Key Evidence: A large meningococcal meningitis epidemic in Burkina Faso cost the health system an estimated US$7.1 million, representing nearly 2% of the country’s entire annual health budget.
From the VoICE editors: In this study of a 2007 outbreak, 86% of the health system cost covered a reactive vaccination campaign using older polysaccharide vaccines. Routine vaccination with new, conjugate vaccines are expected to prevent or limit future outbreaks and thus reduce these costs.
Key Evidence: A large measles outbreak in the Netherlands in 2013-14 resulted in 2700 cases of disease and cost an estimated US$4.7 million — or US$1,739 per case. Costs included outbreak response (including vaccination and enhanced surveillance), the cost of treatment (primarily hospitalizations), and the loss of productivity among caregivers ($365,000, less than 8% of total costs). Due to the likely under-reporting of the disease, the actual costs could be nearly 20% greater ($5.6 million).
Key Evidence: Two meningococcal meningitis outbreaks in Brazil resulted in US$128,000 (9 cases, 2007) and US$34,000 (3 cases, 2011) in direct costs to the health system to investigate cases and manage the outbreak (including emergency vaccination). The investigation and response activities related to the 2011 outbreak alone cost $11,475 per case, and an additional $6,600 overall for supplemental disease surveillance activities.
Key Evidence: According to the World Bank, the economic impact of the 2014-15 Ebola epidemic outlasted the epidemiological impact of outbreak, resulting in estimated losses of US$2.8 billion in Guinea, Liberia, and Sierra Leone (or 16% of their combined GDP).
Key Evidence: The US state of Iowa incurred more than US$140,000 in direct costs of outbreak containment stemming from a single case of measles in an unvaccinated student infected overseas. Swift containment procedure limited the outbreak to 3 additional cases but included significant and costly steps including tracking down contacts of the infected student, establishing a measles information hotline, testing exposed medical staff for immunity, conducting measles vaccination clinics, and putting quarantines into effect.
From the VoICE editors: Although even small outbreaks of highly contagious diseases can be exceedingly costly to contain, the value of containment to society is very high. Traditional economic evaluations of outbreaks which include just the costs of illness to individuals should be expanded to include the costs and value of containing the outbreak required to protect society.
Key Evidence: In a comprehensive accounting of the costs of the 2014 Ebola outbreak in West Africa, Huber et al. estimate the economic and social costs to have been US$53 billion, of which US$18.8 billion was attributed to non-Ebola deaths.