Economic cost of illness due to E. coli O157 infections in the United States

Economic Research Service, U.S. Department of Agriculture, 1800 M Street N.W., Washington, DC 20036-5831, USA.
Journal of food protection (Impact Factor: 1.85). 01/2006; 68(12):2623-30.
Source: PubMed


The Centers for Disease Control and Prevention (CDC) has estimated that Shiga toxin-producing Escherichia coli O157 (0157 STEC) infections cause 73,000 illnesses annually in the United States, resulting in more than 2,000 hospitalizations and 60 deaths. In this study, the economic cost of illness due to O157 STEC infections transmitted by food or other means was estimated based on the CDC estimate of annual cases and newly available data from the Foodborne Diseases Active Surveillance Network (FoodNet) of the CDC Emerging Infections Program. The annual cost of illness due to O157 STEC was $405 million (in 2003 dollars), including $370 million for premature deaths, $30 million for medical care, and $5 million in lost productivity. The average cost per case varied greatly by severity of illness, ranging from $26 for an individual who did not obtain medical care to $6.2 million for a patient who died from hemolytic uremic syndrome. The high cost of illness due to O157 STEC infections suggests that additional efforts to control this pathogen might be warranted.

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    • "for primary diagnosis (Buzby et al., 1996, 1997; Frenzen et al., 2005; HCUP, 2006; ERS, 2011). Hospital duration for remaining pathogens, as well as durations of moderate and mild symptoms, are midpoints of ranges drawn from medical textbooks, reviews of clinical characteristics, surveillance summaries, outbreak reports, and prior disease burden estimates. "
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    ABSTRACT: Abstract Measures of disease burden such as quality-adjusted life years (QALYs) are increasingly important to risk-based food safety policy. They provide a means of comparing relative risk from diverse health outcomes. We present detailed disease-outcome trees and EQ-5D scoring for 14 major foodborne pathogens representing over 95% of foodborne illnesses, hospitalizations, and deaths due to specified agents in the United States (Campylobacter spp., Clostridium perfringens, Cryptosporidium parvum, Cyclospora cayetanensis, Escherichia coli O157:H7, Shiga toxin-producing E. coli non-O157, Listeria monocytogenes, nontyphoidal Salmonella enterica, Shigella, Toxoplasma gondii, Vibrio vulnificus, Vibrio parahaemolyticus and other noncholera Vibrio, and Yersinia enterocolitica). We estimate over 5800 QALYs lost per 1000 cases of L. monocytogenes and V. vulnificus, compared to 125 QALYs lost per 1000 cases of T. gondii, 26 for E. coli O157:H7, 16 for Salmonella and Campylobacter, and 14 for Y. enterocolitica. The remaining 7 pathogens are estimated to cause less than 5 QALYs lost per 1000 cases. In total, these 14 pathogens cause over 61,000 in QALY loss annually, with more than 90% due solely to acute infection being responsible for 65% of total QALY loss, with premature mortality and morbidity due to chronic and congenital illness responsible for another 28%. These estimates of the burden of chronic sequelae are likely conservative; additional epidemiological research is needed to support more accurate burden estimates. This study shows the value of using integrated metrics for comparing disease burden, and the need to consider chronic and congenital illness when prioritizing foodborne pathogens.
    Full-text · Article · Mar 2014 · Foodborne Pathogens and Disease
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    • "Epidemiological surveys conducted over the past several years indicate that E. coli O157:H7 is ubiquitous at the herd level in both dairy and beef cattle operations but prevalence of these bacteria in individual animals or animals in pens varies greatly [33] [34] [35] [36]. Thus, application of strategies for reducing pre-harvest prevalence of E. coli O157:H7 at the farm is important for enhancing safety of bovine food products and mitigating economic impact of E. coli O157:H7 caused disease outbreaks on the public health system and the food industry [37]. Since LEE-encoded proteins are critical in gastrointestinal colonization of cattle by E. coli O157:H7, several studies have reported evaluations of vaccines containing one or more LEE-encoded proteins to reduce intestinal colonization in cattle experimentally or naturally infected with E. coli O157:H7 [31,38–41]. "
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    ABSTRACT: Escherichia coli O157:H7 colonizes cattle intestines by using the locus of enterocyte effacement (LEE)-encoded proteins. The induction of systemic immune response against LEE-encoded proteins, therefore, will prove effective in reducing E. coli O157:H7 colonization in cattle. The previous studies have demonstrated that a hha (encodes for a hemolysin expression modulating protein) deletion enhances expression of LEE-encoded proteins and a sepB (encodes an ATPase required for the secretion of LEE-encoded proteins) deletion results in intracellular accumulation of LEE proteins. In this study, we demonstrate the efficacy of the hha and hha sepB deletion mutants as bacterins for reducing fecal shedding of E. coli O157:H7 in experimentally inoculated weaned calves. The weaned calves were injected intramuscularly with the bacterins containing 10(9) heat-killed cells of the hha(+) wild-type or hha or hha sepB isogenic mutants, and boosted with the same doses 2- and 4-weeks later. The evaluation of the immune response two weeks after the last booster immunization revealed that the calves vaccinated with the hha mutant bacterin had higher antibody titers against LEE proteins compared to the titers for these antibodies in the calves vaccinated with the hha sepB mutant or hha(+) wild-type bacterins. Following oral inoculations with 10(10) CFU of the wild-type E. coli O157:H7, the greater numbers of calves in the group vaccinated with the hha or hha sepB mutant bacterins stopped shedding the inoculum strain within a few days after the inoculations compared to the group of calves vaccinated with the hha(+) wild-type bacterin or PBS sham vaccine. Thus, the use of bacterins prepared from the hha and hha sepB mutants for reducing colonization of E. coli O157:H7 in cattle could represent a potentially important pre-harvest strategy to enhance post-harvest safety of bovine food products, water and produce.
    Preview · Article · May 2011 · Vaccine
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    • "Escherichia coli O157:H7, which is responsible for c. 73 500 cases of infections in the United States each year (Mead et al. 1999), can colonize the intestinal tract of cattle and be introduced into beef products during slaughtering and subsequent processing. A recent study by Frenzen et al. (2005) estimated that 'the annual cost of E. coli O157:H7 illnesses is $405 million, which includes $370 million for premature deaths, $30 million for medical care and $5 million for lost productivity'. Different intervention methods have been used in the meat industry to prevent or decrease E. coli O157:H7 contamination from various potential sources. "
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    ABSTRACT: The aim of this study was to develop and optimize a novel method that combines ethidium bromide monoazide (EMA) staining with real-time PCR for the detection of viable Escherichia coli O157:H7 in ground beef. EMA can penetrate dead cells and bind to intracellular DNA, preventing its amplification via PCR. Samples were stained with EMA for 5 min, iced for 1 min and exposed to bright visible light for 10 min prior to DNA extraction, to allow EMA binding of the DNA from dead cells. DNA was then extracted and amplified by TaqMan real-time PCR to detect only viable E. coli O157:H7 cells. The primers and TaqMan probe used in this study target the uidA gene in E. coli O157:H7. An internal amplification control (IAC), consisting of 0.25 pg of plasmid pUC19, was added in each reaction to prevent the occurrence of false-negative results. Results showed a reproducible application of this technique to detect viable cells in both broth culture and ground beef. EMA, at a final concentration of 10 microg ml(-1), was demonstrated to effectively bind DNA from 10(8) CFU ml(-1) dead cells, and the optimized method could detect as low as 10(4) CFU g(-1) of viable E. coli O157:H7 cells in ground beef without interference from 10(8) CFU g(-1) of dead cells. EMA real-time PCR with IAC can effectively separate dead cells from viable E. coli O157:H7 and prevent amplification of DNA in the dead cells. The EMA real-time PCR has the potential to be a highly sensitive quantitative detection technique to assess the contamination of viable E. coli O157:H7 in ground beef and other meat or food products.
    Preview · Article · Jun 2009 · Journal of Applied Microbiology
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