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May 3, 2012
TOPEKA Total costs of this year's measles outbreak in Garden City are being tallied by state and local officials and ultimately could be more than $100,000 per case.
Charles Hunt, state epidemiologist at the Kansas Department of Health and Environment, would not yet venture an estimate for the cost of the six cases confirmed in January in Finney County. However, he pointed to a recent estimate by the New England Journal of Medicine that put the average cost per case at $160,000 for investigation, follow-up and hospitalization.
"I would characterize the cost as substantial," Hunt said. "It's an all-hands-on-deck situation."
He said between 500 and 600 people in Finney County were suspected of having contact with the six persons known to be infected before they were quarantined. Health workers have worked to reach each of the hundreds of persons potentially exposed.
"Each one of those persons has to be contacted, assessed for their immunization status, determined whether they're at risk, whether or not they've been ill and so on," Hunt said.
Measles, 'every day, all day long'
That work was done by several KDHE officials and employees at the Finney County Health Department. Director Ashley Goss said for the first two weeks of the outbreak, staff worked cases for about 55 hours a week each.
"I would say an average of six staff worked on measles every day, all day long" for the first month, she said.
"But honestly it involved all of my staff. With the phone calls and everything else, at any given time it involved probably 20 staff members," Goss said. "That's all they did. Either in patients' houses, or following up on phone calls, or going to check on patients, talking to the doctors — that kind of thing."
She said an average total cost of $160,000 per person infected would not surprise her.
"The public health department would not foot all of that bill, but on the whole I can very easily see how it could get that high depending on how severe the complications were, how long hospital stays were, medications, machines used, things like that," Goss said.
At St. Catherine Hospital — where two of those infected were hospitalized — among the expenses incurred were 12 boosters at $20 each and a maximum of $4,700 in wages associated with measles care, said chief executive Victor Hawkins. Officials there were not able to provide a total cost of care.
Goss said the impact of the measles outbreak was more than financial. Women's health services and children's physicals at the health department were cut entirely for two weeks, and many services were scaled back while staff dealt in part with measles.
"We tried to maintain, just at a reduced level," she said.
At St. Catherine, two of 69 workers exposed to measles lacked immunization documentation and were kept out of the hospital for 21 days with pay.
Measles cases at 15-year high
In 2011, six measles cases were confirmed in Kansas, all in Johnson County. Before that, one case was confirmed in 2006.
Nationwide, there were more cases than in any of the last 15 years — 222 in 31 states, according to a recent report from the Centers for Disease Control and Prevention.
While measles has not been common in the U.S. since the 1970s, cases are still occasionally imported from other countries by travelers who are not vaccinated or have not developed immunity. KDHE officials confirm that is how the cases in Garden City were introduced, but would not disclose further details, citing patient privacy concerns.
State law requires parents to have their children immunized before enrolling them in public or private schools or licensed preschools or day care centers. The law exempts children who are medically fragile, home schooled or belong to a religious denomination that opposes immunization. This year, some Kansans lobbied legislators to expand the exemptions to include a parent’s personal beliefs.
About 90 percent of Kansans have been vaccinated for measles, compared to 91.5 percent nationwide, said Dr. Dennis Cooley, a member of the Kansas Immunization Advisory Committee.
"Most parents today have never seen a case of measles and they don't know measles can be serious and cause even death. I think the result is some don't know just how serious these diseases are," Cooley said.
In Finney County, the population was well-vaccinated, particularly those in schools, said KDHE's Hunt.
"We think that helped suppress additional transmission," he said.
Goss said she hopes the outbreak will change the minds of parents who have chosen not to vaccinate their children.
"I did talk to some parents who do not believe in vaccinating their children and they are very well aware of the measles outbreak that was going on," Goss said.
"If they firmly believe that they should not vaccinate their children, nothing will" change their minds, she said. "I hope that some people who were on the fence (will) now go ahead and vaccinate their kids."
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