The objective of this study was to estimate the direct financial costs of hospital care for management of invasive group A streptococcal (GAS) infections using hospital records for cases diagnosed in England. We linked laboratory-confirmed cases (n = 3696) identified through national surveillance to hospital episode statistics and reimbursement codes. From these codes we estimated the direct hospital costs of admissions. Almost all notified invasive GAS cases (92% of 3696) were successfully matched to a primary hospital admission. Of these, secondary admissions (within 30 days of primary admission) were further identified for 593 (17%). After exclusion of nosocomial cases (12%), the median costs of primary and secondary hospital admissions were estimated by subgroup analysis as £1984–£2212 per case, totalling £4·43–£6·34 million per year in England. With adjustment for unmatched cases this equated to £4·84–£6·93 million per year. Adults aged 16–64 years accounted for 48% of costs but only 40% of cases, largely due to an increased number of surgical procedures. The direct costs of hospital admissions for invasive GAS infection are substantial. These estimated costs will contribute to a full assessment of the total economic burden of invasive GAS infection as a means to assess potential savings through prevention measures.

The North American beef cattle industry has endured many changes throughout the years but is encountering some of the most dramatic challenges in history during the first decade of the 21st century. The US beef cattle inventory increased from 1990 to a high of 103.5 million in 1996 and since has declined to a low of 94.5 million on 1 January 2009. Even though economic signals have encouraged the cow herd to increase over the last 5 years, a significant decrease occurred during 2008. It is difficult to determine the precise cost of bovine respiratory disease (BRD) to the industry but it is reported to be greater than US$500 million per year. Data from our practice indicate that losses from BRD over the last 18 years have been characterized by 5-year cycles of decreases and increases. Perhaps it is time for the industry to look for ways to reduce death loss by methods that focus on the animal's response to the pathogens instead of continuing to focus on the pathogens.