Pichichero M E, Treanor J
Department of Microbiology and Immunology, University of Rochester Medical Center, NY, USA.
Arch Pediatr Adolesc Med. 1997 Jan;151(1):35-40. doi: 10.1001/archpedi.1997.02170380039006.
To assess the economic consequences of pertussis in Monroe County, New York (population, 713969), during a 6-year period (1989-1994).
Cases of pertussis were identified retrospectively by passive reporting and diagnosis based on culture, positive results of direct fluorescent antibody testing, or Centers for Disease Control and Prevention clinical criteria (cough for > 14 days otherwise unexplained or for > 7 days with paroxysms or whoop epidemiologically linked to a laboratory-confirmed case). One hundred seven (50%) of 216 subjects with identified cases of pertussis completed questionnaires and had medical records reviewed to ascertain the costs of illness, including physician office visits, laboratory tests, medications, hospitalization, emergency department visits, additional child care, and lost days from school (children) or from work (parents or adult cases).
Ninety-three (87%) of the pertussis case occurred in children. The average duration of illness before diagnosis was 21.3 days (range, 12-37 days). One hundred one patients (94%) saw a physician at least once; overall, the average number of visits per case was 3.2 (range, 1-15). Ninety-seven patients (91%) received at least 1 course of antibiotic therapy (average cost for all antibiotics, $95/case), and all took symptomatic treatment (average cost, $48/case). Fifteen patients (14%) required hospitalization; average cost per admission was $13425 (range, $1732-$69637). Thirty patients (28%) were seen in emergency departments; average cost was $202 (range, $69-$289). Additional child care costs ranged from $12 to $2688. For 50 families, 1 adult lost workdays because of illness or to provide child care for an average of 8.3 days (range, 1-45 days). For 4 families, 2 adults lost an average of 44 days from work (range, 10-120 days). The cumulative number of lost workdays was 758 in association with the 107 cases of pertussis. The average full recovery time from illness was 72.9 days (range, 25-115 days).
Total direct and indirect cost for 107 cases of pertussis in Monroe County was $381052. The economic burden of pertussis is substantial and encourages broader use of vaccination to prevent disease.
评估1989 - 1994年6年间纽约门罗县（人口713969）百日咳的经济后果。
通过被动报告回顾性确定百日咳病例，并根据培养结果、直接荧光抗体检测阳性结果或疾病控制与预防中心的临床标准（咳嗽超过14天且无其他解释，或伴有阵咳或鸡鸣样吼声超过7天且在流行病学上与实验室确诊病例相关）进行诊断。216例确诊百日咳病例中的107例（50%）完成了问卷调查，并对病历进行了审查，以确定疾病成本，包括医生门诊就诊、实验室检查、药物治疗、住院治疗、急诊就诊、额外的儿童护理以及儿童缺课天数（儿童）或父母或成年病例的误工天数（父母或成年病例）。
93例（87%）百日咳病例发生在儿童中。诊断前疾病的平均持续时间为21.3天（范围12 - 37天）。101例患者（94%）至少看了一次医生；总体而言，每例患者的平均就诊次数为3.2次（范围1 - 15次）。97例患者（91%）接受了至少1个疗程的抗生素治疗（所有抗生素的平均成本为95美元/例），并且所有患者都接受了对症治疗（平均成本为48美元/例）。15例患者（14%）需要住院治疗；每次住院的平均成本为13425美元（范围1732 - 69637美元）。30例患者（28%）在急诊科就诊；平均成本为202美元（范围69 - 289美元）。额外的儿童护理成本从12美元到2688美元不等。对于50个家庭，1名成年人因患病或照顾孩子而误工，平均误工8.3天（范围1 - 45天）。对于4个家庭，2名成年人平均误工44天（范围10 - 120天）。与107例百日咳病例相关的累计误工天数为758天。疾病的平均完全康复时间为72.9天（范围25 - 115天）。
门罗县107例百日咳病例的直接和间接总成本为381052美元。百日咳的经济负担巨大，这鼓励更广泛地使用疫苗来预防疾病。
