Some estimates are slowly starting to come in for the painful suffering and deaths associated with Europe’s ongoing E. coli O104 outbreak.


Until now, the price tags on the deadly outbreak have come from farmers throughout the European Union, who experienced crop losses when they could not sell fresh produce as the hunt for the source of O104 jumped from cucumbers to lettuce and tomatoes before settling on sprouts.

The European Commission in Brussels has put up 210 million euros or about $304 million. It won’t be enough.

But the really big costs will come in care for the victims of the deadly outbreak.

Most of those victims are being treated in about 20 university hospitals, primarily centered in and around Hamburg.

According to the Federation of German University Hospitals, the costs of medical care are piling up.

German’s government-backed insurance companies have an annual budget of about 180 billion euros for both the university and regional hospitals. The outbreak has now blown such a big hole in those budgets that the German hospitals are not going to make it through the current year without a financial infusion.

A spokesman for the federation has estimated that treatment for E. coli patients requiring dialysis has already amounted to more than 20,000 euros per victim. Those who survive are looking at possible lifelong follow up treatments for everything from kidney to neurological issues.

Calculating the costs of foodborne illness, especially those caused by the dangerous E. coli O157:H7, is something you can do at home thanks to USDA’s Economic Research Service (ERS).  

“The ERS STEC O157 calculator could be used to estimate the costs of a similar E coli O104 outbreak in the United States (but not in Europe), if the user substituted the distribution of cases by severity from the European outbreak,” says  USDA’s Dr. Paul D. Frenzen.  “Otherwise, the costs would be underestimated because the European outbreak was apparently even more severe than (those associated with) O157.”

Dr Frenzen, along with Alison Drake and Frederick J. Angulo, co-authored the 2005 “Economic Cost of Illnesses Due to Escherichia coli O157 Infections in the United States,” a ground-breaking work for estimating the cost burden of the deadly pathogen on the U.S. economy.  The work was carried forward in USDA’s Foodborne Illnesses Calculator.

Use it to calculate the cost of a hypothetical U.S. outbreak of O104 with the magnitude and case distribution being experienced in the Europe, and  the model easily produces a number in the half billion dollar range.

But that’s about as far as the U.S. model can go in estimating the Euro outbreak.  “I would be very cautious about comparing the costs between the U.S. and Europe,” Frenzen adds.  “U.S. medical costs are substantially higher, and lifetime medical care for end-stage renal disease is not necessarily a government entitlement in Europe, unlike the U.S.”

Another method of making estimates for a costly outbreak comes from Bill Marler, the American food safety attorney and sponsor of Food Safety News, who has obtained jury verdicts and settlements in more foodborne illnesses cases than anyone else. He’s made estimates on his personal blog that are about $3 billion more than the model calculator (for a similar O104 outbreak in the U.S.).

The high percentage of hemolytic uremic syndrome (HUS) cases in the Euro outbreak is what makes the outbreak the most costly in history, Marler says.

“HUS is a devastating disease with mild cases requiring hospitalization, blood transfusions and/or dialysis for the patient to survive,” he says. “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.”

“Medical costs can run from a few hundred for non-HUS cases to several million for the most severe HUS cases,” he says. “Future medical costs 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.”

Marler’s estimates, based on settlements and jury verdicts in the U.S., of the values involved are:

  • Wrongful deaths (37)  will require $1 to $7 million to settle for a mode number of $1.5 million or total of $55.5 million.
  • HUS injuries (817) will require $1 to $30 million to settle for a mode number of $3.5 million or total of  $2.859 billion
  • Non-HUS cases (2518)  will require $10,000 to $1 million to settle for a mode number of $250,000 or total of $644,500,000

Marler’s grand total is $3,559,500,000.  “That is a lot of damage and human suffering,” he said.