According to the CDC, in the United States, six confirmed cases of STEC O104:H4 infections have been identified. Of these six cases, five recently traveled to Germany, where they were likely exposed. Bacterial isolates from four HUS cases reported in Arizona (1), Massachusetts (1), Michigan (1) and Wisconsin (1), and two cases with diarrheal illness reported in Michigan (1) and North Carolina (1), have all been confirmed as matching the outbreak strain. One death has been reported in the Arizona resident with HUS who traveled to Germany before becoming ill. The Michigan resident with diarrheal illness did not travel to Germany, but likely acquired this infection through close contact with the Michigan resident with HUS.
The outbreak has been linked to Egyptian fenugreek seeds imported to Europe and consumed in Germany and France. To date as many as 51 deaths, 4,250 illness with 900 hemolytic uremic syndrome cases have occurred on a dozen European counties and the United States.
As I have said before, this has been the most deadly E. coli outbreak on record and is now firmly in second place in number ill after the Japan bean sprout outbreak in the 1990’s that sickened over 10,000.
What is perhaps most concerning is the number of HUS cases (about 21% of total – typical outbreak 10% with the highest I recall being 18% in the 2006 spinach outbreak) in this outbreak. HUS is a devastating disease with mild cases requiring hospitalization, blood transfusions and/or dialysis for the patient to survive. More severe cases can require months, if not years, of hospitalization and rehabilitation. Some will suffer strokes or more subtle brain injuries. There may well be multiple surgeries (removal of large intestine, gall bladder and placement of dialysis catheter). And, even after the acute HUS illness is over patients are at risk of future brain, bowel (even in non-HUS cases), and heart and kidney complications. Some survivors are left with diabetes and with slowly progressive kidney failure with the need for transplants – perhaps multiple ones.
All of this medical treatment is expensive – very expensive, and it does not even touch the cost of lost wages and productivity or the pain and suffering of losing a loved one or of living with a brain injury or risk of a kidney transplant.
Of course no one has spoken of the cost to the human victims. All of the gnashing of teeth has been over the loss to farmers (true, human too) around the world (especially Spain and now Egypt) as people shy away from potentially contaminated vegetables and as product is recalled and destroyed. Farmers should be compensated – especially those who have suffered because of being incorrectly targeted for the cause of the outbreak.
But, what about the cost to the families of the 51 who died and the 4,250 sickened – especially the 900 with HUS? It is hard to estimate costs, but I have a pretty good idea of jury verdict and settlement values after nearly 20 years of involvement in every major E. coli outbreak in the United States (I have secured over $500,000,000 in verdicts and settlements on behalf of E. coli victims – E. coli O157:H7 and non-O157 cases – mostly children).
Past medical bills can run from a few hundred for non-HUS cases to several million for the most severe HUS cases. Future medical bills can vary widely depending on the severity of the future disease progression. Wage loss of course can vary widely depending on how long someone is unemployed or if they are ever able to work again. Pain and suffering is likely incalculable, but real.
So lets do some math (in U.S. dollars) for settlement or jury value.
Death cases – $1,000,000 to $7,000,000 – mode $1,500,000 times 51 = $76,500,000.
Non-HUS cases – $10,000 to $1,000,000 – mode $250,000 times 3,350 = $837,500,000.
HUS cases – $1,000,000 to $30,000,000 – mode $3,500,000 times 900 = $3,150,000,000.
Total =$4,060,000,000. That is a lot of damage and human suffering.