In JAMA Network Open yesterday, scientists from the Centers for Disease Control and Prevention (CDC) and Illinois public health agencies estimated the cost of a 2024 measles outbreak in two Chicago shelters for unhoused people newly arrived in the country at $8.7 million.

The economic evaluation tallied the costs of the outbreak, which took place from March 7 to April 30, in terms of the public-health response, direct medical expenses, and productivity losses in patients in isolation or quarantine and those caring for children who missed school or daycare due to isolation.

“Measles outbreak responses are highly intensive, requiring rapid case identification and isolation and contact management,” the authors wrote.

In total, 57 people, including 30 women (median age, 3 years) contracted measles amid the outbreak, and authorities traced 3,569 contacts (median age, 17 years). The estimated societal cost was $8.7 million, or $152,636 per measles case.

Public-health response costs totaled $1.8 million in personnel costs, $1.4 million in vaccination expenses, $200,489 for lab testing costs, $104,263 for transportation, and $63,023 in other material costs. 

Though the outbreak placed a considerable cost burden on both public health and health care systems, rapid disease identification and mass vaccination among shelter residents prevented a more costly and larger outbreak.

Direct medical costs tallied $4.4 million, mostly from hospitalizations, and estimated productivity losses were $683,895, with 17,113 lost school days. Total health-sector and payer costs, including public health response and direct medical costs, were $8 million ($140,638 per case, and $2,246 per shelter contact).

“This outbreak response was one of the most expensive in the measles postelimination era due to the large costs associated with vaccination and isolation and quarantine in hospitals,” the authors wrote. “Though the outbreak placed a considerable cost burden on both public health and health care systems, rapid disease identification and mass vaccination among shelter residents prevented a more costly and larger outbreak.” 

“Strategies to reduce disease transmission and costs during outbreaks among undervaccinated populations living in congregate settings may include funding non–health care isolation and quarantine spaces and vaccinating new shelter residents on arrival,” the researchers concluded.

The Ebola outbreak in the Democratic Republic of Congo (DRC) continues to infect those in Ituri province at an alarming rate, according to a new report published by the European Centre for Disease Prevention and Control (ECDC) yesterday. According to the report, the DRC has 7,773 confirmed cases, including 3,759 deaths, with 40 new confirmed cases and 27 deaths reported during a 48-hour period earlier this week. 

“Ituri province remains the most affected, with 5,966 cases, including 2,737 deaths, reported from 28 of 36 health zones,” the ECDC wrote. “In total, 84.5% of identified case contacts are under follow-up in the affected provinces.”

Without a high rate of case contact follow-up, the outbreak will continue to ravage the region, experts have warned, with new, unknown transmission chains accounting for new cases. 

Today the World Health Organization (WHO) published an account of a family’s resistance to safe burial techniques in the DRC, with the family refusing a safe and dignified burial for more than 24 hours because they did not want a body bag used.

Experts in risk communication and community engagement were called in, and eventually a safe burial took place. The WHO said acts of community engagement and education are the best tools currently used to stop this outbreak.