title: Economic Evaluation of Fungal Meningitis Outbreak Response in New River Valley: Local Health Department Perspective.
abstract: BACKGROUND
  The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was injection of contaminated lots of methylprednisolone acetate used in epidural spinal injections. Roanoke and New River Valley were the epicenter of this outbreak in Virginia, with two clinical centers having administered the contaminated injections to their patients. New River Health District, in coordination with hospitals, and state and federal agencies, deployed its resources to control the local impact of the outbreak.
  
  
  OBJECTIVE
  The objective of this study was to conduct an economic evaluation of the fungal meningitis outbreak response in New River Valley of Virginia, from the local public health department perspective.
  
  
  METHODS
  The health department conducted the outbreak investigation from October 2012 until March 2013 to ascertain that all possible cases were identified and treated. Data were collected on the costs associated with the local health department in the outbreak response, and the epidemiologic effectiveness estimated, using the metric of disability adjusted life years (DALYs).
  
  
  RESULTS
  The cost incurred by the local health department was estimated to be $30,493; the epidemiologic effectiveness was estimated to be 138 DALYs averted among the patients, for an incremental cost-effectiveness ratio of $221 per DALY averted.
  
  
  CONCLUSIONS
  The incremental cost effectiveness ratio of the fungal meningitis outbreak response in New River Valley assists the local health department to analyze the costs and epidemiologic effectiveness of the outbreak response.
authors: Virginia Tech, kaja.abbas@gmail.com.
authors: Kaja M
authors: KM
authors: Abbas
authors: Virginia Tech, nargesd@vt.edu.
authors: Nargesalsadat
authors: N
authors: Dorratoltaj
authors: New River Health District, Virginia Department of Health, Molly.ODell@vdh.virginia.gov.
authors: Margaret L
authors: ML
authors: O'Dell
authors: New River Health District, Virginia Department of Health, Paige.Bordwine@vdh.virginia.gov.
authors: Paige
authors: P
authors: Bordwine
authors: Virginia Tech Carilion School of Medicine, tmkerkering@carilionclinic.org.
authors: Thomas M
authors: TM
authors: Kerkering
authors: Virginia Tech, kredican@vt.edu.
authors: Kerry J
authors: KJ
authors: Redican
keywords: Cost-effectiveness analysis; Virginia; fungal meningitis outbreak; local health department