The economic cost of measles: Healthcare, public health and societal costs of the 2012–13 outbreak in Merseyside, UK

Ghebrehewet, Sam; Thorrington, Dominic; Farmer, Siobhan; Kearney, James; Blissett, Deidre; McLeod, Hugh; Keenan, A.

doi:10.1016/j.vaccine.2016.02.029

Cited by 29 publications

(20 citation statements)

References 19 publications

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“…Conversely, close countermeasures might not be necessary when an M-Me case was judged as presenting low infectiousness. Earlier studies have shown that approximately 40% of economic costs related to measles outbreaks are public health costs [23, 24]. Field epidemiological investigation using results of genetic tests enables public health officials to administer focused countermeasures, which can ultimately reduce economic costs related to measles outbreaks.…”

Section: Discussionmentioning

confidence: 99%

Detection of modified measles and super-spreader using a real-time reverse transcription PCR in the largest measles outbreak, Yamagata, Japan, 2017 in its elimination era

et al. 2018

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We aimed to verify the effectiveness of real-time reverse transcription (rRT) polymerase chain reaction (PCR) for detecting cases of modified measles (M-Me) and for predicting super-spreader candidates through the experience of a measles outbreak dominated by M-Me in Yamagata, Japan, during March-April 2017. We applied rRT-PCR to specimens from 35 cases of M-Me, nine cases of typical measles (T-Me) and nine cases of prodromal stage of T-Me (P-Me). From rRT-PCR among the M-Me cases, peripheral blood mononuclear cells (PBMC) showed the highest positive rate (80.0%), followed by throat swab (48.6%), urine (33.3%) and serum (3.1%). The negative result of PBMC in M-Me cases was recovered by the result of a throat swab. In specimens of PBMC, throat swab and urine, M-Me group showed the significantly higher cycle of threshold (i.e., lower viral load) in the rRT-PCR than T-Me and P-Me groups, respectively. Furthermore, three super-spreaders in T-Me or P-Me showed an extremely low cycle of threshold in their throat swab specimens. rRT-PCR using PBMC and throat swab might be helpful for clinical management and measles control by certain detection of M-Me cases and by predicting super-spreading events resulting from measles cases with the high viral load.

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Section: Discussionmentioning

confidence: 99%

Detection of modified measles and super-spreader using a real-time reverse transcription PCR in the largest measles outbreak, Yamagata, Japan, 2017 in its elimination era

et al. 2018

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“…The economic consequences of measles vaccine hesitancy can be significant [e.g., see predictions of (163)]. Furthermore, a retrospective modeling analysis following the 2012-2013 outbreak in Merseyside, UK established that this outbreak could have been averted with 11,793 vaccines (182,909 pounds) instead of costing 4.4 million pounds due to infections (164). In addition, there are serious public health risks associated with vaccine hesitancy, including substantially more infections (163) and infection risk for those that refuse vaccines [e.g., for measles risk pertaining to exemptions in children, see (165)].…”

Section: Case Study: Measlesmentioning

confidence: 99%

Economic and Behavioral Influencers of Vaccination and Antimicrobial Use

Wagner

Prentice

Saad-Roy

et al. 2020

Front. Public Health

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Despite vast improvements in global vaccination coverage during the last decade, there is a growing trend in vaccine hesitancy and/or refusal globally. This has implications for the acceptance and coverage of a potential vaccine against COVID-19. In the United States, the number of children exempt from vaccination for “philosophical belief-based” non-medical reasons increased in 12 of the 18 states that allowed this policy from 2009 to 2017 (1). Meanwhile, the overuse and misuse of antibiotics, especially in young children, have led to increasing rates of drug resistance that threaten our ability to treat infectious diseases. Vaccine hesitancy and antibiotic overuse exist side-by-side in the same population of young children, and it is unclear why one modality (antibiotics) is universally seen as safe and effective, while the other (vaccines) is seen as potentially hazardous by some. In this review, we consider the drivers shaping the use of vaccines and antibiotics in the context of three factors: individual incentives, risk perceptions, and social norms and group dynamics. We illustrate how these factors contribute to the societal and individual costs of vaccine underuse and antimicrobial overuse. Ultimately, we seek to understand these factors that are at the nexus of infectious disease epidemiology and social science to inform policy-making.

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“…The total cost of the Liverpool measles outbreak was estimated to be £4.4 million, whereas the cost of providing all missing MMR vaccinations over the 5 years prior to the outbreak would have been ∼4% of the cost of the outbreak. 28 Therefore, commissioners and policymakers need to urgently consider the need for robust and well-resourced vaccination programmes to improve vaccination uptake rates in order to consistently achieve herd protection across all settings and population groups.…”

Section: Implications For Policymakers/immunisation Commissionersmentioning

confidence: 99%

Measles outbreaks in the UK, is it when and where, rather than if? A database cohort study of childhood population susceptibility in Liverpool, UK

et al. 2017

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ObjectivesThere was a large outbreak of measles in Liverpool, UK, in 2012–2013, despite measles, mumps and rubella (MMR) immunisation uptake rates that were higher than the national average. We estimated measles susceptibility of a cohort of children born in Liverpool between 1995 and 2012 to understand whether there was a change in susceptibility before and after the outbreak and to inform vaccination strategy.DesignRetrospective cohort study.SettingThe city of Liverpool, North West UK.ParticipantsAll children born in Liverpool (72 101) between 1995 and 2012 inclusive who were identified using the Child Health Information System (CHIS) and were still resident within Liverpool in 2014.Primary and secondary outcome measuresWe estimated cohort age-disaggregated and neighbourhood-disaggregated measles susceptibility according to WHO thresholds before and after the outbreak for children aged 1–17 years.ResultsSusceptibility to measles was above WHO elimination thresholds before and after the measles outbreak in the 10+ age group. The proportion of children susceptible before and after outbreak, respectively: age 1–4 years 15.0% before and 14.9% after; age 5–9 years 9.9% before and 7.7% after; age 10+ years 8.6% before and 8.5% after. Despite an intensive MMR immunisation catch-up campaign after the 2012–2013 measles outbreak, the overall proportion of children with no MMR remains high at 6.1% (4390/72 351). Across all age groups and before and after the outbreak, measles susceptibility was clustered by neighbourhood, with deprived areas having the greatest proportion of susceptible children.ConclusionsThe risk of sustained measles outbreaks remains, especially as large pools of susceptible older children will start leaving secondary education and continue to aggregate in higher education, employment and other community settings and institutions resulting in the potential for a propagated measles outbreak.

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The economic cost of measles: Healthcare, public health and societal costs of the 2012–13 outbreak in Merseyside, UK

Cited by 29 publications

References 19 publications

Detection of modified measles and super-spreader using a real-time reverse transcription PCR in the largest measles outbreak, Yamagata, Japan, 2017 in its elimination era

Detection of modified measles and super-spreader using a real-time reverse transcription PCR in the largest measles outbreak, Yamagata, Japan, 2017 in its elimination era

Economic and Behavioral Influencers of Vaccination and Antimicrobial Use

Measles outbreaks in the UK, is it when and where, rather than if? A database cohort study of childhood population susceptibility in Liverpool, UK

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