Journal Article

Epidemiology of Salmonellosis in California, 1990–1999: Morbidity, Mortality, and Hospitalization Costs

R. T. Trevejo, J. G. Courtney, M. Starr and D. J. Vugia

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 157, issue 1, pages 48-57
Published in print January 2003 | ISSN: 0002-9262
Published online January 2003 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwf155
Epidemiology of Salmonellosis in California, 1990–1999: Morbidity, Mortality, and Hospitalization Costs

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Salmonella is a common cause of bacterial foodborne illness in the United States. The epidemiology and costs of nontyphoidal salmonellosis in California from 1990 through 1999 are described using surveillance, hospitalization, and death data. Trends in Salmonella rates and factors associated with prolonged hospitalization were evaluated using Poisson and linear regression models, respectively. There were 56,660 reported cases, 11,102 hospitalizations, and 74 deaths attributed to Salmonella. Reported case and hospital discharge rates have decreased since 1996. Among reported cases, infants had the highest rate (121 cases per 105 person-years), followed by children 1–4 years of age (40 cases per 105 person-years). The highest hospitalization rates were among the elderly and young children. Most deaths occurred among persons aged 65 or more years (59%). Among hospitalizations, gastroenteritis (61%) and septicemia (23%) were the most common Salmonella diagnoses. Salmonella pneumonia patients were the oldest (median age, 55 years) and Salmonella meningitis patients the youngest (median age, 0.3 years). These two diagnoses were the costliest, approaching $30,000 (median) per hospitalization. Having an acquired immunodeficiency syndrome diagnosis or multiple Salmonella diagnoses was independently associated with prolonged hospitalization. The estimated 10-year hospitalization costs for Salmonella were $200 million. Salmonellosis is a costly disease that disproportionately affects the young and elderly.

Keywords: cause of death; cost of illness; hospitalization; length of stay; population surveillance; Salmonella infections; Abbreviations: AIDS, acquired immunodeficiency syndrome; ICD, International Classification of Diseases.

Journal Article.  6274 words.  Illustrated.

Subjects: Public Health and Epidemiology

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