THE ECONOMIC BURDEN IMPOSED BY A RESIDUAL CASE OF EASTERN ENCEPHALITIS

To estimate the economic burden imposed by eastern encephalitis (EE), we identified a series of residents of eastern Massachusetts who had s urvived EE infection and enumerated any costs that could be attributed to their experience. The records of three people who suffered only a transient episode of disease were analyzed as well as those of three w ho suffered severe residual sequelae. Transiently affected subjects ma inly required assistance for direct medical services; the average tota l cost per case was $21,000. Those who suffered persistent sequelae re mained at home and seemed Likely to Live a normal span of years, but w ithout gainful employment. Early in the course of their chronic illnes s, costs ranged as high as $0.4 million per year, but plateaued at abo ut $0.1 million after three years. Hospital costs, which dominated ear ly in the disease experience, approached $0.3 million per patient. Edu cational costs tended to replace hospital costs after two years as the dominant economic burden and totaled about $0.3 million per patient d uring the first six years. Total costs then averaged almost $0.8 milli on. By the time that these subjects will have reached 22 years of age, disease-related costs will have totaled about $1.5 million. Instituti onalization will impose an additional lifetime cost of $1.0 million. I nsecticidal interventions designed to avert outbreaks of human EE infe ction cost between $0.7 million and $1.4 million, depending on the ext ent of the treated region. The direct costs of an intervention are les s than the $3 million imposed on one person suffering residual sequela e of EE.