News Scan for Oct 09, 2014

Costs of foodborne illness
Severe illness with MERS
Haiti cholera lawsuit

New estimates put price of US foodborne disease at $15.6 billion per year

Costs associated with foodborne illnesses in the United States total more than $15.6 billion annually, according to a data product released Oct 7 by the US Department of Agriculture's (USDA's) Economic Research Service containing updated estimates.

The pathogen associated with the greatest cost is Salmonella, accounting for $3.7 billion each year. Next in order are Toxopasma gondii at $3.3 billion and Listeria at $2.8 billion.

The total cost is based on estimates for illness caused by the 15 pathogens responsible for more than 95% of foodborne illness in the country, explains a USDA overview. Specifically, the estimates "build on [Centers for Disease Control and Prevention] estimates of the incidence of foodborne disease; peer-reviewed synthesis of data on medical costs, and economic, medical and epidemiological literature; and publicly available data on wages," it says.

Excel files for each of the pathogens contain spreadsheets giving estimated low, mean, and high costs of the illness in question; assumptions used in estimating costs for that pathogen; disease outcomes and associated costs; technical notes and documentation; and relevant research and publications.

A story today in Food Safety News (FSN) says the data help inform food safety policy discussions and provide a foundation for economic analysis of food safety policy. The FSN story also points out that economic costs are only part of the story, with costs to industry and to tax payers also considerable.
Oct 7 USDA overview on the estimates with links to spreadsheets
Oct 9 FSN


Case-series study: Severe illness common with MERS

Experience gained at one Saudi Arabia institution on the clinical aspects and outcomes of 70 MERS-CoV patients found that severe illness was common, particularly in those with concomitant infections and/or low albumin levels, as were fatalities, with age 65 or over the only independent risk factor for death.

The study was released today in the International Journal of Infectious Disease.

The records of 70 consecutive lab-confirmed MERS-CoV (Middle East respiratory syndrome coronavirus) cases seen at tertiary care center Prince Sultan Military Medical City in Riyadh from Oct 1, 2012, through May 31, 2014, were examined retrospectively. Median age was 62 years, males accounted for 65.7% of the cases, and just over half (55.7%) acquired their illness in the healthcare setting.

Hospital admission was required in 64 cases (91.4%). Fever, dyspnea, and cough were the most common symptoms, occurring in 43 (61.4%), 42 (60%), and 38 (54.3%) case-patients, respectively. Pneumonia developed in 63 (90%), and 49 (70%) were treated in the intensive care unit (ICU).

Forty-nine patients (70%) required ICU admission; associated factors were concomitant infections (odds ratio [OR], 14.13; 95% confidence interval [CI] 1.58-126.09; P = 0.018) and low levels of albumin (OR, 6.31; 95% CI, 1.24-31.90; P = 0.026). Forty-two patients (60%) died in the hospital, with age over 65 years associated with mortality (OR, 4.39; 95% CI, 2.13-9.05; P < 0.0001).

Recent (within 2 weeks of illness onset) exposure to animals, including camels, was present in only 3 cases (4.3%).

The authors noted multiple healthcare-associated clusters in their cohort and note that one patient transmitted the disease to 10 others.

The first case of MERS-CoV was reported in June of 2012 in Saudi Arabia. Since that time it has caused more than 750 cases with more than 320 deaths in multiple countries.
Oct 9 Int J Infect Dis abstract


Lawsuit against UN over Haiti cholera outbreak to proceed

A federal judge in New York has agreed to allow a lawsuit against the United Nations over Haiti's cholera outbreak to proceed, The New York Times reported yesterday.

The lawsuit was filed last year by advocates for Haitian victims of a cholera epidemic that began in 2010, has sickened more than 700,000 people, and has killed more than 8,000. The suit argues that UN peacekeepers were responsible for introducing the disease to Haiti through contaminated sewage in their compound.

Oral arguments are slated to start Oct 23 at the US District Court for the Southern District of New York.
Oct 8 New York Times story

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