RKI in Germany reports 2453 cases of E. coli O104:H4 infection with 782 cases of HUS and 36 deaths (2 year old died today according to press reports) for a total in Germany of 3235 cases.  The earliest onset of illness on May 1 and the latest on June 9.

Other European countries report the following illnesses – 33 HUS, 61 Illnesses and 1 death for a total of 95 cases.

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The United State report 5 cases (2 with HUS.  Total:  Death Toll Hits 37 with 3335 Ill and 817 with HUS.

What is perhaps most concerning is the number of HUS cases (about 25% 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) 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.

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 37 = $55,500,000.

Non-HUS cases – $10,000 to $1,000,000 – mode $250,000 times 2518 = $644,500,000.

HUS cases – $1,000,000 to $30,000,000 – mode $3,500,000 times 817 = $2,859,500,000.

Total =$3,559,500,000. That is a lot of damage and human suffering.