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Volume 11, Number 2—February 2005


Managing Febrile Respiratory Illnesses during Hypothetical SARS Outbreaks

Kamran Khan*Comments to Author , Peter Muennig†, Michael Gardam‡, and Joshua Graff Zivin†
Author affiliations: *St. Michael’s Hospital, Toronto, Ontario, Canada; †Columbia University, New York, New York, USA; ‡University Health Network, Toronto, Ontario, Canada

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Table 1

Selected costs in the decision-analysis model*

Costs† Low Base High Source
Vaccines and medications
Influenza vaccine $10.00 $27.78 $40.00 11
Antibiotics for FRI‡ $30.00 $64.72 $80.00 12
Medical care§
Ambulatory clinic visit $40.00 $60.03 $80.00 13
Hospitalization for FRI $5,000 $11,645 $15,000 14
Hospitalization for influenza $7,500 $17,465 $25,000 14
Hospitalization for PUI $15,000 $19,441 $25,000 14
Hospitalization for SARS $20,000 $28,502 $40,000 14,15
Diagnostic tests
Rapid influenza test $15.00 $26.86 $40.00 16
Multiplex¶ RT-PCR $50.00 $154.02 $200.00 Prodesse Inc., pers. comm.
SARS# RT-PCR $20.00 $54.80 $100.00 Prodesse Inc., pers. comm.
Patient time (per hour) $15.00 $24.55 $30.00 17
Contact investigation (per SARS contact) $100.00 $222.94 $300.00 5,18

*FRI, febrile respiratory illness; PUI, person under investigation (for SARS); SARS, severe acute respiratory syndrome; RT-PCR, reverse transcription–polymerase chain reaction.
†Medical and nonmedical costs were adjusted to 2004 U.S. dollars by using the Consumer Price Index.
‡Antimicrobial drug costs are based on a 7-day course of oral levofloxacin.
§Includes laboratory tests, transportation costs, and patient time.
¶Detects influenza viruses A and B, respiratory syncytial viruses A and B, parainfluenza viruses 1–3, human metapneumovirus, Legionella pneumophila, L. micdadei, Mycoplasma pneumoniae, Chlamydia pneumoniae, and Bordetella pertussis.
#Detects SARS-associated coronavirus and coronaviruses OC43 and 229E.

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