The costs of containing measles within a health care service

Abstract

Objective: During a recent Melbourne-wide measles outbreak, we reviewed cases admitted to a single health service, to identify infection control measures implemented and to measure resources required to implement the recommendations to control measles in healthcare facilities. Here we analyse the economic impact of measles containment efforts in a single health service.

Design, participants and setting: All cases of measles identified in the service from 1 January–31 March 2009 were included. Contacts were individuals (staff, patients and relatives) who were present within the emergency departments at the same time as the case and for 2 h after the visit.

Results: Twelve episodes (17 confirmed individual cases) of measles were identified. The mean time before patients were placed into appropriate precautions was 19 h (range 0–72 h). The total number of people requiring follow-up was 871 (365 staff and 506 patients and relatives). More than 82 individuals required vaccination and immunoglobulin was administered to 11 patients. More than 150 h of personnel time were expended in containing this outbreak. Estimated costs, over and above the costs of hospitalisation of the cases, was $10 339. One case of nosocomial transmission of measles occurred.

Conclusions: Measles containment efforts in our health service are expensive. The key to decreasing cost is through early case recognition, prompt instigation of airborne precautions, maintaining near-total immunity among healthcare workers with an active staff vaccination program and increasing community awareness over the importance of vaccination.