was not significantly correlated with total costs incurred. The separate hospital based cost study indicated that private costs were three times greater for admissions at the mission versus public hospital: $13.68 mission vs. $4.47 public hospital (difference $ 9.21 (95% CI: 7.89 -10.52), p<0.0001). In both locations, approximately 50% of the cost was determined by the duration of admission, with each day in hospital increasing private costs by about 12% (95% CI: 5% - 21%). Conclusion The more severely ill a child, the higher the probability of attending hospital. We did not find association between household wealth and attending a health facility; nor was there an association between household wealth and private

  1. 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

  2. Molecular techniques for detecting and typing of bacteria, advantages and application to foodborne pathogens isolated from ducks.

    PubMed

    Adzitey, Frederick; Huda, Nurul; Ali, Gulam Rusul Rahmat

    2013-04-01

    In recent times, several foodborne pathogens have become important and a threat to public health. Surveillance studies have provided data and a better understanding into the existence and spread of foodborne pathogens. The application of molecular techniques for detecting and typing of foodborne pathogens in surveillance studies provide reliable epidemiological data for tracing the source of human infections. A wide range of molecular techniques (including pulsed field gel electrophoresis, multilocus sequence typing, random amplified polymorphism deoxyribonucleic acid, repetitive extragenic palindromic, deoxyribonucleic acid sequencing, multiplex polymerase chain reaction and many more) have been used for detecting, speciating, typing, classifying and/or characterizing foodborne pathogens of great significance to humans. Farm animals including chickens, cattle, sheep, goats and pigs, and others (such as domestic and wild animals) have been reported to be primary reservoirs for foodborne pathogens. The consumption of contaminated poultry meats or products has been considered to be the leading source of human foodborne infections. Ducks like other farm animals are important source of foodborne pathogens and have been implicated in some human foodborne illnesses and deaths. Nonetheless, few studies have been conducted to explore the potential of ducks in causing foodborne outbreaks, diseases and its consequences. This review highlights some common molecular techniques, their advantages and those that have been applied to pathogens isolated from ducks and their related sources.

  3. Investigating on a foodborne outbreak: analysis of the critical points.

    PubMed

    Panico, M G; Caporale, V; Agozzino, E

    2006-01-01

    The Authors describe an epidemiological survey performed after a cluster of cases of foodborne infection involving several participants at a wedding reception. The aim was to identify the food, the responsible pathogen and any shortcomings in the coordination between the various services and the territorial operating units involved in the outbreak investigation. The investigation involved 149 participants; fifty seven persons (38.3%) had a foodborne illness. The only food item that remained associated with illness after multiple regression analysis was the ricotta cheese (RR 3.58, I.C. 1.,72-7.48 ). The finding of B. cereus in samples of ricotta cheese collected at the dairy food supplier indicate its responsibility for the outbreak but diagnostic certainty could not be achieved as no leftovers were available. Thus, shortcomings in this epidemiological investigation are constituted by: delayed notification, which prevented the acquisition of food samples, lack of a reference laboratory and lack of a specific diagnostic protocols, which prevented the microbiological research for the rapid identification of new pathogens incriminated in foodborne diseases. Finally, environmental and sanitary inspections showed deficiencies in the hygienic measures of food storage, particularly regarding refrigeration and in the HACCP plan that was not properly implemented.

  4. Evolving public health approaches to the global challenge of foodborne infections.

    PubMed

    Tauxe, R V; Doyle, M P; Kuchenmüller, T; Schlundt, J; Stein, C E

    2010-05-30

    The landscape of foodborne infections is in flux. New pathogens emerge, established pathogens may acquire new characteristics and appear in unexpected food vehicles, while many existing problems remain unsolved. Consumers want more fresh foods year round, populations age and migrate, and the technologies and trade practices that produce foods change. Protecting the public health and minimizing the burden of foodborne illness mean expecting the unexpected, and being prepared to understand it when it occurs, so that prevention can be improved. Public health surveillance is also constantly evolving, as new diseases emerge and are judged worthy of notification, as new diagnostic tests change the ease and specificity of routine diagnosis and as social interest in particular issues waxes and wanes. Accurate health information, including reliable estimates of the burden of foodborne disease, can improve foodborne disease prevention, foster global health security, promote economic growth and development and strengthen evidence-based policy making.

  5. 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.

  6. Surveillance for foodborne disease outbreaks--United States, 2009-2010.

    PubMed

    2013-01-25

    Known pathogens cause an estimated 9.4 million foodborne illnesses annually in the United States. CDC collects data on foodborne disease outbreaks submitted by all states, the District of Columbia, and Puerto Rico through CDC's Foodborne Disease Outbreak Surveillance System. Data reported for each outbreak include the number of illnesses, hospitalizations, and deaths; the etiologic agent; the implicated food vehicle; and other factors involved in food preparation and consumption. During 2009-2010, a total of 1,527 foodborne disease outbreaks (675 in 2009 and 852 in 2010) were reported, resulting in 29,444 cases of illness, 1,184 hospitalizations, and 23 deaths. Among the 790 outbreaks with a single laboratory-confirmed etiologic agent, norovirus was the most commonly reported, accounting for 42% of outbreaks. Salmonella was second, accounting for 30% of outbreaks. Among the 299 outbreaks attributed to a food composed of ingredients from one of 17 predefined, mutually exclusive food commodities, those most often implicated were beef (13%), dairy (12%), fish (12%), and poultry (11%). The commodities in the 299 outbreaks associated with the most illnesses were eggs (27% of illnesses), beef (11%), and poultry (10%). Public health, regulatory, and food industry professionals can use this information when creating targeted control strategies along the farm-to-table continuum for specific agents, specific foods, and specific pairs of agents and foods. This information also supports efforts to promote safe food-handling practices among food workers and the public.

  7. Analyses of the contributing factors associated with foodborne outbreaks in school settings (2000-2010).

    PubMed

    Venuto, Margaret; Garcia, Kristin

    2015-03-01

    State-reported school foodborne outbreaks account for about 3.8% (n = 464) of all outbreaks and 8.2% (n = 20,667) of all illnesses reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. Of 464 school foodborne outbreaks, 122 (26%) outbreaks, 7,603 illnesses, and 301 reported food safety errors met the criteria for inclusion in the analyses. The purpose of the authors' study was to examine the role of contributing factors in school foodborne outbreaks. Contamination factors accounted for the greatest proportion (49.2%) of outbreaks involving some level of food handling interaction by a school food service worker, followed by proliferation (34.9%) and survival factors (15.9%). Over 56% of all illnesses were associated with norovirus and food service worker practices. The results of these analyses highlight the importance of effective food safety education programs that focus on the role of contributing factors and prevention of foodborne disease from food safety errors.

  8. "New" food-borne pathogens of public health significance.

    PubMed

    Ryser, E T; Marth, E H

    1989-07-01

    Recent work by epidemiologists and microbiologists has uncovered several hitherto unrecognized food-borne bacterial pathogens of public health significance. One of these, Listeria monocytogenes, has attracted considerable attention because of two major cheese-related outbreaks of listeriosis that were characterized by cases of meningitis, abortion, and perinatal septicemia. Thus far, L. monocytogenes has been responsible for well over 300 reported cases of food-borne listeriosis, including about 100 deaths, and has cost the dairy industry alone more than 66 million dollars as a result of product recalls. The ability of L. monocytogenes to grow at refrigeration temperatures, coupled with appearance of the pathogen in raw and processed meats, as well as poultry, vegetables, and seafood, makes this bacterium a serious threat to susceptible consumers and to the entire food industry. Yersinia enterocolitica, another psychrotrophic food-borne pathogen of recent concern, was linked to several outbreaks of yersiniosis associated with consumption of both raw and pasteurized milk, as well as contaminated water. Food-borne infections involving Y. enterocolitica typically result in enterocolitis, which may be mistaken for acute appendicitis. Unfortunately, inadvertent removal of healthy appendixes from victims of food-borne yersiniosis is all too common. Although known for many years, Campylobacter jejuni has only recently been recognized as a food-borne pathogen and a leading cause of gastroenteritis in the United States. Notable outbreaks of campylobacteriosis linked to consumption of raw milk, cake icing, eggs, poultry, and beef have underscored the need for thorough cooking and proper handling of raw products.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. 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

  10. Food-borne pathogens, health and role of dietary phytochemicals.

    PubMed

    Shetty, K; Labbe, R G

    1998-12-01

    Infectious diseases transmitted by food have become a major public health concern in recent years. In the USA alone, there are an estimated 6-33 million cases each year. The list of responsible agents continues to grow. In the past 20 years some dozen new pathogens that are primarily food-borne have been identified. Fruits and vegetables, often from the global food market, have been added to the traditional vehicles of food-borne illness; that is, undercooked meat, poultry, seafood, or unpasteurized milk. Such products are minimally processed and have fewer barriers to microbial growth such as salt, sugar or preservatives. The evolution of the epidemiology of food-borne illness requires a rethinking of traditional, though still valid, solutions for their prevention. Among various strategies to prevent food-borne pathogens, use of dietary phytochemicals is promising. The major obstacle in the use of dietary phytochemical is the consistency of phytochemicals in different foods due to their natural genetic variation. We have developed a novel tissue-culture-based selection strategy to isolate elite phenolic phytochemical-producing clonal lines of species belonging to the family Lamiaceae. Among several species we have targeted elite clonal lines of thyme (Thymus vulgaris) and oregano (Origanum vulgare) against Escherichia coli and Clostridium perfrigens in fresh and processed meats. We are also evaluating high phenolic profile-containing clonal lines of basil (Ocimum basilicum) to inhibit gastric ulcer-causing Helicobacter pylori. Other elite lines of the members of the family Lamiaceae, rosemary (Rosmarinus officinalis) and salvia (Salvia officinalis) also hold promise against a wide range of food pathogens such as Salmonella species in poultry products and Vibrio species in seafood.

  11. Risk-based Estimate of Effect of Foodborne Diseases on Public Health, Greece

    PubMed Central

    Reij, Martine W.; Havelaar, Arie H.; Zwietering, Marcel H.; Gorris, Leon G.M.

    2011-01-01

    The public health effects of illness caused by foodborne pathogens in Greece during 1996–2006 was quantified by using publicly available surveillance data, hospital statistics, and literature. Results were expressed as the incidence of different disease outcomes and as disability-adjusted life years (DALY), a health indicator combining illness and death estimates into a single metric. It has been estimated that each year ≈370,000 illnesses/million inhabitants are likely caused because of eating contaminated food; 900 of these illnesses are severe and 3 fatal, corresponding to 896 DALY/million inhabitants. Ill-defined intestinal infections accounted for the greatest part of reported cases and 27% of the DALY. Brucellosis, echinococcosis, salmonellosis, and toxoplasmosis were found to be the most common known causes of foodborne illnesses, being responsible for 70% of the DALY. Overall, the DALY metric provided a quantitative perspective on the impact of foodborne illness that may be useful for prioritizing food safety management targets. PMID:21888782

  12. The Effect of Severity of Illness on Spine Surgery Costs Across New York State Hospitals: An Analysis of 69,831 Cases.

    PubMed

    Kaye, I David; Adrados, Murillo; Karia, Raj J; Protopsaltis, Themistocles S; Bosco, Joseph A

    2017-09-18

    Observational database review. To determine the effect of patient severity of illness (SOI) on the cost of spine surgery among New York state hospitals. National health care spending has risen at an unsustainable rate with musculoskeletal care, and spine surgery in particular, accounting for a significant portion of this expenditure. In an effort towards cost-containment, health care payers are exploring novel payment models some of which reward cost savings but penalize excessive spending. To mitigate risk to health care institutions, accurate cost forecasting is essential. No studies have evaluated the effect of SOI on costs within spine surgery. The New York State Hospital Inpatient Cost Transparency Database was reviewed to determine the costs of 69,831 hospital discharges between 2009 and 2011 comprising the 3 most commonly performed spine surgeries in the state. These costs were then analyzed in the context of the specific all patient refined diagnosis-related group (DRG) SOI modifier to determine this index's effect on overall costs. Overall, hospital-reported cost increases with the patient's SOI class and patients with worse baseline health incur greater hospital costs (P<0.001). Moreover, these costs are increasingly variable for each worsening SOI class (P<0.001). This trend of increasing costs is persistent for all 3 DRGs across all 3 years studied (2009-2011), within each of the 7 New York state regions, and occurs irrespective of the hospital's teaching status or size. Using the 3M all patient refined-DRG SOI index as a measure of patient's health status, a significant increase in cost for spine surgery for patients with higher SOI index was found. This study confirms the greater cost and variability of spine surgery for sicker patients and illustrates the inherent unpredictability in cost forecasting and budgeting for these same patients.

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

    PubMed

    2016-06-24

    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.

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

    USDA-ARS?s Scientific Manuscript database

    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...

  15. Inactivation of foodborne pathogens in chicken purge or skin using a 405-nm LED array

    USDA-ARS?s Scientific Manuscript database

    Raw meat poultry are sometimes contaminated with foodborne pathogens, which can lead to illness in humans. In recent years research has focused on a variety of light technologies to decontaminate food and food contact surfaces during meat and poultry processing. In this study we evaluated the abilit...

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

    USDA-ARS?s Scientific Manuscript database

    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...

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

    USDA-ARS?s Scientific Manuscript database

    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...

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

    USDA-ARS?s Scientific Manuscript database

    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...

  19. 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.

  20. 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.

  1. 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

  2. Foodborne hazards of microbial origin.

    PubMed

    Foster, E M

    1978-10-01

    Foods can serve as vehicles of many pathogenic and toxigenic agents of disease. Bacterial agents comprise three groups: 1) those that grow in the food and produce an active toxin before consumption (e.g., clostridium botulinium); 2) those that merely exist as contaminants in the food but are able to initiate infection when swallowed (e.g., Salmonella spp.); and 3) those that multiply and produce large numbers of vegetative cells in the food, then release an active enterotoxin when they sporulate in the gut. A few parasitic (e.g., Trichinella spiralis) and viral agents (e.g., hepatitis A) also can be transmitted by food. Botulinum poisoning is the deadliest foodborne disease. The potential danger of botulism from cured meats is a major factor in the argument over use of nitrites as meat curing agents. A new disease called infant botulism has been recognized since 1976. Apparently it is not foodborne but results from intraintestinal growth of C. botulinum in very young infants. Salmonellosis is the most important of the foodborne diseases from the standpoint of overall human health. The primary vehicles are contaminated raw meat, poultry, and eggs. Faulty food handling practices are responsible for most food poisoning in the United States.

  3. The role, challenges, and support of pulsenet laboratories in detecting foodborne disease outbreaks.

    PubMed

    Boxrud, David; Monson, Timothy; Stiles, Tracy; Besser, John

    2010-01-01

    In recent years, there have been several high-profile nationwide foodborne outbreaks due to enteric organisms in food products, including Salmonella Typhimurium in peanut products, Salmonella Saintpaul in peppers, and Escherichia coli O157:H7 in spinach. PulseNet, the national molecular subtyping network for foodborne disease surveillance, played a key role in detecting each of these outbreaks. PulseNet laboratories use bacterial subtyping methods to rapidly detect clusters of foodborne disease, which are often the first indication that an outbreak is occurring. Rapid outbreak detection reduces ongoing transmission through product recalls, restaurant closures, and other mechanisms. By greatly increasing the sensitivity of outbreak detection, PulseNet allows us to identify and correct problems with our food production and distribution systems that would not otherwise have come to our attention. Annually, millions of potentially preventable cases of foodborne illness result in billions of dollars in lost productivity and health-care expenses. We describe the critical role PulseNet laboratories play in the detection of foodborne outbreaks and discuss current challenges and potential improvements for PulseNet laboratories to more rapidly identify future foodborne outbreaks.

  4. Epidemiology of restaurant-associated foodborne disease outbreaks, United States, 1998-2013.

    PubMed

    Angelo, K M; Nisler, A L; Hall, A J; Brown, L G; Gould, L H

    2017-02-01

    Although contamination of food can occur at any point from farm to table, restaurant food workers are a common source of foodborne illness. We describe the characteristics of restaurant-associated foodborne disease outbreaks and explore the role of food workers by analysing outbreaks associated with restaurants from 1998 to 2013 reported to the Centers for Disease Control and Prevention's Foodborne Disease Outbreak Surveillance System. We identified 9788 restaurant-associated outbreaks. The median annual number of outbreaks was 620 (interquartile range 618-629). In 3072 outbreaks with a single confirmed aetiology reported, norovirus caused the largest number of outbreaks (1425, 46%). Of outbreaks with a single food reported and a confirmed aetiology, fish (254 outbreaks, 34%) was most commonly implicated, and these outbreaks were commonly caused by scombroid toxin (219 outbreaks, 86% of fish outbreaks). Most outbreaks (79%) occurred at sit-down establishments. The most commonly reported contributing factors were those related to food handling and preparation practices in the restaurant (2955 outbreaks, 61%). Food workers contributed to 2415 (25%) outbreaks. Knowledge of the foods, aetiologies, and contributing factors that result in foodborne disease restaurant outbreaks can help guide efforts to prevent foodborne illness.

  5. Contributing factors in restaurant-associated foodborne disease outbreaks, FoodNet sites, 2006 and 2007.

    PubMed

    Gould, L Hannah; Rosenblum, Ida; Nicholas, David; Phan, Quyen; Jones, Timothy F

    2013-11-01

    An estimated 48 million cases of foodborne illness occur each year in the United States, resulting in approximately 128,000 hospitalizations and 3,000 deaths. Over half of all foodborne disease outbreaks reported to the Centers for Disease Control and Prevention are associated with eating in restaurants or delicatessens. We reviewed data from restaurant-associated foodborne disease outbreaks to better understand the factors that contribute to these outbreaks. Data on restaurant-associated foodborne disease outbreaks reported by sites participating in the Foodborne Diseases Active Surveillance Network (FoodNet) were analyzed to characterize contributing factors reported in foodborne disease outbreaks and the levels of evidence used to identify these factors. Of 457 foodborne disease outbreaks reported in 2006 and 2007 by FoodNet sites, 300 (66%) were restaurant associated, and of these 295 (98%) had at least one reported contributing factor. One to nine (with a median of two) contributing factors were reported per outbreak. Of the 257 outbreaks with a single etiology reported, contributing factors associated with food worker health and hygiene were reported for 165 outbreaks (64%), factors associated with food preparation practices within the establishment were reported for 88 outbreaks (34%), and factors associated with contamination introduced before reaching the restaurant were reported for 56 outbreaks (22%). The pronounced role of food workers in propagating outbreaks makes it clear that more work is needed to address prevention at the local level. Food workers should be instructed not to prepare food while ill to prevent the risk of transmitting pathogens.

  6. Emerging food-borne parasites.

    PubMed

    Dorny, P; Praet, N; Deckers, N; Gabriel, S

    2009-08-07

    Parasitic food-borne diseases are generally underrecognised, however they are becoming more common. Globalization of the food supply, increased international travel, increase of the population of highly susceptible persons, change in culinary habits, but also improved diagnostic tools and communication are some factors associated with the increased diagnosis of food-borne parasitic diseases worldwide. This paper reviews the most important emerging food-borne parasites, with emphasis on transmission routes. In a first part, waterborne parasites transmitted by contaminated food such as Cyclospora cayetanensis, Cryptosporidium and Giardia are discussed. Also human fasciolosis, of which the importance has only been recognised in the last decades, with total numbers of reported cases increasing from less than 3000 to 17 million, is looked at. Furthermore, fasciolopsiosis, an intestinal trematode of humans and pigs belongs to the waterborne parasites as well. A few parasites that may be transmitted through faecal contamination of foods and that have received renewed attention, such as Toxoplasma gondii, or that are (re-)emerging, such as Trypanosoma cruzi and Echinococcus spp., are briefly reviewed. In a second part, meat-borne parasite infections are reviewed. Humans get infected by eating raw or undercooked meat infected with cyst stages of these parasites. Meat inspection is the principal method applied in the control of Taenia spp. and Trichinella spp. However, it is often not very sensitive, frequently not practised, and not done for T. gondii and Sarcocystis spp. Meat of reptiles, amphibians and fish can be infected with a variety of parasites, including trematodes (Opisthorchis spp., Clonorchis sinensis, minute intestinal flukes), cestodes (Diphyllobothrium spp., Spirometra), nematodes (Gnathostoma, spp., anisakine parasites), and pentastomids that can cause zoonotic infections in humans when consumed raw or not properly cooked. Another important zoonotic food-borne

  7. 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

  8. 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

  9. 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.

  10. Parasitic food-borne and water-borne zoonoses.

    PubMed

    Macpherson, C N; Gottstein, B; Geerts, S

    2000-04-01

    Estimates suggest that almost half of the population of the world is affected by water-borne and food-borne infections. Parasitic food-borne and water-borne zoonoses contribute to this statistic by inflicting a heavy toll on human health and causing serious direct and indirect losses to the agricultural industry. The inability of non-industrialised countries to keep pace with population growth, migration from rural to urban areas and the demand for clean, safe drinking water and proper sanitation means that water-borne zoonoses will continue to exact an increasing burden of ill health in these countries. The consumption of raw or undercooked meat, crustaceans, and fresh-water fish and vegetables facilitates transmission of large numbers of zoonotic infections. The burgeoning tourist industry, emigration and the importation of food from endemic regions has resulted in increasing diagnosis of these infections in non-endemic countries. The authors examine the epidemiology, medical and veterinary public health importance and recent developments in diagnosis, treatment and control of the most important parasitic food-borne and water-borne infections.

  11. Low-water activity foods: increased concern as vehicles of foodborne pathogens.

    PubMed

    Beuchat, Larry R; Komitopoulou, Evangelia; Beckers, Harry; Betts, Roy P; Bourdichon, François; Fanning, Séamus; Joosten, Han M; Ter Kuile, Benno H

    2013-01-01

    Foods and food ingredients with low water activity (a(w)) have been implicated with increased frequency in recent years as vehicles for pathogens that have caused outbreaks of illnesses. Some of these foodborne pathogens can survive for several months, even years, in low-a(w) foods and in dry food processing and preparation environments. Foodborne pathogens in low-a(w) foods often exhibit an increased tolerance to heat and other treatments that are lethal to cells in high-a(w) environments. It is virtually impossible to eliminate these pathogens in many dry foods or dry food ingredients without impairing organoleptic quality. Control measures should therefore focus on preventing contamination, which is often a much greater challenge than designing efficient control measures for high-a(w) foods. The most efficient approaches to prevent contamination are based on hygienic design, zoning, and implementation of efficient cleaning and sanitation procedures in the food processing environment. Methodologies to improve the sensitivity and speed of assays to resuscitate desiccated cells of foodborne pathogens and to detect them when present in dry foods in very low numbers should be developed. The goal should be to advance our knowledge of the behavior of foodborne pathogens in low-a(w) foods and food ingredients, with the ultimate aim of developing and implementing interventions that will reduce foodborne illness associated with this food category. Presented here are some observations on survival and persistence of foodborne pathogens in low-a(w) foods, selected outbreaks of illnesses associated with consumption of these foods, and approaches to minimize safety risks.

  12. Does ambient temperature affect foodborne disease?

    PubMed

    D'Souza, Rennie M; Becker, Niels G; Hall, Gillian; Moodie, Keith B A

    2004-01-01

    Foodborne illness is a significant public health issue in most countries, including Australia. We examined the association between temperature and salmonellosis notifications, and compared these associations for 5 Australian cities. Log-linear models describing monthly salmonellosis notifications in terms of calendar time and monthly average temperatures were fitted over the period 1991 to 2001 for each city. We used a negative binomial chance model to accommodate overdispersion in the counts. The long-term trend showed an increase in salmonellosis notifications in each of the 5 cities. There was a positive association between monthly salmonellosis notifications and mean monthly temperature of the previous month in every city. Seasonal patterns in salmonellosis notifications were fully explained by changes in temperature. The strength of the association, the consistency across 5 cities, and a plausible biologic pathway suggest that higher ambient temperatures are a cause of higher salmonellosis notifications. The lag of 1 month suggests that temperature might be more influential earlier in the production process rather than at the food preparation stage. This knowledge can help to guide policy on food preparation and distribution. It also suggests a basis for an early warning system for increased risk from salmonellosis, and raises yet another possible health problem with global warming.

  13. The economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach.

    PubMed

    de Lagasnerie, Grégoire; Aguadé, Anne-Sophie; Denis, Pierre; Fagot-Campagna, Anne; Gastaldi-Menager, Christelle

    2017-02-11

    A better understanding of the economic burden of diabetes constitutes a major public health challenge in order to design new ways to curb diabetes health care expenditure. The aim of this study was to develop a new cost-of-illness method in order to assess the specific and nonspecific costs of diabetes from a public payer perspective. Using medical and administrative data from the major French national health insurance system covering about 59 million individuals in 2012, we identified people with diabetes and then estimated the economic burden of diabetes. Various methods were used: (a) global cost of patients with diabetes, (b) cost of treatment directly related to diabetes (i.e., 'medicalized approach'), (c) incremental regression-based approach, (d) incremental matched-control approach, and (e) a novel combination of the 'medicalized approach' and the 'incremental matched-control' approach. We identified 3 million individuals with diabetes (5% of the population). The total expenditure of this population amounted to €19 billion, representing 15% of total expenditure reimbursed to the entire population. Of the total expenditure, €10 billion (52%) was considered to be attributable to diabetes care: €2.3 billion (23% of €10 billion) was directly attributable, and €7.7 billion was attributable to additional reimbursed expenditure indirectly related to diabetes (77%). Inpatient care represented the major part of the expenditure attributable to diabetes care (22%) together with drugs (20%) and medical auxiliaries (15%). Antidiabetic drugs represented an expenditure of about €1.1 billion, accounting for 49% of all diabetes-specific expenditure. This study shows the economic impact of the assumption concerning definition of costs on evaluation of the economic burden of diabetes. The proposed new cost-of-illness method provides specific insight for policy-makers to enhance diabetes management and assess the opportunity costs of diabetes complications

  14. Molecular Epidemiology of Foodborne Pathogens

    NASA Astrophysics Data System (ADS)

    Chen, Yi; Brown, Eric; Knabel, Stephen J.

    The purpose of this chapter is to describe the basic principles and advancements in the molecular epidemiology of foodborne pathogens. Epidemiology is the study of the distribution and determinants of infectious diseases and/or the dynamics of disease transmission. The goals of epidemiology include the identification of physical sources, routes of transmission of infectious agents, and distribution and relationships of different subgroups. Molecular epidemiology is the study of epidemiology at the molecular level. It has been defined as "a science that focuses on the contribution of potential genetic and environmental risk factors, identified at the molecular level, to the etiology, distribution and prevention of diseases within families and across populations".

  15. Public Health Care for the Chronically Mentally Ill: Financing Operating Costs Issues and Options for Local Leadership.

    ERIC Educational Resources Information Center

    Dickey, Barbara; Goldman, Howard H.

    1986-01-01

    Describes different types of mental health care reimbursement for the chronically mentally ill, noting that every method of reimbursement carries different response incentives and disincentives for providers and patients. Frames an analysis of long-term care financing models that may have heuristic value for systems of public care for this…

  16. 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

  17. Cost effectiveness of enoxaparin as prophylaxis against venous thromboembolic complications in acutely ill medical inpatients: modelling study from the hospital perspective in Germany.

    PubMed

    Schädlich, Peter K; Kentsch, Michael; Weber, Manfred; Kämmerer, Wolfgang; Brecht, Josef Georg; Nadipelli, Vijay; Huppertz, Eduard

    2006-01-01

    To estimate, from the hospital perspective in Germany, the cost effectiveness of the low-molecular-weight heparin (LMWH) subcutaneous enoxaparin sodium 40 mg once daily (ENOX) relative to no pharmacological prophylaxis (NPP) and relative to subcutaneous unfractionated heparin (UFH) 5,000 IU three times daily (low-dose UFH [LDUFH]). Each is used in addition to elastic bandages/compression stockings and physiotherapy in the prevention of venous thromboembolic events (VTE) in immobilised acutely ill medical inpatients without impaired renal function or extremes of body weight. The incremental cost-effectiveness ratios (ICERs) of the 'additional cost for ENOX per clinical VTE avoided versus NPP' and 'additional cost for ENOX per episode of major bleeding avoided versus LDUFH' were chosen as target variables. The target variables were quantified using a modelling approach based on the decision-tree technique. Resource use during thromboprophylaxis, diagnosis and treatment of VTEs, episode of major bleeding and secondary pneumonia after pulmonary embolism (PE) was collected from a hospital survey. Costs were exclusively those to hospitals incurred by staff expenses, drugs, devices, disposables, laboratory tests and equipment for diagnostic procedures. These costs were determined by multiplying utilised resource items by the price or tariff of each item as of the first quarter of 2003. Safety and efficacy values of the comparators were taken from the MEDENOX (prophylaxis in MEDical patients with ENOXaparin) and the THE-PRINCE (THromboEmbolism-PRevention IN Cardiac or respiratory disease with Enoxaparin) trials and from a meta-analysis. The evaluation encompassed 8 (6-14) days of thromboprophylaxis plus time to treat VTE and episode of major bleeding in hospital. Point estimates of all model parameters were applied exclusively in the base-case analysis. There were incremental costs of euro 1,106 for ENOX per clinical VTE avoided versus NPP (1 euro approximately equals 1

  18. Foodborne microbial risks in the press: the framing of listeriosis in Canadian newspapers.

    PubMed

    Gauthier, Elisabeth

    2011-03-01

    Outbreaks of foodborne illness generally receive abundant print media coverage. However, the framing of outbreaks and representations of foodborne pathogens in the media discourse are not necessarily homogeneous. Drawing on previous research on media coverage of emerging diseases and on the conceptual tools of framing theory, this paper explores the diversity of frames and representations used in the media coverage of two listeriosis outbreaks that occurred in Canada in fall 2008. In the dominant war against microbes frame, microbes are portrayed as posing serious risks that call for stringent control measures. This frame coexists with other frames which rather emphasize economic, ecosystem or nutrition issues and which are supported by representations of microbial risks that either mitigate these risks, present them as inevitable or as less serious than others. The implications of these observations for the public understanding of foodborne microbial risks are discussed.

  19. Foodborne viruses: an emerging problem.

    PubMed

    Koopmans, Marion; Duizer, Erwin

    2004-01-01

    Several groups of viruses may infect persons after ingestion and then are shed via stool. Of these, the norovirus (NoV) and hepatitis A virus (HAV) are currently recognised as the most important human foodborne pathogens with regard to the number of outbreaks and people affected in the Western world. NoV and HAV are highly infectious and may lead to widespread outbreaks. The clinical manifestation of NoV infection, however, is relatively mild. Asymptomatic infections are common and may contribute to the spread of the infection. Introduction of NoV in a community or population (a seeding event) may be followed by additional spread because of the highly infectious nature of NoV, resulting in a great number of secondary infections (50% of contacts). Hepatitis A is an increasing problem because of the decrease in immunity of populations in countries with high standards of hygiene. Molecular-based methods can detect viruses in shellfish but are not yet available for other foods. The applicability of the methods currently available for monitoring foods for viral contamination is unknown. No consistent correlation has been found between the presence of indicator microorganisms (i.e. bacteriophages, E. coli) and viruses. NoV and HAV are highly infectious and exhibit variable levels of resistance to heat and disinfection agents. However, they are both inactivated at 100 degrees C. No validated model virus or model system is available for studies of inactivation of NoV, although investigations could make use of structurally similar viruses (i.e. canine and feline caliciviruses). In the absence of a model virus or model system, food safety guidelines need to be based on studies that have been performed with the most resistant enteric RNA viruses (i.e. HAV, for which a model system does exist) and also with bacteriophages (for water). Most documented foodborne viral outbreaks can be traced to food that has been manually handled by an infected foodhandler, rather than to

  20. Systematic Review of the Costs and Benefits of Prescribed Cannabis-Based Medicines for the Management of Chronic Illness: Lessons from Multiple Sclerosis.

    PubMed

    Herzog, Samuel; Shanahan, Marian; Grimison, Peter; Tran, Anh; Wong, Nicole; Lintzeris, Nicholas; Simes, John; Stockler, Martin; Morton, Rachael L

    2017-09-02

    Cannabis-based medicines (CBMs) may offer relief from symptoms of disease; however, their additional cost needs to be considered alongside their effectiveness. We sought to review the economic costs and benefits of prescribed CBMs in any chronic illness, and the frameworks used for their economic evaluation. A systematic review of eight medical and economic databases, from inception to mid-December 2016, was undertaken. MeSH headings and text words relating to economic costs and benefits, and CBMs were combined. Study quality was assessed using relevant checklists and results were synthesised in narrative form. Of 2514 identified records, ten studies met the eligibility criteria, all for the management of multiple sclerosis (MS). Six contained economic evaluations, four studies reported utility-based quality of life, and one was a willingness-to-pay study. Four of five industry-sponsored cost-utility analyses for MS spasticity reported nabiximols as being cost-effective from a European health system perspective. Incremental cost-effectiveness ratios per quality-adjusted life-year (QALY) gained for these five studies were £49,257 (UK); £10,891 (Wales); €11,214 (Germany); €4968 (Italy); and dominant (Spain). Nabiximols for the management of MS spasticity was not associated with statistically significant improvements in EQ-5D scores compared with standard care. Study quality was moderate overall, with limited inclusion of both relevant societal costs and discussions of potential bias. Prescribed CBMs are a potentially cost-effective add-on treatment for MS spasticity; however, this evidence is uncertain. Further investment in randomised trials with in-built economic evaluations is warranted for a wider range of clinical indications. PROSPERO Registration Number: CRD42014006370.

  1. 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.

  2. Management patterns and health care use after intracerebral hemorrhage. a cost-of-illness study from a societal perspective in Germany.

    PubMed

    Weimar, Christian; Weber, Carsten; Wagner, Markus; Busse, Otto; Haberl, Roman Ludwig; Lauterbach, Karl W; Diener, Hans Christoph

    2003-01-01

    The German cost-of-illness study of stroke is a multicenter study in 6 departments of internal medicine, 9 departments of general neurology and 15 departments of neurology with an acute stroke unit. The aims of this study are to describe the management patterns, cost of treatment and overall resource utilization after intracerebral hemorrhage (ICH) as well as the major differences to ischemic stroke (IS). During a 12-month period, 30 participating centers with a special interest in stroke prospectively included 586 patients with ICH which were collected in a joint data bank. About 75% of all patients could be centrally followed up via structured telephone interviews after 3 and 12 months to assess further acute hospital and rehabilitation stays, outpatient resource utilization, functional outcome and quality of life. Mortality after 3 months (33.5%) was markedly higher than in patients with IS from the same hospitals. Accordingly, only 30.9% of patients had regained independent functional status after 3 months. Cumulative cost of treatment amounted to 5301 EUR for inpatient stay in the documenting hospital and 8920 EUR for the overall hospital stay including rehabilitation. Mean direct cost after discharge during the first year amounted to 4598 EUR and the loss of work force was equivalent to 5537 EUR in all surviving patients. This study provides a comprehensive overview of patient characteristics, treatment strategies and health care cost of ICH from a societal perspective in Germany. Copyright 2003 S. Karger AG, Basel

  3. Cost-of-illness analysis of patients with chronic hand eczema in routine care in Germany: focus on the impact of occupational disease.

    PubMed

    Diepgen, Thomas L; Purwins, Sandra; Posthumus, Jan; Kuessner, Daniel; John, Swen M; Augustin, Matthias

    2013-09-04

    Chronic hand eczema places a heavy burden on patients, often affecting their ability to work. This paper compares the cost-of-illness and treatment approaches for patients with refractory chronic hand eczema, in relation to whether the disease was occupational or unrelated to work factors. Data from 2 surveys, comprising 310 patients with chronic hand eczema insured by German statutory health insurance (SHI) (including work-impaired patients, work-unaffected patients and non-working patients) and known work-related chronic hand eczema insured by occupational health insurance (OHI). Annual healthcare costs of managing work-impaired patients (SHI) and patients with work-related chronic hand eczema (OHI) were €3,164 and €3,309, respectively, approximately double the costs of managing non-working and work-unaffected (SHI) patients. This analysis shows that the costs associated with chronic hand eczema are affected by the correlation of chronic hand eczema with work, with costs being higher for occupational patients with chronic hand eczema.

  4. Cost-Effectiveness of a Collaborative Care Depression and Anxiety Treatment Program in Patients with Acute Cardiac Illness.

    PubMed

    Celano, Christopher M; Healy, Brian; Suarez, Laura; Levy, Douglas E; Mastromauro, Carol; Januzzi, James L; Huffman, Jeff C

    2016-01-01

    To use data from a randomized trial to determine the cost-effectiveness of a collaborative care (CC) depression and anxiety treatment program and to assess effects of the CC program on health care utilization. The CC intervention's impact on health-related quality of life, depression-free days (DFDs), and anxiety-free days (AFDs) over the 24-week postdischarge period was calculated and compared with the enhanced usual care (EUC) condition using independent samples t tests and random-effects regression models. Costs for both the CC and EUC conditions were calculated on the basis of staff time, overhead expenses, and treatment materials. Using this information, incremental cost-effectiveness ratios were calculated. A cost-effectiveness acceptability plot was created using nonparametric bootstrapping with 10,000 replications, and the likelihood of the CC intervention's cost-effectiveness was assessed using standard cutoffs. As a secondary analysis, we determined whether the CC intervention led to reductions in postdischarge health care utilization and costs. The CC intervention was more costly than the EUC intervention ($209.86 vs. $34.59; z = -11.71; P < 0.001), but was associated with significantly greater increases in quality-adjusted life-years (t = -2.49; P = 0.01) and DFDs (t = -2.13; P = 0.03), but not AFDs (t = -1.92; P = 0.057). This translated into an incremental cost-effectiveness ratio of $3337.06 per quality-adjusted life-year saved, $13.36 per DFD, and $13.74 per AFD. Compared with the EUC intervention, the CC intervention was also associated with fewer emergency department visits but no differences in overall costs. This CC intervention was associated with clinically relevant improvements, was cost-effective, and was associated with fewer emergency department visits in the 24 weeks after discharge. Copyright © 2016. Published by Elsevier Inc.

  5. 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".

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

    USDA-ARS?s Scientific Manuscript database

    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...

  7. Visual Analytics of Surveillance Data on Foodborne Vibriosis, United States, 1973–2010

    PubMed Central

    Sims, Jennifer N.; Isokpehi, Raphael D.; Cooper, Gabrielle A.; Bass, Michael P.; Brown, Shyretha D.; St John, Alison L.; Gulig, Paul A.; Cohly, Hari H.P.

    2011-01-01

    Foodborne illnesses caused by microbial and chemical contaminants in food are a substantial health burden worldwide. In 2007, human vibriosis (non-cholera Vibrio infections) became a notifiable disease in the United States. In addition, Vibrio species are among the 31 major known pathogens transmitted through food in the United States. Diverse surveillance systems for foodborne pathogens also track outbreaks, illnesses, hospitalization and deaths due to non-cholera vibrios. Considering the recognition of vibriosis as a notifiable disease in the United States and the availability of diverse surveillance systems, there is a need for the development of easily deployed visualization and analysis approaches that can combine diverse data sources in an interactive manner. Current efforts to address this need are still limited. Visual analytics is an iterative process conducted via visual interfaces that involves collecting information, data preprocessing, knowledge representation, interaction, and decision making. We have utilized public domain outbreak and surveillance data sources covering 1973 to 2010, as well as visual analytics software to demonstrate integrated and interactive visualizations of data on foodborne outbreaks and surveillance of Vibrio species. Through the data visualization, we were able to identify unique patterns and/or novel relationships within and across datasets regarding (i) causative agent; (ii) foodborne outbreaks and illness per state; (iii) location of infection; (iv) vehicle (food) of infection; (v) anatomical site of isolation of Vibrio species; (vi) patients and complications of vibriosis; (vii) incidence of laboratory-confirmed vibriosis and V. parahaemolyticus outbreaks. The additional use of emerging visual analytics approaches for interaction with data on vibriosis, including non-foodborne related disease, can guide disease control and prevention as well as ongoing outbreak investigations. PMID:22174586

  8. Visual analytics of surveillance data on foodborne vibriosis, United States, 1973-2010.

    PubMed

    Sims, Jennifer N; Isokpehi, Raphael D; Cooper, Gabrielle A; Bass, Michael P; Brown, Shyretha D; St John, Alison L; Gulig, Paul A; Cohly, Hari H P

    2011-01-01

    Foodborne illnesses caused by microbial and chemical contaminants in food are a substantial health burden worldwide. In 2007, human vibriosis (non-cholera Vibrio infections) became a notifiable disease in the United States. In addition, Vibrio species are among the 31 major known pathogens transmitted through food in the United States. Diverse surveillance systems for foodborne pathogens also track outbreaks, illnesses, hospitalization and deaths due to non-cholera vibrios. Considering the recognition of vibriosis as a notifiable disease in the United States and the availability of diverse surveillance systems, there is a need for the development of easily deployed visualization and analysis approaches that can combine diverse data sources in an interactive manner. Current efforts to address this need are still limited. Visual analytics is an iterative process conducted via visual interfaces that involves collecting information, data preprocessing, knowledge representation, interaction, and decision making. We have utilized public domain outbreak and surveillance data sources covering 1973 to 2010, as well as visual analytics software to demonstrate integrated and interactive visualizations of data on foodborne outbreaks and surveillance of Vibrio species. Through the data visualization, we were able to identify unique patterns and/or novel relationships within and across datasets regarding (i) causative agent; (ii) foodborne outbreaks and illness per state; (iii) location of infection; (iv) vehicle (food) of infection; (v) anatomical site of isolation of Vibrio species; (vi) patients and complications of vibriosis; (vii) incidence of laboratory-confirmed vibriosis and V. parahaemolyticus outbreaks. The additional use of emerging visual analytics approaches for interaction with data on vibriosis, including non-foodborne related disease, can guide disease control and prevention as well as ongoing outbreak investigations.

  9. Cost-effectiveness of preventive case management for parents with a mental illness: a randomized controlled trial from three economic perspectives.

    PubMed

    Wansink, Henny J; Drost, Ruben M W A; Paulus, Aggie T G; Ruwaard, Dirk; Hosman, Clemens M H; Janssens, Jan M A M; Evers, Silvia M A A

    2016-07-07

    The children of parents with a mental illness (COPMI) are at increased risk for developing costly psychiatric disorders because of multiple risk factors which threaten parenting quality and thereby child development. Preventive basic care management (PBCM) is an intervention aimed at reducing risk factors and addressing the needs of COPMI-families in different domains. The intervention may lead to financial consequences in the healthcare sector and in other sectors, also known as inter-sectoral costs and benefits (ICBs). The objective of this study was to assess the cost-effectiveness of PBCM from three perspectives: a narrow healthcare perspective, a social care perspective (including childcare costs) and a broad societal perspective (including all ICBs). Effects on parenting quality (as measured by the HOME) and costs during an 18-month period were studied in in a randomized controlled trial. Families received PBCM (n = 49) or care as usual (CAU) (n = 50). For all three perspectives, incremental cost-effectiveness ratios (ICERs) were calculated. Stochastic uncertainty in the data was dealt with using non-parametric bootstraps. Sensitivity analyses included calculating ICERs excluding cost outliers, and making an adjustment for baseline cost differences. Parenting quality improved in the PBCM group and declined in the CAU group, and PBCM was shown to be more costly than CAU. ICERs differ from 461 Euros (healthcare perspective) to 215 Euros (social care perspective) to 175 Euros (societal perspective) per one point improvement on the HOME T-score. The results of the sensitivity analyses, based on complete cases and excluding cost outliers, support the finding that the ICER is lower when adopting a broader perspective. The subgroup analysis and the analysis with baseline adjustments resulted in higher ICERs. This study is the first economic evaluation of family-focused preventive basic care management for COPMI in psychiatric and family services. The effects

  10. 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.

  11. 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

  12. Drug utilization pattern and cost for the treatment of severe sepsis and septic shock in critically ill cancer patients.

    PubMed

    Nazer, Lama; Al-Shaer, Mohammad; Hawari, Feras

    2013-12-01

    Cancer patients are at high risk for developing sepsis. To our knowledge, there are no studies that evaluated the type of medications utilized and the associated cost in cancer patients with severe sepsis and septic shock. To describe the drug utilization pattern and drug cost in the treatment of cancer patients with severe sepsis and septic shock. 12-bed medical/surgical intensive care unit (ICU) of a comprehensive teaching cancer center. A retrospective cohort study of cancer patients with severe sepsis or septic shock who were treated in the ICU between January and December, 2010. The ICU sepsis database was used to identify patients. The patient demographics and characteristics were recorded. In addition, the number and type of prescribed medications, total cost for each medication, type of infection, and culture results were determined. The main outcomes were the type of medication classes utilized and the cost of the medications. During the study period, 116 cases were identified. Upon presentation, the mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 21.8 (SD ± 7.8), 30 (25.9 %) patients had neutropenia, and 94 (81 %) had positive cultures. The total cost of the medications prescribed for this cohort of patients was 291,030 Euro. The mean number of medications prescribed per patient and the mean total cost per patient were 11.7 (SD ± 4.7) and 2,509 Euro (SD ± 2,844), respectively. The most commonly prescribed medication classes were acid suppressive therapy, glycopeptides, penicillins/cephalosporins and vasopressors prescribed in 113 (97 %), 104 (89.7 %), 103 (88.9 %), and 102 (88 %) patients, respectively. The highest medication costs were associated with antifungals (mean 1,288 Euro/patient) and colony stimulating factors (mean 829 Euro/patient), prescribed in 55 (47.4 %) and 37 (31.9 %) patients, respectively. Medication costs were higher in non-survivors, compared to survivors (3,664 Euro vs. 1,430 Euro, p = 0.0001), and in

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

    USDA-ARS?s Scientific Manuscript database

    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...

  14. 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

  15. 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

  16. Costing Question Handling and ILL/Photocopying. A Study of Two State Contract Libraries in New Jersey. Volume II: Annexes.

    ERIC Educational Resources Information Center

    Robinson, Barbara M.

    This report contains annex materials from a study conducted for the New Jersey State Library (NJSL) with two major objectives: (1) to determine how much it costs two state contract libraries--the Central Library of the Newark Public Library and the Bureau of Law and Reference of the New Jersey State Library--to provide supplemental question…

  17. Variability among states in investigating foodborne disease outbreaks.

    PubMed

    Jones, Timothy F; Rosenberg, Lauren; Kubota, Kristy; Ingram, L Amanda

    2013-01-01

    Over 1,100 foodborne disease outbreaks cause over 23,000 illnesses in the United States annually, but the rates of outbreaks reported and successful investigation vary dramatically among states. We used data from the Centers for Disease Control and Prevention's outbreak reporting database, Association of Public Health Laboratories' PulseNet laboratory subtyping network survey and Salmonella laboratory survey, national public health surveillance data, and national surveys to examine potential causes of this variability. The mean rate of reporting of Salmonella outbreaks was higher in states requiring submission of all isolates to the state public health laboratory, compared to those that do not (5.9 vs. 4.1 per 10 million population, p=0.0062). Rates of overall outbreak reporting or successful identification of an etiology or food vehicle did not correlate at the state level with population, rates of sporadic disease reporting, health department organizational structure, or self-reported laboratory or epidemiologic capacity. Foodborne disease outbreak surveillance systems are complex, and improving them will require a multi-faceted approach to identifying and overcoming barriers.

  18. Genomics-based food-borne pathogen testing and diagnostics: possibilities for the U.S. Department of Agriculture's Food Safety and Inspection Service.

    PubMed

    Withee, James; Dearfield, Kerry L

    2007-06-01

    The use of genomic technologies at the U.S. Department of Agriculture could enhance inspection, monitoring, and risk assessment capabilities within its Food Safety and Inspection Service (FSIS). Molecular assays capable of detecting hundreds of microbial DNA sequences within a single food sample that identify food-borne pathogens of concern and characterize their traits most relevant to human health risk are of great interest for FSIS. For example, a high-density assay, or combination of assays, could screen FSIS inspected food for pathogens relevant to public health (e.g., Salmonella, Listeria, and toxic E. coli) as well as their associated virulence factors and antibiotic resistance genes. Because most genotype assays can be completed in one working day with a minimum of reagents, use of such assays could potentially save FSIS a significant amount of cost/time for analyses. Further, a genotype assay can detect specific microbial traits relevant to human health risk based on the DNA sequence of toxin producing genes, antibiotic resistance alleles, and more. By combining rapid analysis with specific data on human health risks, information from such high-density genotype assays could provide expanded support for test and hold situations, recalls, outbreak management, and microbial risk assessments (e.g., provide data needed for food-borne illness source attribution). Environ. Mol. Mutagen.

  19. Clinical outcomes and cost effectiveness of two aftercare models provided by general physicians and nurses to patients with severe mental illness

    PubMed Central

    Malakouti, Seyed Kazem; Mirabzadeh, Arash; Nojomi, Marzieh; Ahmadi Tonkaboni, Ali; Nadarkhani, Faranak; Mirzaie, Mosleh; Chimeh, Narges

    2015-01-01

    Background: Implementing community-based psychiatric services is one of the priorities of the WHO/EMRO mental health programs. This study presents an aftercare service, as a community based-service, for patients with severe mental illness (SMIs). Methods: In this randomized controlled clinical trial design, 176 patients, who attended selective hospitals with SMI, were allocated into three groups: clinical case managers provided by general practitioners, nurses and the control group (usual treatment). The clients and their caregivers received monthly home visits (education and treatment supervision). The effectiveness of the intervention was measured by indicators of psychopathology such as scores of YOUNG, caregivers’ knowledge and satisfaction with the services. Health-related quality of life (SF-36) was considered as the primary outcome variable. Data were collected at baseline and at 12 months follow-up. Direct and indirect medical costs were obtained through a periodic completion of questionnaires and interviews by caregivers. Cost effectiveness ratio was estimated as cost per QALY gained in each group. SPSS 16.0 was used in this survey and statistical methods were chi-square, ANOVA, Scheffe as post-Hoc test and paired sample t-test with 95% confidence interval and 0.05 significance level. Results: The results of our study revealed that the score of YOUNG, caregivers’ knowledge and satisfaction with service were improved in both intervention groups after 12 months. Improvement in health-related quality of life was observed in the general practitioner and nurse group. The incremental cost effectiveness ratio was 5740807 IRR and 5048459 IRR per QALYs gained in the general practitioner and nurse groups, respectively. Conclusion: The model of aftercare services provided by trained nurses is the most cost- effective and feasible model for Iran’s socio-economic conditions with low resource allocations. PMID:26157714

  20. Cost-Effectiveness Analysis of the Use of a Prophylactic Antibiotic for Patients Undergoing Lower Limb Amputation due to Diabetes or Vascular Illness in Colombia.

    PubMed

    Ceballos, Mateo; Orozco, Luis Esteban; Valderrama, Carlos Oliver; Londoño, Diana Isabel; Lugo, Luz Helena

    2017-04-01

    The use of a prophylactic antibiotic in an amputation surgery is a key element for the successful recovery of the patient. We aim to determine, from the perspective of the Colombian health system, the cost-effectiveness of administering a prophylactic antibiotic among patients undergoing lower limb amputation due to diabetes or vascular illness in Colombia. A decision tree was constructed to compare the use and nonuse of a prophylactic antibiotic. The probabilities of transition were obtained from studies identified from a systematic review of the clinical literature. The chosen health outcome was reduction in mortality due to prevention of infection. The costs were measured by expert consensus using the standard case methodology, and the resource valuation was carried out using national-level pricing manuals. Deterministic sensitivity, scenarios, and probabilistic analyses were conducted. In the base case, the use of a prophylactic antibiotic compared with nonuse was a dominant strategy. This result was consistent when considering different types of medications and when modifying most of the variables in the model. The use of a prophylactic antibiotic ceases to be dominant when the probability of infection is greater than 48%. The administration of a prophylactic antibiotic was a dominant strategy, which is a conclusion that holds in most cases examined; therefore, it is unlikely that the uncertainty around the estimation of costs and benefits change the results. We recommend creating policies oriented toward promoting the use of a prophylactic antibiotic during amputation surgery in Colombia. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Direct healthcare costs for patients hospitalized with Crimean-Congo haemorrhagic fever can be predicted by a clinical illness severity scoring system

    PubMed Central

    Bozkurt, Ilkay; Sunbul, Mustafa; Yilmaz, Hava; Esen, Saban; Beeching, Nicholas J.

    2016-01-01

    Crimean–Congo hemorrhagic fever (CCHF) is endemic in Turkey, with peak incidence of hospital admissions in the summer months. The aim of this pilot study was to evaluate the role of the severity grading score (SGS) in predicting length of hospital stay, laboratory usage, need for blood products, and hence total costs of patients. Thirty-five patients admitted to one specialist center in Turkey in 2013 and 2014 with PCR-proven CCHF. The mean (SD) age was 55 (±14) and 63% of the patients were male, with 8 (22.9%) mortality. Patients were classified by SGS into three groups with mortality as follows: low risk (0/19); intermediate (6/14); and high (2/2). The direct hospital cost of these admissions was at least $41 740 with median (range) of $1210 ($97–$13 054) per patient. There was a significant difference between low-risk and combined (intermediate–high) risk groups as 635 (97–1500) and 2264.5 (154–13 054), respectively (p = 0.012). In conclusion, a clinical grading score can be used to predict illness severity and to predict associated health care costs. PMID:27077310

  2. Illness-associated productivity costs among women with employer-sponsored insurance and newly diagnosed breast cancer.

    PubMed

    Meadows, Eric S; Johnston, Stephen S; Cao, Zhun; Foley, Kathleen A; Pohl, Gerhardt M; Johnston, Joseph A; Ramsey, Scott D

    2010-04-01

    Determine lost work time and job attrition for incident breast cancer (BC). The cases were employed women, aged 18 to 64, with BC identified by a validated algorithm between 1999 and 2005, from claims (MarketScan) and attendance databases. Controls without cancer were matched 3:1 on age, comorbidity, and index year. First-year mean disability days were 60 (cases, N = 880) versus 5 (controls, N = 2640) (P < 0.001). The first-year disability costs were $4900 for cases versus $385 for controls (P < 0.001). In years 2 through 4, the disability days and associated costs were similar for the cases versus controls. After 4 years, 56.4% of cases were still enrolled in the employer-sponsored insurance programs compared to 6.5% of controls (P < 0.001). The lost work associated with BC is substantial in the first year after diagnosis. Employee retention is much higher for BC cases versus controls.

  3. Mental Illness

    MedlinePlus

    ... questionnaire to help answer these questions. Determining which mental illness you have Sometimes it's difficult to find out ... insurance companies to reimburse for treatment. Classes of mental illness The main classes of mental illness are: Neurodevelopmental ...

  4. A cross-national perspective on cost of illness: a comparison of studies from The Netherlands, Australia, Canada, Germany, United Kingdom, and Sweden.

    PubMed

    Polder, Johan J; Meerding, Willem Jan; Bonneux, Luc; van der Maas, Paul J

    2005-09-01

    All Western health systems are in search of efficiency. Cost of illness (COI) studies can contribute to the efficiency debate by elucidating the relation between health expenditure and health status and population demography. Since the purpose of COI data being summarized in the OECD Health Data publications is to facilitate cross-national comparisons, it is important to assess the comparability. We compared COI data from six countries at macrolevel of total health expenditure and disaggregated the data from four countries to sectors such as hospitals, drugs, health professionals, and residential care. Although the distribution of health expenditure over major diseases showed similar patterns in all countries, overall comparability was bad. We conclude that the current scope of COI studies is bound to national levels because health care systems dominate the magnitude and distribution of health expenditure. Cross-national comparisons may be possible if data and methods are standardized, and COI estimates are made for a common comparable package.

  5. 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

  6. Consumer Response to Gastrointestinal Illness Perceived To Originate from Food Service Facilities.

    PubMed

    Garnett, Erin S; Gretsch, Stephanie R; Null, Clair; Moe, Christine L

    2016-10-01

    Consumer responses to food product recalls have been documented, but there is little information on how consumers respond to illnesses or outbreaks associated with food service facilities. This study uses an on-line survey of 885 adults conducted in 2012 to determine how respondents changed their dining behavior following personal experiences with and secondhand reports of gastrointestinal illness believed to be associated with food service facilities. In response to personally experiencing gastrointestinal illness that they attributed to a food service facility, 90% of survey participants reported that they avoided the implicated facility for a time following the incident; almost one-half decided to never return to the facility they believed had made them ill. In response to a secondhand report of gastrointestinal illness, 86% of respondents reported they would avoid the implicated facility for a time, and 22% said they would never return to the facility. After both personal experiences of illness and secondhand reports of illness, consumer responses were significantly more severe toward the implicated facility than toward all other food service facilities. Frequent diners avoided facilities for shorter periods of time and were less likely to never go back to a facility than were infrequent diners. The survey results indicate that 24 to 97 fewer meals were purchased per respondent, or a 11 to 20% reduction in meals purchased outside the home, in the year following respondents' illness. Future estimates of the economic burden of foodborne illnesses, including those caused by noroviruses, should consider the impacts on the food service industry attributable to changes in consumer behavior, in addition to health care costs and loss of productivity.

  7. Costs of care for people living with combined HIV/AIDS, chronic mental illness, and substance abuse disorders.

    PubMed

    Conover, Christopher J; Weaver, Marcia; Ang, Alfonso; Arno, Peter; Flynn, Patrick M; Ettner, Susan L

    2009-12-01

    To determine healthcare access and costs for triply diagnosed adults, we examined baseline data from the HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study, a multi-site cohort study of HIV+ adults with co-occurring mental and substance abuse disorders conducted between 2000 and 2004. Baseline interviews were conducted with 1138 triply diagnosed adults in eight predominantly urban sites nationwide. A modified version of Structured Interview for DSM-IV Axis I Disorders (SCID) was used to assign Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses for the preceding year. Utilization of a broad range of inpatient and outpatient services and medications over the preceding three months was patient-reported in face-to-face interviews. We then applied nationally representative unit costs to impute average monthly expenditures. We measured (poor) access to care during the three-month period by whether the patient had: (a) no outpatient medical visits; (b) at least one emergency room visit without an associated hospitalization; and (c) at least one hospitalization. At baseline, mean expenditures were $3880 per patient per month. This is nearly twice as high as expenditures for HIV/AIDS patients in general. Inpatient care (36%), medications (33%), and outpatient services (31%) each accounted for roughly one-third of expenditures. Expenditures varied by a factor of 2:1 among subgroups of patients, with those on Medicare or Medicaid, not in stable residences, or with poor physical health or high viral loads exhibiting the highest costs. Access to care was worse for women and those with low incomes, unstable residences, same-sex exposure, poor physical or mental health, and high viral loads. We conclude that HIV triply diagnosed adults account for roughly one-fifth of medical spending on HIV patients and that there are large variations in utilization/costs across patient subgroups. Realized access is good for many triply diagnosed

  8. Foodborne infections and intoxications in Poland in 2013.

    PubMed

    Polański, Piotr; Ostrek, Joanna; Sadkowska-Todys, Małgorzata

    2015-01-01

    The purpose of the study is to assess the epidemiological situation of food poisonings and infections in Poland in 2013. The evaluation was based on the analysis of information from re