Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. This retrospective study estimates the overall cost to society of the 2019 Clark County, WA measles outbreak to be nearly $3.4 million, as a consequence of the public health response, direct medical costs, and productivity losses.

2. These results highlight the economic impact and societal reach of under-vaccination.

Evidence Rating Level: 2 (Good)

Study Rundown:

As sporadic measles outbreaks occur in the United States, public health agencies from the local to federal levels are mobilized, leading to considerable expenditures that are required to contain and mitigate viral spread. This study aimed to quantify the economic impact of a recent outbreak in Clark County (WA) and examined costs associated with the public health response, direct medical costs, and productivity losses. Data was culled from administrative record summaries from accounting departments related to the responding agencies, insurance claim databases, and estimates of productivity based on age and sex. Adjusted estimates for the overall cost of the studied Clark County measles outbreak amount to $3.4 million, or $47,479 per case. Previous studies on the subject largely focused only on costs related to public health efforts to control outbreaks, while this study more comprehensively considered direct medical costs and productivity losses. Although the cost estimate was limited by inability to include certain expenditures, and methods for cost accounting varied by institution, this study comprehensively highlights the economic burden of measles outbreaks. This information may help policymakers better allocate funds for epidemic response and recovery in the future.

In-Depth [retrospective cohort]:

Of the estimated $3.4 million in costs ($47,479/case, or $814/contact) incurred due to the 2019 measles outbreak in Clark County, about two-thirds was attributed to the public health response to mitigate the outbreak ($2.3 million), with loss of productivity amounting to nearly $1.0 million, and direct medical costs totaling $76,000. Public health considerations included personnel labor, response and quarantine materials, and contracted services (administration, nurses, interpreters). Productivity loss (e.g. lost employment and caregiving) was most directly a result of mandated quarantine for exposed individuals over the age of 15, and was stratified by age and sex (patients under 15 were assumed to have zero loss of productivity). Direct medical costs are associated with hospital and outpatient visits, drug costs, and laboratory testing. Sensitivity analyses were performed by considering the upper and lower bounds of variations within each of the study criteria, and varying caregiver to quarantined children ratios assumption from 1:2 and 1:4.

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