Botulism in Native Peoples - An Economic Study.

Type E botulism occurs regularly in scattered locations in the Canadian Arctic and northern coastal British Columbia from the consumption of improperly fermented fish and marine mammal products by native peoples, with an average of eight cases and 1.5 deaths each year. Local treatment at nursing stations is often followed by the evacuation of the patients to the main northern hospitals, e.g. Iqaluit and Inuvik with subsequent intensive care, if necessary, in Montreal, Winnipeg, Edmonton or Vancouver. Estimates of costs of six incidents in these northern regions showed that the evacuation of patients was the most expensive component (mean, 31.2%), followed by hospitalization (23.8%) and investigation of the illnesses (19.4%). The mean cost per incident was over $70,000, or $7,200 per case. If these figures are extrapolated, the cost of botulism in these areas is about $2 million each year, with $1.5 million being considered the value of the lives lost. Current and future health care practices in northern regions should be evaluated in relation to these and other costs.