Measles Outbreak Cost Estimation

Estimates hospitalization, tracing, and productivity costs for measles outbreaks across three outbreak-size scenarios.

Authors: Edward Wang, Olivia Banks, George G. Vega Yon, Richard Nelson

Model id: measles. Open it in the app with ?model=measles; see Sharing links.

About this model

Overview

This calculator estimates the economic burden of measles outbreaks by modeling three key cost components: direct medical costs (hospitalization), indirect costs (lost productivity from quarantine), and public health response costs (contact tracing).

Scenarios

The model evaluates three outbreak scenarios based on historical U.S. measles outbreaks:

• 22 Cases: Small outbreak (typical in high-vaccination areas)
• 100 Cases: Medium outbreak
• 803 Cases: Large outbreak (similar to 2019 U.S. outbreak)

Key Assumptions

• All costs are in USD
• Hospitalization rate and costs based on CDC surveillance data
• Contact tracing effort scales linearly with case count
• Lost productivity only counts quarantined unvaccinated contacts
• Wage figures represent average hourly earnings

Parameters

Medical Costs

Parameter	Default	Unit	Range or choices	Sources
Cost of measles hospitalization cost_measles_hospitalization Average direct medical cost per hospitalized measles case, including hospital stay, treatments, and complications.	31,168	USD	0 to 500,000	Ortega-Sanchez et al. (2014). Economics of an outbreak: Cost of measles. Vaccine, 32(34).
Proportion of cases hospitalized proportion_hospitalized Fraction of confirmed measles cases requiring hospital admission.	0.2	proportion	0 to 1	CDC Measles surveillance data (2018-2019).

Lost Productivity

Parameter	Default	Unit	Range or choices	Sources
Proportion of quarantine days that would be a missed day of work proportion_missed_workdays Fraction of quarantine period that falls on workdays (accounting for weekends and non-working contacts).	0.5	proportion	0 to 1
Hourly wage for worker hourly_wage_worker Average hourly wage for calculating lost productivity during quarantine.	29.36	USD/hour	0 to 500	U.S. Bureau of Labor Statistics (2024).
Length of quarantine (days) quarantine_days Number of days unvaccinated contacts must quarantine to prevent disease spread.	21	days	0 to 30	CDC Measles quarantine guidelines (21 days from last exposure).
Vaccination rate in community vaccination_rate Proportion of population with measles immunity (through vaccination or prior infection). Only unvaccinated contacts require quarantine.	0.8	proportion	0 to 1	CDC National Immunization Survey (2023).

Contact Tracing

Parameter	Default	Unit	Range or choices	Sources
Number of contacts per case contacts_per_case Average number of close contacts identified per confirmed measles case.	141.5	contacts	0 to 500	Parker et al. (2006). Implications of a 2005 measles outbreak in Indiana for sustained elimination. NEJM.
Hours of contact tracing per contact hours_contact_tracing_per_contact Staff time required to identify, notify, and monitor each contact.	0.832	hours	0 to 40	CDC Contact Tracing Guidelines for Measles.
Hourly wage for contract tracer hourly_wage_contract_tracer Hourly wage for public health contact tracers.	40	USD/hour	0 to 200	Bureau of Labor Statistics median for epidemiologists/health educators (2024).

Set per scenario

Each scenario supplies its own value for these; the default applies to scenarios added in the app.

Parameter	Default	Unit	Range or choices	Sources
Number of cases n_cases Number of detected measles cases in the outbreak.	22	cases	1 to 10,000

Scenarios

Scenario	Number of cases
22 Cases 22_cases	22
100 Cases 100_cases	100
803 Cases 803_cases	803

Presets

Preset	Changes
School or daycare setting school_daycare	contacts_per_case = 89 vaccination_rate = 0.95 proportion_hospitalized = 0.18
Healthcare facility exposure healthcare_facility	contacts_per_case = 200 vaccination_rate = 0.9 proportion_hospitalized = 0.35
Low-resource setting low_resource	contacts_per_case = 110 vaccination_rate = 0.68 cost_measles_hospitalization = 2,400 hourly_wage_worker = 4.5 hourly_wage_contract_tracer = 6

Equations

Evaluated in order; each can use the parameters and any equation above it.

Hospitalization cost (USD) eq_hosp

n_cases * proportion_hospitalized * cost_measles_hospitalization

Lost productivity (USD) eq_lost_prod

n_cases * contacts_per_case * (1 - vaccination_rate) * quarantine_days * proportion_missed_workdays * hourly_wage_worker

Contact tracing cost (USD) eq_tracing

n_cases * contacts_per_case * hours_contact_tracing_per_contact * hourly_wage_contract_tracer

Total cost (USD) eq_total

eq_hosp + eq_lost_prod + eq_tracing