title: Direct costs of a single case of refugee-imported measles in Kentucky.
abstract: BACKGROUND
  Refugees are highly vulnerable populations with limited access to health care services. The United States accepts 50,000-75,000 refugees for resettlement annually. Despite residing in camps and other locations where vaccine-preventable disease outbreaks, such as measles, occur frequently, refugees are not required to have any vaccinations before they arrive in the United States.
  
  
  OBJECTIVE
  We estimated the medical and public-health response costs of a case of measles imported into Kentucky by a refugee.
  
  
  METHODS
  The Kentucky Refugee Health Coordinator recorded the time and labor of local, state, and some federal personnel involved in caring for the refugee and implementing the public health response activities. Secondary sources were used to estimate the labor and medical care costs of the event.
  
  
  RESULTS
  The total costs to conduct the response to the disease event were approximately $25,000. All costs were incurred by government, either public health department or federal, because refugee health costs are paid by the federal government and the event response costs are covered by the public health department.
  
  
  CONCLUSIONS
  A potentially preventable case of measles that was imported into the United States cost approximately $25,000 for the public health response.
  
  
  CONCLUSIONS
  To maintain the elimination of measles transmission in the United States, U.S.-bound refugees should be vaccinated overseas. A refugee vaccination program administered during the overseas health assessment has the potential to reduce the risk of importation of measles and other vaccine-preventable disease and would eliminate costs associated with public health response to imported cases and outbreaks.
authors.affiliation: Centers for Disease Control and Prevention, Division of Global Migration and Quarantine, MS E-03, 1600 Clifton Road, Atlanta, GA 30333, USA. mcoleman@cdc.gov
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Coleman
authors.forename: Luta
authors.initials: L
authors.lastname: Garbat-Welch
authors.forename: Heather
authors.initials: H
authors.lastname: Burke
authors.forename: Michelle
authors.initials: M
authors.lastname: Weinberg
authors.forename: Kraig
authors.initials: K
authors.lastname: Humbaugh
authors.forename: Alicia
authors.initials: A
authors.lastname: Tindall
authors.forename: Janie
authors.initials: J
authors.lastname: Cambron
mesh_terms: D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007629:Kentucky; D008457:Measles / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D012036:Refugees