Public Health Consequences of a 2013 Measles Outbreak in New York City

Abstract

IMPORTANCE Internationally imported cases of measles into the United States can lead to outbreaks requiring extensive and rapid control measures. Importation of measles from an unvaccinated adolescent in 2013 led to what has been the largest outbreak of measles in New York City, New York, since 1992. OBJECTIVE To describe the epidemiology and public health burden in terms of resources and cost of the 2013 measles outbreak in New York City. DESIGN, SETTING, AND PARTICIPANTS This epidemiologic assessment and cost analysis conducted between August 15, 2013, and August 5, 2014, examined all outbreak-associated cases of measles among persons residing in New York City in 2013. EXPOSURES Measles virus.MAIN OUTCOMES AND MEASURES Numbers of measles cases and contacts. Total personnel time and total direct cost to the New York City Department of Health and Mental Hygiene (DOHMH), calculated as the sum of inputs (supplies and materials, equipment, and logistics) and personnel time (salary and fringe benefits).

Vaccine confidence: the keys to restoring trust

“…80 The unnecessary economic burden for society caused by low vaccine confidence was clearly shown by evaluating the economic burden of several past measles outbreaks. [93][94][95][96][97] In 2011, the US experienced 16 measles outbreaks and the total economic burden on public health institutions was estimated to be in the range of USD 2.7-5.3 million. 98 In 2008, a measles outbreak in San Diego, that originated from an intentionally unvaccinated seven-year-old boy, cost the community nearly USD 177,000, which included medical care provision to the confirmed cases, tracking of suspected cases, quarantining people, enhancing surveillance, and following up an infected infant and related contacts in Hawaii.…”

Measles outbreaks in Italy: A paradigm of the re-emergence of vaccine-preventable diseases in developed countries

“…Suboptimal vaccination coverage was identified as the key causative factor, with 87% of the affected individuals being unvaccinated. Similarly, a recent epidemiologic assessment of the 2013 measles outbreak in New York City indicated that 78% of the infected individuals were "unvaccinated owing to parental refusal or intentional delay" (2). The direct cost of the outbreak to the New York City Department of Health and Mental Hygiene was estimated as $394,448 and a total of 10,054 working hours.…”

Transmission Dynamics of and Insights from the 2018-2019 Measles Outbreak in New York City: A Modeling Study

“…Without the implemented vaccination campaigns, the severity of the measles outbreak-including number of infections, hospitalizations, and severe infections needing intensive care-would be about 10 times worse than observed ( Table 2). These estimates, however, did not include the long-term health impacts on affected individuals, particularly young children (10,19,20), nor the enormous economic burdens (13,21,22).…”