The economic burden of sixteen measles outbreaks on United States public health departments in 2011
The economic burden of sixteen measles outbreaks on United States public health departments in 2011
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DOI：
10.1016/j.vaccine.2013.10.012
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发表时间：
2014-03-05
期刊：
影响因子：
5.5
通讯作者：
Wallace, Gregory S.
中科院分区：
文献类型：
--
作者：
Ortega-Sanchez, Ismael R.;Vijayaraghavan, Maya;Wallace, Gregory S.
背景资料：尽管在2000年开展了疫苗接种工作，并有文件证明消除了本土麻疹，但2011年美国麻疹的输入性病例和暴发显著增加。由于麻疹的高传染性和潜在的严重性，这些疫情需要公共卫生机构作出有力的反应。应对这些疫情所需的努力和资源可能会给这些机构带来巨大的经济负担。目的：估计麻疹疫情的经济负担（定义为≥ 3例流行病学相关病例）。方法：从地方和州公共卫生机构的角度来看，我们估计了地方和州公共卫生部门分配给麻疹暴发应对的人员时间和资源，并估算了2011年美国这些疾病爆发的相关成本。我们使用的成本和资源利用数据，从以前的研究麻疹疫情在美国，依靠爆发规模分类的基础上的病例日指数，我们估计所产生的费用由地方和州的公共卫生机构。结果：在2011年，美国经历了16次疫情，107例确诊病例。暴发的平均持续时间为22天（范围：5-68天）。已查明的麻疹病例接触者估计总数为8 936至17 450人，需要42 635至83 133个工时。总体而言，2011年期间处理麻疹疫情的地方和州公共卫生机构的总经济负担估计为270万美元至530万美元。结论：调查和应对麻疹疫情对地方和州卫生机构造成了重大经济负担。疫情持续时间和潜在易感接触者的数量加剧了这种影响。(C)2013作者由爱思唯尔有限公司出版。保留所有权利。
Background: Despite vaccination efforts and documentation of elimination of indigenous measles in 2000, the United States (US) experienced a marked increase in imported cases and outbreaks of measles in 2011. Due to the high infectiousness and potential severity of measles, these outbreaks require a vigorous response from public health institutions. The effort and resources required to respond to these outbreaks are likely to impose a significant economic burden on these institutions.Objective: To estimate the economic burden of measles outbreaks (defined as >= 3 epidemiologically linked cases) on the local and state public health institutions in the US in 2011.Methods: From the perspective of local and state public health institutions, we estimated personnel time and resources allocated to measles outbreak response in local and state public health departments, and estimated the corresponding costs associated with these outbreaks in the US in 2011. We used cost and resource utilization data from previous studies on measles outbreaks in the US and, relying on outbreak size classification based on a case-day index, we estimated costs incurred by local and state public health institutions.Results: In 2011, the US experienced 16 outbreaks with 107 confirmed cases. The average duration of an outbreak was 22 days (range: 5-68). The total estimated number of identified contacts to measles cases ranged from 8936 to 17,450, requiring from 42,635 to 83,133 personnel hours. Overall, the total economic burden on local and state public health institutions that dealt with measles outbreaks during 2011 ranged from an estimated $2.7 million to $5.3 million US dollars.Conclusion: Investigating and responding to measles outbreaks imposes a significant economic burden on local and state health institutions. Such impact is compounded by the duration of the outbreak and the number of potentially susceptible contacts. (C) 2013 The Authors. Published by Elsevier Ltd. All rights reserved.