Measles Outbreak Costs in Oregon

What a measles outbreak costs Oregon, using three real Oregon outbreak sizes and Oregon-specific vaccination coverage and wages.

Authors: George G. Vega Yon

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

About this model

What this estimates

What one measles outbreak costs Oregon, across three sizes Oregon has actually seen: an early 5-case cluster, the 31 cases of 2024, and the 45 cases confirmed so far in 2026.

Cost is split three ways:

1. Public health response - a fixed cost to stand up the response, plus staff time per case.
2. Lost work during quarantine - susceptible contacts sent home for 21 days.
3. Medical care - hospitalizations, clinic visits, and lab tests.

The lever that matters is MMR coverage among exposed contacts. Every immune contact is one fewer person in quarantine, so coverage scales the largest cost component directly.

Assumptions

• All costs in 2025-2026 USD, from a societal perspective.
• Contacts are traced and quarantined at the same rate for every case.
• A lost workday is valued at 8 hours of the Oregon average wage.
• Long-term costs (SSPE, deaths, lost school days) are not counted, so these are conservative.

Sources

• Oregon Health Authority, student immunization rates, May 2026.
• Oregon Health Authority measles case counts (31 in 2024; 45 as of Aug 13, 2026).
• Pike et al. (2021), Societal Costs of a Measles Outbreak, Pediatrics 147(4).
• Johns Hopkins IVAC, Vaccine (2025), review of U.S. measles outbreak costs, 2000-2025.
• CDC measles surveillance, 2026 year to date.
• U.S. Bureau of Labor Statistics OEWS, May 2025; Oregon Employment Department, 2025.

Parameters

Outbreak spread

Parameter	Default	Unit	Range or choices	Sources
MMR coverage among exposed contacts mmr_coverage Share of exposed contacts already immune. Only the remaining susceptible contacts are quarantined, so this is the single biggest lever in the model.	0.9	proportion	0 to 1	Oregon Health Authority (May 2026): 90.2% of Oregon K-12 students are up to date on required vaccines; only 85.6% of kindergartners are, and 36% of Oregon schools fall below the 93% MMR threshold.
Exposed contacts per case contacts_per_case Average number of exposed people public health must identify and follow up per confirmed case.	58	contacts	0 to 500	Pike et al. (2021), Pediatrics 147(4): the Clark County, WA outbreak traced roughly 4,200 contacts across 72 cases.

Public health response

Parameter	Default	Unit	Range or choices	Sources
Fixed cost of standing up a response fixed_response_cost One-time cost of activating an outbreak response (incident command, communications, clinic and lab surge) regardless of how many cases follow.	297,747	USD	0 to 2,000,000	Johns Hopkins IVAC / Vaccine (2025). Review of 27 U.S. measles outbreak cost studies, 2000-2025.
Public health staff hours per case staff_hours_per_case Investigation, contact tracing, and quarantine monitoring hours per confirmed case.	176	hours	0 to 1,000	Clark County Public Health: 12,684 staff hours across 72 cases in the 2018-2019 outbreak (local staff only; state, CDC, and volunteer hours are additional).
Hourly wage, public health responder hourly_wage_ph_staff Loaded hourly wage for the epidemiologists and communicable disease nurses running the response.	47.06	USD/hour	0 to 200	U.S. Bureau of Labor Statistics, OEWS May 2025: epidemiologists (19-1041), mean hourly wage $47.06.

Quarantine and lost work

Parameter	Default	Unit	Range or choices	Sources
Quarantine length quarantine_days Days a susceptible contact must stay home after exposure.	21	days	0 to 30	CDC guidance: 21 days from last exposure.
Fraction of quarantine days that are workdays workday_fraction Five workdays in seven.	0.714	proportion	0 to 1
Share of quarantined contacts costing a workday share_costing_a_workday Fraction of quarantined contacts whose quarantine costs someone a day of paid work, either their own or a caregiver's. Most quarantined contacts in Oregon outbreaks are school-age children, so this captures parents who must stay home.	0.6	proportion	0 to 1
Hourly wage, Oregon worker hourly_wage_worker Average Oregon hourly wage used to value a lost workday (8 hours).	34.6	USD/hour	0 to 200	Oregon Employment Department / QualityInfo (2025): statewide all-occupations average of $71,964 per year, or $34.60 per hour.

Medical care

Parameter	Default	Unit	Range or choices	Sources
Share of cases hospitalized proportion_hospitalized Fraction of confirmed cases admitted to hospital.	0.07	proportion	0 to 1	CDC measles surveillance, 2026 year to date: 7% of 2,465 confirmed U.S. cases hospitalized (11% in 2025).
Cost per hospitalization cost_hospitalization Average direct medical cost of one hospitalized measles case.	34,000	USD	0 to 500,000	New Mexico 2025 outbreak: $238,000 in charges across 7 hospitalizations.
Outpatient and lab cost per case cost_outpatient_per_case Clinic visits and confirmatory laboratory testing per confirmed case.	520	USD	0 to 10,000	New Mexico 2025 outbreak: $32,000 in outpatient visits and $20,000 in laboratory tests across 100 cases.

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
Confirmed cases n_cases Number of confirmed measles cases in the outbreak.	31	cases	1 to 5,000

Scenarios

Scenario	Confirmed cases
5 cases (early cluster) cluster_5	5
31 cases (Oregon 2024) outbreak_31	31
45 cases (Oregon 2026 YTD) outbreak_45	45

Presets

Preset	Changes
Oregon kindergarten coverage (85.6%) kindergarten	mmr_coverage = 0.856 contacts_per_case = 89
At the 93% MMR threshold herd_immunity	mmr_coverage = 0.93
Under-vaccinated school cluster (75%) undervaccinated_school	mmr_coverage = 0.75 contacts_per_case = 100

Equations

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

Contacts traced (people) eq_contacts

round(n_cases * contacts_per_case)

Susceptible contacts quarantined (people) eq_quarantined

round(eq_contacts * (1 - mmr_coverage))

Public health response (USD) eq_response

fixed_response_cost + n_cases * staff_hours_per_case * hourly_wage_ph_staff

Lost work during quarantine (USD) eq_quarantine_loss

eq_quarantined * quarantine_days * workday_fraction * share_costing_a_workday * hourly_wage_worker * 8

Medical care (USD) eq_medical

n_cases * (proportion_hospitalized * cost_hospitalization + cost_outpatient_per_case)

Total cost (USD) eq_total

eq_response + eq_quarantine_loss + eq_medical

Cost per case (USD) eq_cost_per_case

eq_total / n_cases