Preliminary Estimates of Costs of Foodborne Disease in the United States

1989 ◽  
Vol 52 (8) ◽  
pp. 595-601 ◽  
Author(s):  
EWEN C. D. TODD
Keyword(s):  
United States ◽  
Food Industry ◽  
The United States ◽  
Control Measures ◽  
Effective Control ◽  
Foodborne Diseases ◽  
Hemorrhagic Colitis ◽  
E Coli ◽  
The Cost ◽  
Total Impact

Although the full economic impact of foodborne diseases has yet to be measured, preliminary studies show that the cost of illness, death, and business lost is high indeed. This impact is probably greatest in developing countries, but few facts are known. For the United States, preliminary estimates are 12.6 million cases costing $8.4 billion. These may seem excessive but other authors have postulated even higher case and dollar figures. Microbiological diseases (bacterial and viral) represent 84% of the United States' costs, with salmonellosis and staphylococcal intoxication being the most economically important diseases (annually $4.0 billion and $1.5 billion, respectively). Other costly types of illnesses are toxoplasmosis ($445 million), listeriosis ($313 million), campylobacteriosis ($156 million), trichinosis ($144 million), Clostridium perfringens enteritis ($123 million), and E. coli infections including hemorrhagic colitis ($223 million). Botulism has a high cost per case ($322,200), but its total impact is only $87 million because relatively few cases occur (270). This is because the food industry has been able to introduce effective control measures. Salmonellosis, however, is much more widespread (2.9 million cases) and affects all sectors of the food industry.

Worldwide Surveillance of Foodborne Disease: the Need to Improve†

1996 ◽  
Vol 59 (1) ◽  
pp. 82-92 ◽  
Author(s):  
EWEN C. D. TODD
Keyword(s):  
Latin American ◽  
Disease Surveillance ◽  
Large Population ◽  
The United States ◽  
Control Measures ◽  
Annual Reports ◽  
Effective Control ◽  
Surveillance Program ◽  
Foodborne Disease ◽  
E Coli

A foodborne-disease surveillance program is an essential part of a food safety program. Foodborne surveillance should be able to issue early alerts on contaminated food to which a large population is exposed; collate notifications of enteric diseases and laboratory isolations; report foodborne disease incidents on a regular basis; and use sentinel and specific epidemiological studies as required. Although most countries have some kind of reporting of notifiable diseases, few have foodborne-disease surveillance programs, and little is known of foodborne disease in general on a worldwide basis. However, in the last decade many European countries have generated annual reports to join those of Canada, England/Wales, Japan and the United States. In addition, a few other countries are attempting to develop foodborne-disease reporting programs but are hampered by lack of resources. However, it is apparent that staphylococcal intoxication has been decreasing in most nations, except in some Latin American countries where cheese from unpasteurized milk and cream-filled desserts are widely consumed. In contrast, salmonellosis has been increasing or remaining steady as the main foodborne disease in practically all other countries. Newly-recognized agents such as E. coli O157:H7 and other verotoxigenic E. coli, or previously-known agents in new food associations such as Clostridium botulinum, are also being documented in several countries. Although the socioeconomic impact of foodborne diseases is very high, there are at best limited effective control measures to reduce them, even in industrialized countries. One reason control is difficult to achieve is that surveillance is inadequate and the burden of foodborne disease is not fully understood by policy-makers. Another reason is that a consistent and coordinated effort by industry and government is required, as has been practiced in Sweden to reduce substantially the Salmonella contamination of poultry. Improvement of surveillance on a worldwide basis is all the more important with increasing world trade and travel, and international organizations need to take a lead role in accomplishing this.

Transmission and control of Escherichia coli O157:H7 — A review

2002 ◽  
Vol 82 (4) ◽  
pp. 475-490 ◽  
Author(s):  
S. J. Bach ◽  
T. A. McAllister ◽  
D. M. Veira ◽  
V. P. J. Gannon ◽  
R. A. Holley
Keyword(s):  
United States ◽  
Escherichia Coli ◽  
Foodborne Pathogen ◽  
The United States ◽  
Urban Environments ◽  
Effective Control ◽  
Feed Water ◽  
Escherichia Coli O157 ◽  
Bacteriophage Therapy ◽  
E Coli

Escherichia coli 157:H7 has evolved as an important foodborne pathogen since its initial description in 1982. Outbreaks of illness associated with E. coli O157:H7 have been reported throughout the northern hemisphere, most frequently in Canada, the United States, Japan, and the United Kingdom. In Canada, infections due to E. coli O157: H7 appear to be more common in the western provinces than in the east, in rural vs. urban environments, and during summer as opposed to winter months. Undercooked ground beef has been implicated as the primary vehicle in E. coli O157:H7 infection, but contaminated fruits, vegetables and water have also been linked to E. coli O157:H7 outbreaks. Epidemiological investigations demonstrate that dairy and beef cattle are primary reservoirs of this organism, carrying it asymptomatically and shedding it intermittently and seasonally in their feces. Surveys in Canada and the United States indicate widespread distribution of E. coli O157:H7 in cattle operations. The prevalence of E. coli O157:H7 in cattle has been increasing in recent reports, likely due to the development of more sensitive methods for the detection of the organism. Escherichia coli O157:H7 has been isolated from feed, water for livestock, manure, soil and flies, all of which represent potential sources of contamination for cattle and their environment. To date, effective methods for controlling E. coli O157:H7 in cattle have not been identified, although dietary manipulation, vaccination and bacteriophage therapy have been reported to have potential as intervention strategies. Effective control of E. coli O157:H7 requires reducing the frequency and intensity of fecal shedding of this pathogen by cattle, in addition to targeting environmental sources of the organism. Key words: Escherichia coli O157:H7, cattle, sources, diet, transmission

scholarly journals 1675. Epidemiology of Urinary Tract Infections in the United States, 2009 - 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S823-S823
Author(s):  
Kendra Foster ◽  
Linnea A Polgreen ◽  
Brett Faine ◽  
Philip M Polgreen
Keyword(s):  
United States ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Proteus Mirabilis ◽  
Antibiotic Use ◽  
The United States ◽  
Drug Resistant ◽  
E Coli ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections. There is a lack of large epidemiologic studies evaluating the etiologies of UTIs in the United States. This study aimed to determine the prevalence of different UTI-causing organisms and their antimicrobial susceptibility profiles among patients being treated in a hospital setting. Methods We used the Premier Healthcare Database. Patients with a primary diagnosis code of cystitis, pyelonephritis, or urinary tract infection and had a urine culture from 2009- 2018 were included in the study. Both inpatients and patients who were only treated in the emergency department (ED) were included. We calculated descriptive statistics for uropathogens and their susceptibilities. Multi-drug-resistant pathogens are defined as pathogens resistant to 3 or more antibiotics. Resistance patterns are also described for specific drug classes, like resistance to fluoroquinolones. We also evaluated antibiotic use in this patient population and how antibiotic use varied during the hospitalization. Results There were 640,285 individuals who met the inclusion criteria. Females make up 82% of the study population and 45% were age 65 or older. The most common uropathogen was Escherichia Coli (64.9%) followed by Klebsiella pneumoniae (8.3%), and Proteus mirabilis (5.7%). 22.2% of patients were infected with a multi-drug-resistant pathogen. We found that E. Coli was multi-drug resistant 23.8% of the time; Klebsiella pneumoniae was multi-drug resistant 7.4%; and Proteus mirabilis was multi-drug resistant 2.8%. The most common antibiotics prescribed were ceftriaxone, levofloxacin, and ciprofloxacin. Among patients that were prescribed ceftriaxone, 31.7% of them switched to a different antibiotic during their hospitalization. Patients that were prescribed levofloxacin and ciprofloxacin switched to a different antibiotic 42.8% and 41.5% of the time, respectively. Conclusion E. Coli showed significant multidrug resistance in this population of UTI patients that were hospitalized or treated within the ED, and antibiotic switching is common. Disclosures All Authors: No reported disclosures

scholarly journals Epidemiologic and Microbiologic Characteristics of 28 Hospitalized Patients Cocolonized With Multiple Carbapenem-Resistant Enterobacteriaceae (CRE) in the United States

2020 ◽  
Vol 41 (S1) ◽  
pp. s62-s62
Author(s):  
Timileyin Adediran ◽  
Anthony Harris ◽  
J. Kristie Johnson ◽  
David Calfee ◽  
Loren Miller ◽  
...  
Keyword(s):  
United States ◽  
Secondary Analysis ◽  
Positive Culture ◽  
The United States ◽  
Healthcare Personnel ◽  
Surveillance Culture ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Multicenter Prospective Cohort Study ◽  
Epidemiological Significance

Background: As carbapenem-resistant Enterobacteriaceae (CRE) prevalence increases in the United States, the risk of cocolonization with multiple CRE may also be increasing, with unknown clinical and epidemiological significance. In this study, we aimed to describe the epidemiologic and microbiologic characteristics of inpatients cocolonized with multiple CRE. Methods: We conducted a secondary analysis of a large, multicenter prospective cohort study evaluating risk factors for CRE transmission to healthcare personnel gown and gloves. Patients were identified between January 2016 and June 2019 from 4 states. Patients enrolled in the study had a clinical or surveillance culture positive for CRE within 7 days of enrollment. We collected and cultured samples from the following sites from each CRE-colonized patient: stool, perianal area, and skin. A modified carbapenem inactivation method (mCIM) was used to detect the presence or absence of carbapenemase(s). EDTA-modified CIM (eCIM) was used to differentiate between serine and metal-dependent carbapenemases. Results: Of the 313 CRE-colonized patients enrolled in the study, 28 (8.9%) were cocolonized with at least 2 different CRE. Additionally, 3 patients were cocolonized with >2 different CRE (1.0%). Of the 28 patients, 19 (67.6%) were enrolled with positive clinical cultures. Table 1 summarizes the demographic and clinical characteristics of these patients. The most frequently used antibiotic prior to positive culture was vancomycin (n = 33, 18.3%). Among the 62 isolates from 59 samples from 28 patients cocolonized patients, the most common CRE species were Klebsiella pneumoniae (n = 18, 29.0%), Escherichia coli (n = 10, 16.1%), and Enterobacter cloacae (n = 9, 14.5%). Of the 62 isolates, 38 (61.3%) were mCIM positive and 8 (12.9%) were eCIM positive. Of the 38 mCIM-positive isolates, 33 (86.8%) were KPC positive, 4 (10.5%) were NDM positive, and 1 (2.6%) was negative for both KPC and NDM. Also, 2 E. coli, 1 K. pneumoniae, and 1 E. cloacae were NDM-producing CRE. Conclusion: Cocolonization with multiple CRE occurs frequently in the acute-care setting. Characterizing patients with CRE cocolonization may be important to informing infection control practices and interventions to limit the spread of these organisms, but further study is needed.Funding: NoneDisclosures: None

scholarly journals SWK-11. ASSESSMENT OF THE INDIRECT COSTS ASSOCIATED WITH PROTON THERAPY TREATMENT FOR ALBERTA PATIENTS REFERRED OUT OF COUNTRY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii466-iii466
Author(s):  
Karina Black ◽  
Jackie Middleton ◽  
Sunita Ghosh ◽  
David Eisenstat ◽  
Samor Patel
Keyword(s):  
United States ◽  
Proton Therapy ◽  
Malignant Tumors ◽  
Indirect Costs ◽  
The United States ◽  
Current Data ◽  
Opportunity Costs ◽  
Proton Treatment ◽  
Out Of Pocket Expenses ◽  
The Cost

Abstract BACKGROUND Proton therapy for benign and malignant tumors has dosimetric and clinical advantages over photon therapy. Patients in Alberta, Canada are referred to the United States for proton treatment. The Alberta Heath Care Insurance Plan (AHCIP) pays for the proton treatment and the cost of flights to and from the United States (direct costs). This study aimed to determine the out-of-pocket expenses incurred by patients or their families (indirect costs). METHODS Invitation letters linked to an electronic survey were mailed to patients treated with protons between 2008 and 2018. Expenses for flights for other family members, accommodations, transportation, food, passports, insurance, and opportunity costs including lost wages and productivity were measured. RESULTS Fifty-nine invitation letters were mailed. Seventeen surveys were completed (28.8% response rate). One paper survey was mailed at participant request. Nine respondents were from parent/guardian, 8 from patients. All patients were accompanied to the US by a family member/friend. Considerable variability in costs and reimbursements were reported. Many of the accompanying family/friends had to miss work; only 3 patients themselves reported missed work. Time away from work varied, and varied as to whether it was paid or unpaid time off. CONCLUSIONS Respondents incurred indirect monetary and opportunity costs which were not covered by AHCIP when traveling out of country for proton therapy. Prospective studies could help provide current data minimizing recall bias. These data may be helpful for administrators in assessing the societal cost of out-of-country referral of patients for proton therapy.

scholarly journals The Effect of Massachusetts' Health Reform on Employer-Sponsored Insurance Premiums

2010 ◽  
Vol 13 (2) ◽  
Author(s):  
John F Cogan ◽  
R. Glenn Hubbard ◽  
Daniel Kessler
Keyword(s):  
United States ◽  
Health Reform ◽  
Medical Expenditure Panel Survey ◽  
Private Insurance ◽  
The United States ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Reform Plan ◽  
The Difference ◽  
The Cost

In this paper, we use publicly available data from the Medical Expenditure Panel Survey - Insurance Component (MEPS-IC) to investigate the effect of Massachusetts' health reform plan on employer-sponsored insurance premiums. We tabulate premium growth for private-sector employers in Massachusetts and the United States as a whole for 2004 - 2008. We estimate the effect of the plan as the difference in premium growth between Massachusetts and the United States between 2006 and 2008—that is, before versus after the plan—over and above the difference in premium growth for 2004 to 2006. We find that health reform in Massachusetts increased single-coverage employer-sponsored insurance premiums by about 6 percent, or $262. Although our research design has important limitations, it does suggest that policy makers should be concerned about the consequences of health reform for the cost of private insurance.

Importance of Behavioral and Psychological Symptoms of Dementia in Primary Care

2000 ◽  
Vol 12 (S1) ◽  
pp. 67-72 ◽  
Author(s):  
William H. Coleman
Keyword(s):  
United States ◽  
Primary Care ◽  
Psychological Distress ◽  
Direct Relationship ◽  
Psychological Symptoms ◽  
The United States ◽  
Comprehensive Treatment ◽  
The Cost ◽  
Number Of Individuals ◽  
Behavioral And Psychological Symptoms

There is a direct relationship between years lived beyond age 65 and the number of individuals diagnosed with dementia, primarily Alzheimer's disease (AD). The occurrence of AD has no socioeconomic, geographical, or ethnic limitations. The problem is worldwide. Its magnitude is demonstrated by the following facts: (a) approximately 6% to 8% of persons 65 years or older have AD, and the prevalence of the disease doubles each 5 years after 60 years of age; (b) 30% of 85-year-old individuals can be expected to have the disease; (c) AD affects an estimated 4 million people in the United States, and is expected to affect approximately 14 million Americans within the next few decades; (d) AD patients average 6 to 10 years of comprehensive treatment from symptom onset to death; (e) AD is the fourth leading cause of mortality among elderly Americans, more than 100,000 each year; (f) caregiver attempts at management of the behavioral and psychological symptoms of AD result in up to 50% developing significant psychological distress themselves; and (g) the cost for the management of AD patients is estimated to be between US $80 billion and US $120 billion annually. Primary care is essential for the appropriate diagnosis and treatment of the complex set of behavioral and psychological symptoms of dementia (BPSD) associated with AD.

scholarly journals Projections of the Cost of Cancer Care in the United States: 2010-2020

2011 ◽  
Vol 103 (2) ◽  
pp. 117-128 ◽  
Author(s):  
A. B. Mariotto ◽  
K. Robin Yabroff ◽  
Y. Shao ◽  
E. J. Feuer ◽  
M. L. Brown
Keyword(s):  
United States ◽  
Cancer Care ◽  
The United States ◽  
The Cost

LE LETTERE DI GIUSEPPE PEANO NELLA CORRISPONDENZA DI ERNESTO CESÀRO

Nuncius ◽  
1993 ◽  
Vol 8 (1) ◽  
pp. 249-281
Author(s):  
FRANCO PALLADINO
Keyword(s):  
United States ◽  
Nineteenth Century ◽  
The United States ◽  
Cost Of Living ◽  
Infinitesimal Calculus ◽  
Italian School ◽  
Actuarial Mathematics ◽  
Important Member ◽  
The Cost ◽  
Giuseppe Peano

Abstract<title> SUMMARY </title>We have gathered here twenty-six writings from the correspondence of Giuseppe Peano, as well as letters by Alexander Macfarlane and Alexander Ziwet.Peano's letters were addressed to Ernesto Cesaro, an important member of the great Italian school of mathematics founded in the second half of the Nineteenth century. In these writings, Peano discusses various topics: Infinitesimal calculus and Barycentric calculus, the «Rivista di Matematica» and the «Formulario» of which he was editor; didactics and a question about Actuarial mathematics. Some of the writings are confidential in nature: in one letter, Peano proposes exchanging his professorial chair with Cesaro's, and hence transferring from Turin to Naples.The letters written by Macfarlane and Ziwet were sent to Peano; they contain, at the request of Cesaro, information concerning university chairs and the cost of living in the United States.

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