Estimation of the monetary burden of cystic echinococcosis in Spain

Objective: Estimate the overall economic losses due to human and animal cystic echinococcosis (CE) in Spain in 2005.

Methods: Epidemiological data on annual CE incidence were obtained from surveillance and abattoir data and CE-related treatment, mortality and productivity losses were obtained from the literature for humans and animals. Costs associated with diagnosis, chemotherapy, medical care and hospitalization in humans and condemnation of offal in livestock (sheep, goats, pigs, and cattle) were included in the direct costs. Indirect costs included human productivity losses and the reduction in growth, fecundity, and milk production in livestock species.

Results: The annual economic loss attributable to CE-associated illness in humans and animals was 12,326,147 €/year [range: 10,127,954-14,613,912]. Animal-associated costs constituted 92% of total losses [mean: 11,463,100 €/year, range: 9,264,907-13,507,865]. Human-associated losses were much smaller [mean 865,048 €/year].

Discussion: This first estimate of the economical burden of CE in Spain demonstrates that this neglected zoonosis is still a veterinary public health issue for the country. Our results may even underestimate the burden since animal productivity reduction, losses associated with asymptomatic and undiagnosed cases, and the incapacity to fully account for long-term disability and disease re-occurrence were not included here. Our results clearly show that CE continues to afflict areas with extensive and semi-extensive farming activity despite the success of several control initiatives beginning in 1980. Sustaining efforts to reduce disease prevalence should be an integral component in Spain's national health policy, aided considerably by improvements in disease surveillance, data-collection techniques, and greater inter-agency cooperation.