Cost analysis of measles in refugees arriving at Los Angeles International Airport from Malaysia

Author/s:
Margaret Coleman, Heather Burke, Bethany Welstead, Tarissa Mitchell, Eboni Taylor, Dmitry Shapovalov, Brian Maskery, Heesoo Joo, Michelle Weinberg

Year:
2017

Language:
English

Publication Type:
Scientific reports (Journal)
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Description: 

ABSTRACT

  • Background: On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified.
  • Methods: We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia.
  • Results: State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases.
  • Conclusion: A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees’ health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs.
Publisher: 
Taylor and Francis group