Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 3, Number 2—June 1997

The Economic Impact of a Bioterrorist Attack: Are Prevention and Postattack Intervention Programs Justifiable?

Arnold F. Kaufmann, Martin I. MeltzerComments to Author , and George P. Schmid
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Main Article

Table 3

Costsa($ millions) of a bioterrorist attack with no postexposure prophylaxis program

Anthrax Tularemia Brucellosis
Direct costs
Medical: Base estimatesb
Hospital 194.1 445.8 170.3
OPVc 2.0 10.5 48.9
Medical: Upper estimatesd
Hospital 237.1 543.3 211.7
OPVc 4.4 18.5 78.3
Lost productivity
Hospital 21.6 50.9 18.8
OPVc 0.7 3.9 15.0
3% discountf 25,985.7 4,891.2 326.5
5% discountf 17,889.3 3,367.3 224.7
Total costs
Base estimates
3% discountf 26,204.1 5,402.4 579.4
5% discountf 18,107.7 3,878.4 477.7
Upper estimates
3% discountf 26,249.7 5,507.9 650.1
5% discountf 18,153.1 3,983.9 548.4

aAssuming 100,000 exposed.
bMedical costs are the costs of hospitalization (which include follow-up outpatient visits) and outpatient visits (Table 1).
cOPV = outpatient visits.
Upper estimates calculated with data in Table 1.
eLost productivity due to illness is the value of time spent in hospital and during OPVs (Table 1).
fDiscount rate applied to calculate the present value of expected future earnings and housekeeping services, weighted by age and sex composition of the United States workforce (16), lost due to premature death.

Main Article

  1. Cole  LA. The specter of biological weapons.Sci Am. 1996;275:605. DOIPubMedGoogle Scholar
  2. Gochenour  WS. Aerobiology. Mil Med. 1963;128:869.PubMedGoogle Scholar
  3. Abramova  FAN, Grinberg  LM, Yampolskaya  OV, Walker  DH. Pathology of inhalational anthrax in 42 cases from the Sverdlovsk outbreak of 1979. Proc Natl Acad Sci U S A. 1993;90:22914. DOIPubMedGoogle Scholar
  4. Benenson  AS, ed. Control of communicable diseases manual. 16th ed. Washington (DC): American Public Health Association, 1995.
  5. Messelson  M, Guillemin  J, Hugh-Jones  M, Langmuir  A, Popova  I, Shelokov  A, The Sverdlosvsk anthrax outbreak of 1979. Science. 1994;266:12028. DOIPubMedGoogle Scholar
  6. Kaufmann  AF, Fox  MD, Boyce  JM, Anderson  DC, Potter  ME, Martone  WJ, Airborne spread of brucellosis. Ann N Y Acad Sci. 1980;335:10514. DOIGoogle Scholar
  7. Olle-Goig  JE, Canela-Soler  J. An outbreak of Brucella melitensis infection by airborne transmission among laboratory workers. Am J Public Health. 1987;77:3358. DOIPubMedGoogle Scholar
  8. Staszkiewicz  J, Lewis  CM, Colville  J, Zervos  M, Band  J. Outbreak of Brucella melitensis among microbiology laboratory workers in a community hospital.J Clin Microbiol. 1991;29:28790. PubMedGoogle Scholar
  9. Trever  RW, Cluff  LE, Peeler  RN, Bennett  IL. Brucellosis I. laboratory-acquired acute infection. Arch Intern Med. 1959;103:38197.
  10. McCrumb  FR. Aerosol infection of man with Pasteurella tularensis. Bacteriol Rev. 1961;25:2627.PubMedGoogle Scholar
  11. Saslaw  S, Eigelsbach  HT, Wilson  HR, Prior  JA, Carhart  S. Tularemia vaccine study II. respiratory challenge. Arch Intern Med. 1961;107:689701.PubMedGoogle Scholar
  12. Friedlander  AM, Welkos  SL, Pitt  MLM, Ezzell  JW, Worsham  PL, Rose  KJ, Postexposure prophylaxis against experimental inhalation anthraxJ Infect Dis. 1993;167:123942.PubMedGoogle Scholar
  13. Sawyer  WD, Dangerfield  HG, Hogge  AL, Crozier  D. Antibiotic prophylaxis and therapy of airborne tularemia PubMed. Bacteriol Rev. 1966;30:5428.PubMedGoogle Scholar
  14. Solera  J, Rodriguez-Zapata  M, Geijo  P, Largo  J, Paulino  J, Saez  L, Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis.Antimicrob Agents Chemother. 1995;39:20617. PubMedGoogle Scholar
  15. Luce  BR, Manning  WG, Siegel  JE, Lipscomb  J. Estimating costs in cost-effectiveness analysis. In: Gold MR, Siegel JE, Russell LB, Weinstein MC, editors. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1966:176-213.
  16. Haddix  AC, Teutsch  SM, Shaffer  PA, Dunet  DO, eds. Prevention effectiveness: a guide to decision analysis and economic evaluation. New York: Oxford University Press, 1996.
  17. Lipscomb  J, Weinstein  MC, Torrance  GW. Time preference. In: Gold MR, Siegel JE, Russell LB, Weinstein MC, editors. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1966:214-35.
  18. U.S. Bureau of the Census. Statistical abstract of the United States: 1995. 115th ed. Washington (DC): U.S. Government Printing Office, 1996.
  19. National Center for Health Statistics. Health, United States, 1995. Hyattsville (MD):U.S.Departmentof Health and Human Services, Public Health Service, 1996.
  20. HealthCare Consultants of America, Inc. HealthCare Consultants' 1996 physicians fee and coding guide. 6th ed. Augusta (GA): HealthCare Consultants of America, Inc. 1996.
  21. Cardinale  V, ed. 1996 Drug Topics Red Book. Montvale (NJ): Medical Economics Company, Inc., 1996.
  22. Robison  LJ, Barry  PJ. The competitive firm's response to risk. New York: Macmillan, 1987.

Main Article

Page created: December 21, 2010
Page updated: December 21, 2010
Page reviewed: December 21, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.