THE COST OF A FOOD-BORNE OUTBREAK OF HEPATITIS-A IN DENVER, COLO

Background: In 1992, a food-borne outbreak of hepatitis A associated w ith a catering facility in Denver, Cole, resulted in 43 secondary case s of hepatitis A and the potential exposure of approximately 5000 patr ons. Objectives: To assess (1) disease control costs, including state and local health department personnel costs, provision and administrat ion of immune globulin, and cost of extra hepatitis A serologic tests performed; (2) business losses; and (3) cost of the cases' illnesses. Methods: Cost data were collected from hospitals, health maintenance o rganizations, health departments, laboratories, the caterer's insuranc e company, and the catering facility involved in the outbreak. Results : The total costs assessed in the outbreak from a societal perspective were $809 706. Disease control rests were $689 314, which included $4 50 397 for 16 293 immune globulin injections and $105 699 for 2777 hou rs of health department personnel time. The cases' medical costs were $46 064, or 7% of the disease control costs. Conclusions: The cases' m edical costs and productivity losses were only a minor component of th e total cost of this outbreak. The high cost of food-borne outbreaks s hould be taken into account in economic analyses of the vaccination of food handlers with inactivated hepatitis A vaccine.