The Cost of Public Health? Priceless.
Sep 09, 2011

This year, we’ve seen an alarming rise in measles cases in the US compared to years past.
When I see an alert go out to the public regarding an outbreak, I’m always fascinated that it details the exact location where people may have been exposed.  Measles cases happen more frequently that most people may be aware.  Take for instance, last month’s case of an infected Amtrak train passenger who traveled from VA to Boston.  Or the case earlier in the year, of an unimmunized women who contracted measles prior to traveling through four different airports during her two-day return from London.  And then there’s the case of a French consulate worker in Boston, who exposed coworkers, mass transit passengers and even others in her apartment complex.  Maybe you are familiar with these.  Maybe not.
In the case of measles, an official alert is critical because the highly contagious airborne virus can live on infected surfaces for up to 2 hours.  The CDC explains that “if one person has it, 90% of the people close to that person who are not immune will also become infected”.   And what makes containing measles so challenging is that it can be spread to others from four days before, to four days after, the rash appears.   This is why it requires such a concentrated effort on the part of doctors and public health employees  to contain the spread of diseases such as measles.  And often these efforts are completed without any acknowledgment from the general public.
For instance, just this week state health officials are crediting an emergency room physician with helping to contain a measles outbreak in Indiana by correctly diagnosing five family members.  There is no doubt that without proper identification of this contagious disease on the part of the physician, there would not be an adequate and timely response to contain the virus, which could ultimately have resulted in more people falling ill.  In this case, the five family members that were diagnosed with measles could have easily gone on to infect many others.
However, with the success of vaccines, there is a concern that many doctors haven’t seen cases of vaccine-preventable diseases very often, making them a bit more challenging to diagnose.  Patients obviously rely on doctors to make accurate diagnosis.  However, the public at large also relies on our doctors.  Their expertise is critical to preserving public health.
But doctors aren’t the only ones working to protect us.  After the disease is identified, public health employees become intimately involved.  This is when the balls really
starts to roll, the clock starts to tick and the money begins to flow.  People are interviewed, blood tests are taken, immunization clinics are set up, and so much more.  Perhaps the public health employees that read this blog would like to highlight all the swift action that is taken to contain a disease in the comments below.
But of course, there is no denying, that all this time and effort takes money – money that is often being cut from public health funding. Take for instance the numbers detailed in The Journal Gazette earlier this week.

  • A single case of measles in 2004, originating in an unvaccinated traveler, set Iowa’s public health infrastructure back by more than $140,000 in 2004.
  • Indiana’s 2005 outbreak, the largest documented incidence of measles in the United States since 1996, cost the state nearly $170,000 in total, according to the New England Journal of Medicine.

Certainly the list goes on…
While the Indiana state health system has not put a price tag on their recent measles outbreaks, many would argue that their efforts are simply “priceless”.
So while we applaud medical professionals and public health employees for doing what they can to maintain our public health in this country, I would like to suggest that we consider also advocating for the economic value of vaccines.  At a time when the government is calling for us to tighten our government belts, we should consider that the cost of disease prevention could also be reduced by an investment in vaccines.  Isn’t it better to invest in prevention rather than pay for containment?  There are children, and even adults, who go unimmunized because of identified barriers to immunization.  What can we do to address these concerns?
I’d like to hear everyone’s opinions on this, but I am particularly interested in hearing from public health employees.  You are the eyes on the inside of this issue.   What are your thoughts?

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3 responses to “The Cost of Public Health? Priceless.”

  1. Vaccines are still the best prevention against deadly disease and the most cost effective of our century. Wow can’t wait to get to that airport again…:)

  2. Darwy says:

    An ounce (or an injection) of prevention is worth a pound of cure. It is ALWAYS better to be pro-active rather than reactive.

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