{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:24:30Z","timestamp":1790803470833,"version":"4.1.0"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260951-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Measles outbreaks are costly and challenging to control. A measles outbreak associated with a Chicago, Illinois, shelter, which primarily affected shelter residents, resulted in substantial public health response costs, direct medical costs, and productivity losses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260951-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the societal burden of the 2024 Chicago measles outbreak in terms of resources used and costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260951-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This economic evaluation analyzed the costs of a shelter-associated measles outbreak in Chicago between March 7 and April 30, 2024, in terms of measles cases, contacts (children, adult residents, shelter personnel), and relevant agencies involved in the outbreak response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260951-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Measles virus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260951-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Three types of costs were estimated in this limited societal cost analysis: (1) total response costs (personnel time, vaccination, quarantine space, transportation, laboratory testing, and other materials) incurred by the Chicago Department of Public Health and partner agencies; (2) direct medical costs (case isolation in hospitals, emergency department visits, treatment, interfacility emergency transportation, and infrastructure modifications); and (3) productivity losses due to isolation, quarantine, or informal caregiving (including number of days children were excluded from school).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260951-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 57 measles cases (including 30 females [52.6%]; median [IQR] age, 3 [1-22] years) and 3569 contacts (including 1837 females [51.6%]; median [IQR] age, 17 [7-30] years) associated with the shelter outbreak. The associated societal cost was\u2009$8 700 258, or $152 636 per measles case. Response costs included $1 798 780 in personnel costs, $1 397 976 in vaccination costs, $200 489 in laboratory testing costs, $104 263 in transportation costs, and $63 023 in other material costs. Direct medical costs were\u2009$4 399 639, and estimated productivity losses were\u2009$683 895, with 17\u202f113 school days among children lost due to the outbreak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260951-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This economic evaluation of a measles outbreak in a congregate setting found complex response challenges that contributed to substantial costs. This outbreak response was one of the most expensive in the measles postelimination era due to the large costs associated with vaccination and isolation and quarantine in hospitals. Though the outbreak placed a considerable cost burden on both public health and health care systems, rapid disease identification and mass vaccination among shelter residents prevented a more costly and larger outbreak. Strategies to reduce disease transmission and costs during outbreaks among undervaccinated populations living in congregate settings may include funding non\u2013health care isolation and quarantine spaces and vaccinating new shelter residents on arrival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.35328","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T15:00:31Z","timestamp":1790089231000},"page":"e2635328","source":"Crossref","is-referenced-by-count":1,"title":["Cost of a Measles Outbreak in an Urban Shelter"],"prefix":"10.1001","volume":"9","author":[{"given":"Emily A. G.","family":"Faherty","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia"},{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Leung","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Gretsch","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spencer","family":"Gorelick","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Lendacki","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"DeJonge","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"},{"name":"Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby","family":"Daniel-Wayman","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Gressick","sequence":"additional","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia"},{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Nham","sequence":"additional","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia"},{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onofre","family":"Donceras","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Stroger Hospital of Cook County, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon F.","family":"Welbel","sequence":"additional","affiliation":[{"name":"Infectious Diseases, Stroger Hospital of Cook County, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marielle","family":"Fricchione","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Diseases, Rush University Children\u2019s Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Bleasdale Casey","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease and Infection Prevention, Department of Medicine, UI Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"O\u2019Connell","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease and Infection Prevention, Department of Medicine, UI Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison H.","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Chicago Medicine Comer Children\u2019s Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Chicago Medicine Comer Children\u2019s Hospital, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen K.","family":"Bolon","sequence":"additional","affiliation":[{"name":"Department of Healthcare Epidemiology and Infection Prevention, Northwestern Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Healthcare Epidemiology and Infection Prevention, Northwestern Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Zembower","sequence":"additional","affiliation":[{"name":"Department of Healthcare Epidemiology and Infection Prevention, Northwestern Medicine, Chicago, Illinois"},{"name":"Department of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry K.","family":"Kociolek","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayelet","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Barnes","sequence":"additional","affiliation":[{"name":"Illinois Department of Public Health, Springfield"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Geltz","sequence":"additional","affiliation":[{"name":"Illinois Department of Public Health, Springfield"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Spencer","sequence":"additional","affiliation":[{"name":"Illinois Department of Public Health, Springfield"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas D.","family":"Filardo","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Sugerman","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyse","family":"Kittner","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel","family":"Chavez-Torres","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Sloboda","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Funk","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Borah","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie R.","family":"Black","sequence":"additional","affiliation":[{"name":"Chicago Department of Public Health, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamison","family":"Pike","sequence":"additional","affiliation":[{"name":"National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"issue":"45","key":"zoi260951r2","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.15585\/mmwr.mm7345a4","article-title":"Progress toward measles elimination - 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