Citation:

Herrick, R., S. Buchberger, R. Clark, M. Kupferle, R. Murray, AND P. Succop. A Markov Model to Estimate Salmonella Morbidity, Mortality, Illness Duration, and Cost . JOURNAL OF WATER RESOURCES PLANNING AND MANAGEMENT. American Society of Civil Engineers (ASCE), Reston, VA, 21(10):1169-1182, (2012).

Impact/Purpose:

Drinking water utilities need to incorporate possible waterborne disease costs into system improvement decisions. Existing economic models are not suited to predicting disease outbreaks or estimating illness durations. Markov Chain Monte Carlo models were developed to predict morbidity, mortality, duration and resultant costs from a waterborne Salmonella outbreak. Morbidity was classified by medical care sought. The Aggregate Cost Model assumes every case of salmonellosis has the same duration while the Marginal Cost Model explicitly predicts disease duration. Both cost models were tested against the study of the 1993 Salmonella typhimurium outbreak in Gideon, Missouri by Angulo et al. (1997); no significant differences between the model predictions and the actual results were found. The Markov models were then used to calculate a cumulative probability distribution of possible costs of the Gideon outbreak. For the reported 7 deaths among 650 patients, both models predict an economic cost of approximately $32 million (in 1993 dollars).

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