title: Excess healthcare costs of a large waterborne outbreak in Finland.
abstract: BACKGROUND
  The economic effects of waterborne outbreaks have rarely been reported. A large waterborne outbreak occurred in the town of Nokia in Finland in 2007 with half of the population in the contaminated area suffering from gastroenteritis. We studied the healthcare costs of this outbreak.
  
  
  METHODS
  Healthcare costs were studied using register data from the Nokia Health Care Centre, data collected in the regional university hospital, and data from laboratory register on stool samples.
  
  
  RESULTS
  Total excess healthcare costs were EUR 354,496, which is approximately EUR 10 per resident of Nokia. There were 2052 excess visits because of gastroenteritis in Nokia Health Care Centre, 403 excess episodes in the university hospital, and altogether over 2000 excess stool samples due to the outbreak. Care in the Nokia Health Care Centre accounted for 44% and care in the university hospital for 42% of the excess healthcare costs while stool samples accounted for only 10%.
  
  
  CONCLUSIONS
  Despite the high morbidity, the total cost was low because most patients had a relatively mild illness. The situation would have been worse if the microbes involved had been more hazardous or if the financial situation of the community had been worse. Prevention of waterborne outbreaks is important, as there is a risk of severe short- and long-term health effects and substantial health-economic costs.
authors.affiliation: 1Epidemiologic Surveillance and Response Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.
authors.forename: Elisa
authors.initials: E
authors.lastname: Huovinen
authors.forename: Janne
authors.initials: J
authors.lastname: Laine
authors.forename: Mikko J
authors.initials: MJ
authors.lastname: Virtanen
authors.forename: Marja
authors.initials: M
authors.lastname: Snellman
authors.forename: Timo
authors.initials: T
authors.lastname: Hujanen
authors.forename: Urpo
authors.initials: U
authors.lastname: Kiiskinen
authors.forename: Eila
authors.initials: E
authors.lastname: Kujansuu
authors.forename: Jukka
authors.initials: J
authors.lastname: Lumio
authors.forename: Petri
authors.initials: P
authors.lastname: Ruutu
authors.forename: Markku
authors.initials: M
authors.lastname: Kuusi
mesh_terms: D004196:Disease Outbreaks / Q000191:economics*; D060766:Drinking Water / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005387:Finland / Q000453:epidemiology; D005759:Gastroenteritis / Q000191:economics* / Q000453:epidemiology*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D012042:Registries; D014871:Water Microbiology
chemical_list: D060766:Drinking Water
keywords: Finland; gastroenteritis; healthcare costs; outbreak; waterborne