ICEID COVERAGE CDC says common waterborne diseases may cost $539 million

Jul 15, 2010 ATLANTA (CIDRAP News) – A new report from the US Centers for Disease Control and Prevention (CDC) puts the yearly waterborne illness burden at as much as $539 million.

The study, presented yesterday at the International Conference on Emerging Infectious Diseases in Atlanta, is the first to assess the total healthcare costs of all waterborne diseases in the United States, the authors said. Using a large insurance claims database, they gauged the hospitalization costs of three common waterborne illnesses in the United States: Legionnaires' disease, cryptosporidiosis, and giardiasis.

Michael Beach, PhD, an epidemiologist with the CDC's National Center for Zoonotic, Vector-Borne, and Enteric Diseases and senior author of the study, said that the study is useful as a baseline for measuring the effect of future waterborne disease prevention interventions.

In a statement yesterday from the CDC he said when people think of waterborne diseases, they usually think of simple diarrhea that is bothersome, but quickly resolves. "However, these infections can cause severe illness that often results in hospital stays of more than a week, which can quickly drive up healthcare costs," he said.

For each disease, researchers calculated the cost paid by the insurer, the patient's out-of-pocket expenses, and the total amount paid. Total estimated cost ranged from $154 million to $539 million, which included $44 million to $147 million in payments for Medicare and Medicaid.

Cost estimates for individual diseases were:

  • Giardiasis, $16 million to $63 million
  • Cryptosporidiosis, $37 million to $145 million
  • Legionnaires' disease, $101 million to $321 million

Inpatient hospitalization costs were highest for Legionnaires' disease, averaging $34, 000 per patient and lowest for giardiasis, which totaled about $9,000. Inpatient costs for cryptosporidiosis averaged $21,000.

Legionnaires' disease, caused by Legionella bacteria, is a type of pneumonia that infects about 8,000 to 18,000 people each year, according to background information from the CDC. Infections are fatal in 5% to 30% of patients. The bacteria can grow in warm water sources such as air conditioning systems or hot tubs. People typically contract the disease by breathing in vapor or mist from contaminated water sources. Older people and those with underlying lung conditions are most vulnerable to the disease.

Cryptosporidiosis is caused by a parasite containing an outer shell that can resist chlorine disinfectants. It typically spreads through contaminated drinking or recreational water. The main symptom is watery diarrhea that can last as long as 2 weeks. Giardiasis, also known as "backpacker's disease," is also caused by a parasite that can contaminate soil or water, according to the CDC. Symptoms include diarrhea and other intestinal problems that can last from 2 to 6 weeks.

Modest disease prevention investments such as public health education campaigns, appropriate inspection of building water systems, and appropriate maintenance of pools and other recreational water facilities could drive down disease rates and lead to significant healthcare cost savings, Beach said.

See also:

Jul 14 CDC press release

CDC Legionnaires' disease background information

CDC cryptosporidiosis background information

CDC giardiasis background information

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