TY - JOUR AU - Dan, Yock Young AU - Tambyah, Paul A. AU - Sim, Joe AU - Lim, Jeremy AU - Hsu, Li Yang AU - Chow, Wai Leng AU - Fisher, Dale A. AU - Wong, Yue Sie AU - Ho, Khek Yu T1 - Cost-effectiveness Analysis of Hospital Infection Control Response to an Epidemic Respiratory Virus Threat T2 - Emerging Infectious Disease journal PY - 2009 VL - 15 IS - 12 SP - 1909 SN - 1080-6059 AB - The outbreak of influenza A pandemic (H1N1) 2009 prompted many countries in Asia, previously strongly affected by severe acute respiratory syndrome (SARS), to respond with stringent measures, particularly in preventing outbreaks in hospitals. We studied actual direct costs and cost-effectiveness of different response measures from a hospital perspective in tertiary hospitals in Singapore by simulating outbreaks of SARS, pandemic (H1N1) 2009, and 1918 Spanish influenza. Protection measures targeting only infected patients yielded lowest incremental cost/death averted of $23,000 (US$) for pandemic (H1N1) 2009. Enforced protection in high-risk areas (Yellow Alert) and full protection throughout the hospital (Orange Alert) averted deaths but came at an incremental cost of up to $2.5 million/death averted. SARS and Spanish influenza favored more stringent measures. High case-fatality rates, virulence, and high proportion of atypical manifestations impacted cost-effectiveness the most. A calibrated approach in accordance with viral characteristics and community risks may help refine responses to future epidemics. KW - Pandemic (H1N1) 2009 KW - pandemic KW - cost-effectiveness analysis KW - hospital infection control KW - nosocomial infections KW - influenza KW - viruses KW - expedited KW - research KW - Singapore DO - 10.3201/eid1512.090902 UR - https://wwwnc.cdc.gov/eid/article/15/12/09-0902_article ER - End of Reference