title: An Economic Evaluation of PulseNet: A Network for Foodborne Disease Surveillance.
abstract: The PulseNet surveillance system is a molecular subtyping network of public health and food regulatory agency laboratories designed to identify and facilitate investigation of foodborne illness outbreaks. This study estimates health and economic impacts associated with PulseNet. The staggered adoption of PulseNet across the states offers a natural experiment to evaluate its effectiveness, which is measured as reduction of reported illnesses due to improved information, enhanced industry accountability, and more-rapid recalls. Economic impacts attributable to PulseNet include medical costs and productivity losses averted due to reduced illness. Program costs are also reported. Better information and accountability from enhanced surveillance is associated with large reductions of reported illnesses. Data collected between 1994 and 2009 were assembled and analyzed between 2010 and 2015. Conservatively, accounting for underreporting and underdiagnosis, 266,522 illnesses from Salmonella, 9,489 illnesses from Escherichia coli (E. coli), and 56 illnesses due to Listeria monocytogenes are avoided annually. This reduces medical and productivity costs by $507 million. Additionally, direct effects from improved recalls reduce illnesses from E. coli by 2,819 and Salmonella by 16,994, leading to $37 million in costs averted. Annual costs to public health agencies are $7.3 million. The PulseNet system makes possible the identification of food safety risks by detecting widespread or non-focal outbreaks. This gives stakeholders information for informed decision making and provides a powerful incentive for industry. Furthermore, PulseNet enhances the focus of regulatory agencies and limits the impact of outbreaks. The health and economic benefits from PulseNet and the foodborne disease surveillance system are substantial.
authors.affiliation: Department of Human Sciences, The Ohio State University, Columbus, Ohio. Electronic address: scharff.8@osu.edu.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Scharff
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia.
authors.forename: John
authors.initials: J
authors.lastname: Besser
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Sharp
authors.affiliation: Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Jones
authors.affiliation: National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, Georgia.
authors.forename: Gerner-Smidt
authors.initials: GS
authors.lastname: Peter
authors.affiliation: Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Craig W
authors.initials: CW
authors.lastname: Hedberg
mesh_terms: D003362:Cost-Benefit Analysis / Q000191:economics*; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005517:Foodborne Diseases / Q000517:prevention & control*; D006801:Humans; D015233:Models, Statistical; D011159:Population Surveillance / Q000379:methods*; D011634:Public Health; D014481:United States