Lee Bruce Y, Alfaro-Murillo Jorge A, Parpia Alyssa S, Asti Lindsey, Wedlock Patrick T, Hotez Peter J, Galvani Alison P
Public Health Computational and Operations Research (PHICOR) and Global Obesity Prevention Center (GOPC), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America.
PLoS Negl Trop Dis. 2017 Apr 27;11(4):e0005531. doi: 10.1371/journal.pntd.0005531. eCollection 2017 Apr.
As the Zika virus epidemic continues to spread internationally, countries such as the United States must determine how much to invest in prevention, control, and response. Fundamental to these decisions is quantifying the potential economic burden of Zika under different scenarios.
METHODOLOGY/PRINCIPLE FINDINGS: To inform such decision making, our team developed a computational model to forecast the potential economic burden of Zika across six states in the US (Alabama, Florida, Georgia, Louisiana, Mississippi, and Texas) which are at greatest risk of Zika emergence, under a wide range of attack rates, scenarios and circumstances. In order to accommodate a wide range of possibilities, different scenarios explored the effects of varying the attack rate from 0.01% to 10%. Across the six states, an attack rate of 0.01% is estimated to cost $183.4 million to society ($117.1 million in direct medical costs and $66.3 million in productivity losses), 0.025% would result in $198.6 million ($119.4 million and $79.2 million), 0.10% would result in $274.6 million ($130.8 million and $143.8 million) and 1% would result in $1.2 billion ($268.0 million and $919.2 million).
Our model and study show how direct medical costs, Medicaid costs, productivity losses, and total costs to society may vary with different attack rates across the six states and the circumstances at which they may exceed certain thresholds (e.g., Zika prevention and control funding allocations that are being debated by the US government). A Zika attack rate of 0.3% across the six states at greatest risk of Zika infection, would result in total costs that exceed $0.5 billion, an attack rate of 1% would exceed $1 billion, and an attack rate of 2% would exceed $2 billion.
随着寨卡病毒疫情在国际上持续蔓延，美国等国家必须确定在预防、控制和应对方面投入多少资金。这些决策的基础是量化不同情况下寨卡病毒潜在的经济负担。
方法/主要发现：为了为此类决策提供信息，我们的团队开发了一个计算模型，以预测在美国六个寨卡病毒出现风险最高的州（阿拉巴马州、佛罗里达州、佐治亚州、路易斯安那州、密西西比州和得克萨斯州），在广泛的感染率、情况和情形下，寨卡病毒潜在的经济负担。为了适应各种可能性，不同的情形探讨了将感染率从0.01%变化到10%的影响。在这六个州中，估计感染率为0.01%时，社会成本为1.834亿美元（直接医疗成本1.171亿美元，生产力损失6630万美元），0.025%将导致1.986亿美元（1.194亿美元和7920万美元），0.10%将导致2.746亿美元（1.308亿美元和1.438亿美元），1%将导致12亿美元（2.68亿美元和9.192亿美元）。
我们的模型和研究表明，六个州的直接医疗成本、医疗补助成本、生产力损失以及社会总成本如何随不同的感染率以及它们可能超过某些阈值的情形而变化（例如，美国政府正在辩论的寨卡病毒预防和控制资金分配）。在六个寨卡病毒感染风险最高的州中，感染率为0.3%将导致总成本超过5亿美元，1%的感染率将超过10亿美元，2%的感染率将超过20亿美元。
