Dalton C B, Haddix A, Hoffman R E, Mast E E
Colorado Department of Public Health and Environment, Denver, USA.
Arch Intern Med. 1996 May 13;156(9):1013-6.
In 1992, a food-borne outbreak of hepatitis A associated with a catering facility in Denver, Colo, resulted in 43 secondary cases of hepatitis A and the potential exposure of approximately 5000 patrons.
To assess (1) disease control costs, including state and local health department personnel costs, provision and administration of immune globulin, and cost of extra hepatitis A serologic tests performed; (2) business losses; and (3) cost of the cases' illnesses.
Cost data were collected from hospitals, health maintenance organizations, health departments, laboratories, the caterer's insurance company, and the catering facility involved in the outbreak.
The total costs assessed in the outbreak from a societal perspective were $809,706. Disease control costs were $689,314, which included $450,397 for 16,293 immune globulin injections and $105,699 for 2777 hours of health department personnel time. The cases' medical costs were $46,064, or 7% of the disease control costs.
The cases' medical costs and productivity losses were only a minor component of the total cost of this outbreak. The high cost of food-borne outbreaks should be taken into account in economic analyses of the vaccination of food handlers with inactivated hepatitis A vaccine.
1992年,科罗拉多州丹佛市一家餐饮机构引发的甲型肝炎食源性疫情导致43例甲型肝炎继发病例,并使约5000名顾客面临潜在感染风险。
评估(1)疾病控制成本,包括州和地方卫生部门的人员成本、免疫球蛋白的供应与管理以及额外进行的甲型肝炎血清学检测成本;(2)商业损失;(3)病例患病成本。
成本数据收集自医院、健康维护组织、卫生部门、实验室、餐饮供应商的保险公司以及此次疫情所涉及的餐饮机构。
从社会角度评估,此次疫情的总成本为809,706美元。疾病控制成本为689,314美元,其中包括16,293次免疫球蛋白注射的450,397美元以及卫生部门人员2777小时工作时间的105,699美元。病例的医疗成本为46,064美元,占疾病控制成本的7%。
病例的医疗成本和生产力损失只是此次疫情总成本的一小部分。在对食品从业人员接种甲型肝炎灭活疫苗的经济分析中,应考虑食源性疫情的高昂成本。