802The Cost of a Measles Outbreak in 2013, New York City, United States

Background. Although measles was declared eliminated from the United States in 2,000, importations continue to occur. In March 2013, an intentionally unvaccinated adolescent with measles returned to New York City (NYC) from the United Kingdom, leading to an outbreak of 58 cases. We examined the cost to the NYC Department of Health and Mental Hygiene (DOHMH) to respond to and contain the outbreak. Methods. Direct costs were calculated as the sum of inputs (immunoglobulin/vaccine, courier/travel, postage, advertising, laboratory testing) and personnel time. Personnel time cost was calculated as hourly wage x routine business hours worked plus paid overtime and fringe. The incremental cost was calculated as total direct costs minus salary and fringe paid to DOHMH staff during routine business hours. Inkind costs (uncompensated hours worked by DOHMH-funded staff and salaries of DOHMH staff funded by outside agencies), overhead, and costs to outside medical facilities and patients were not included. Results. Direct costs were $394,447 ($62,101 inputs, $332,346 compensated personnel time). The incremental cost was $73,134 (19% of total direct costs). DOHMH-funded staff (n = 75) worked 9,337 hours (8,667 routine business hours, 324 paid overtime, 346 uncompensated). DOHMH staff funded by outside agencies (n = 12) worked 716 hours. Activities included case/contact investigations (5,861 hours, 58%), administrative activities (445 hours, 4%), laboratory work (2,765 hours, 28%), and community outreach (981 hours, 10%). Among all staff, 68% performed duties related to their routine job description. Conclusion. Response and containment of this outbreak required assistance from a large number of staff, of whom one-third performed duties outside of their routine job description. This emphasizes the importance of a robust and flexible public health infrastructure to facilitate redirection of personnel. These cost figures likely underestimate the total cost, as they do not account for in-kind costs or costs to medical facilities, outside agencies, patients, and society. The significant burden and impact of measles outbreaks as well as other public health emergencies, underscore the importance of continued support and resources for public health departments. Disclosures. All authors: No reported disclosures.