Introduction
Cryptosporidium is a protozoan parasite that affects animals and humans gastrointestinal tract. The parasite is shed in the form of “oocyst” and can be seen in feces. The oocyst has a hard shell, and it is not easy protecting it from the environment. The infections may cause abdominal cramps and watery diarrhea or symptomatic in nature. The organism can be transmitted through the focal-oral mechanism. Outbreaks are often connected to waterborne and person-to-person modes. There is also evidence of animal and foodborne to person method (Barzon et al., 2012).
There are numerous reports across the globe about Cryptosporidium outbreaks, both in small and large communities. The largest outbreak of Cryptosporidium was reported in back in 1993 in Milwaukee, Wisconsin, affecting an estimated 403,000 individuals. Such outbreaks bring along disruptions including businesses, governments, and residents disruption. Public health officials are concerned with the findings of oocyst organism in reservoirs, lakes and rivers and even occasionally in treated waters (Ramsey et al., 2008).
The Case of Shadyville
Shady Ville town reports an incident of cryptosporidiosis at an annual rate of 10 new cases for every 100,000 residents. Two contingency plans can be used to remedy the situation: Contingency Plan 1 is a proposal by an international health team that promises to get rid of pathogens from the water system in the town. It is estimated that strategy one will reduce the rate of influenza at a ratio of four new cases every year from 10 cases annually. Contingency plan 2 is an innovative and mandated antidote that will completely protect the population from influenza infection. However, plan 2 comes with adverse side effects – the patients become extremely lethargic and stops to function for about seven days (Danis et al., 2011).
Suggested Control and Eradication Strategies
This paper has suggested two methods for dealing with Cryptosporidium parasites. However, only one method can be implemented. The paper explores literature in an attempt to find the best solution for Shadyville town that will have the best economic impact. Cost-effectiveness and cost-benefit analysis are provided to help in making a reliable and feasible long-term solution to the population (Ramsey et al., 2008).
Prevention: Prevention or minimizing the occurrence of human disease, schizophrenia. The primary focus using preventive technique is to adopt pre-emptive techniques that help in reducing the chances of an outbreak of the disease. Some of the preventive methods that can be taken include investing in technical infrastructure to reduce transmission of the disease, regulating zoosanitary practices on farms, or changing livestock management (Ramsey et al., 2008).
Alleviation: This is a mandated and innovative antidote that totally kills the organism and giving long term effects. However, previous findings indicate that the reduction or eradication of the organism from the body using antidote has some side effects (Danis et al., 2011).
Economic Evaluations
The methods for the economic appraisal can be categorized into three main areas. First is the cost-benefit analysis that looks forward to creating the worthiness of a program or policy by weighing all the necessary costs and benefits. This calls for the expression of all the benefits that are accrued regarding monetary values, which is often a difficult task. This technique is always adopted in the treatment programs, where the health benefits are evident and attributed to treatment. Second is the cost-benefit analysis campaigns that are often low cost, therefore broadly acceptable, leading to the saying “prevention is better than cure.” Third is the cost-effectiveness analysis that does compare two measures costs leading to similar health benefits (Ramsey et al., 2008).
Hazard Identification/ Risk Assessment
Risk assessment of Shadyville helps in determining the environmental conditions, the disease events that will impact on the population adversely, the surrounding environment or the region. This assessment also includes assessing the preventive and control mechanisms required to reduce the possible effect. Cost-benefit analysis and cost-effective have been considering to help justify investment in control and choice between contingency plan 1 and contingency plan 2.
Cost-benefit Analysis
Where the financial loss and risk associated with Cryptosporidium and schizophrenia is believed to be high, it may be acceptable to go the route of high-cost mitigation actions (Barzon et al., 2012). Further, if the perceived benefits are more powerful than the potential impacts, then the potential cost of reversing the situation may be acceptable. The potential environmental impact or the scale of operation may also be a primary factor in determining the cost-effectiveness of a contingency plan (Danis et al., 2011).
Acceptance risk depends on the situation and the position of the government and some other factors. The government may accept a high level of risk especially in scenarios where the potential benefits and returns are great. Some governments and decision makers are the other hand more cautious and would prefer to go with the low levels of returns for a greater consistency of prevention and production. In a small population like Shadyville, it’s not expected that this conflict will be dominating (Ramsey et al., 2008). As the population becomes bigger and bigger, then it becomes difficult in accepting high risks regarding implementing a contingency plan. While it is important to make the level risk acceptance at an early stage before an outbreak, there is need to make the decision in the current case. It is almost necessary that the evaluation takes note that risk assessment for waterborne diseases does affect even the neighboring communities. This organism also affects animals like cows which affect humans indirectly through reduced, milk and meat production (Ramsey et al., 2008).
Cost-effective strategies
There is a broad range of strategies that can be considered. The most important ones need to be prioritized. The strategies can be put into one consolidated master plan, which will help in making decisions. The significant factors to consider include funds available, capability and ability to conduct the strategy. The implementation costs should also be considered in regards to potential risks and assessed risks (Danis et al., 2011).
Economic impact
Some costs and losses are incurred when an outbreak occurs or during the inter-outbreak times in making attempts to put the situation under control. Here are the aspects that are given attention in the event of cryptosporidium outbreak when evaluating the economic impact of disease control and eradication (Ramsey et al., 2008).
Routine Antidote Injection
The costs of antidote injection depend on the number of affected people in the population and the frequency of the injections. Other costs related to eradication through contingency plan 1 for eradicating the disease entirely include costs of distribution of the vaccine, cost of labor and the cost of the antidote (Barzon et al., 2012).
Funds
Some states do have the funds to cater for such kinds of outbreaks. Individuals also contribute to the treatment of the outbreaks by taking individual insurance covers for epidemic outbreaks.
Outbreak periods
Direct Costs
The direct costs are those directly related to the number of deceased people or the affected regions, farms. The direct costs also involve costs of not going to work, the formation of eradication campaigns and costs that require the use of cash instantly.
Mortality
Mortality losses are calculated by expected profitability of the person or animal in future when the outbreak had not occurred until things get back to normal.
Morbidity: effects on (re)production
Yield and growth of production of wool, milk, and eggs are usually substantially reduced by the disease. The level of production may decline due to reduced fertility rate and increased levels of abortion. The disease also minimizes the rate of production of manure (Danis et al., 2011). Cattle manure is an essential part of production in regions like Africa and Asia. This means that epidemic diseases are affecting Shady Ville nutrition directly as a result of reduced milk and meat nutrition and also indirectly due to reduced manure.
Treatment costs
Treatment costs involve a wide population campaign to give the antidote. The process will require the entire government machinery to mobilize the population to come for tests and those with early signs treated. There will be a need for trained expertise (medical practitioners), the cost of the medicine. There will be the related cost of follow-up treatments, transport costs to the hospital.
Contingent Plan 1
Contingency Plan 1 is a proposal by an international health team that promises to get rid of pathogens from the water systems in the town. It is estimated that plan one will reduce the rate of influenza to a ratio of four new cases every year from 10 cases annually (Ramsey et al., 2008).
Contingent Plan 2
Contingency plan 2 is an innovative and mandated antidote that will completely protect the population from influenza infection. However, plan 2 comes with adverse side effects – the patients become extremely lethargic and stops to function for about seven days.
Conclusion
The paper has carried out an economic evaluation of Shadyville in regards to giving the best option for dealing with Cryptosporidium organism. While contingency plan one will help to minimize the level of influenza rate from 10 cases to only 4. This means that the disease will still be at large, and there are still chances of outbreaks in the near future when there is laxity in implementation of the program. Again, for how long can preventive measures be conducted? It only leads to consumption of resources. Where there is a cure, it is important that the cure is given to the patients. While contingency plan 1 has its weakness of side effects, it only lasts for seven days and goes away. The best way forward is to implement contingency plan 2 where the antidote is used to cure the disease once and for all. An alternative medication can be subscribed to help the patient recovers in less number of days. This recommendation follows the recommendations as given in the cost-benefit analysis; where the financial loss and risk associated with Cryptosporidium and schizophrenia is believed to be high, it may be acceptable to go the route of high-cost mitigation actions. Again, the government may accept a high level of risk especially in scenarios where the potential benefits and returns are great. This means that while giving the antidote is high risk; the benefits are great since the disease is entirely gotten rid of.
References
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Danis K, Papa A, Papanikolaou E, Dougas G, Terzaki I, et al. (2011) Ongoing outbreak of
West Nile virus infection in humans, Greece, July to August 2011. Euro surveillance : bulletin europeen sur les maladies transmissibles = European communicable disease bulletin
Ramsey, B. B., Rexhausen, J., Dubey, A., and Yu, L. An Evaluation of the Economic Benefits
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