TY  - JOUR
PY  - 2006//
TI  - The cost-effectiveness of strategies to reduce mortality from an intentional release of aerosolized anthrax spores
JO  - Medical decision making
A1  - Braithwaite, R. Scott
A1  - Fridsma, Douglas
A1  - Roberts, Mark S.
SP  - 182
EP  - 193
VL  - 26
IS  - 2
N2  - BACKGROUND: Intentional exposures to aerosolized Bacillus anthracis spores have caused fatalities. OBJECTIVE: To evaluate the cost-effectiveness of strategies to reduce mortality from future inhalational anthrax exposures. METHODS: Computer cohort simulation of a 100,000-person single-site exposure (worst-case scenario) and a 100-person multiple-site exposure (resembling the recent US attack). For each scenario, universal vaccination and an emergency surveillance and response (ESR) system were compared with a default strategy that assumed eventual discovery of the exposure. RESULTS: If an exposure was unlikely to occur or was small in scale, neither vaccination nor an ESR system was cost-effective. If an exposure was certain and large in scale, an ESR system was more cost-effective than vaccination ($73 v. $29,600 per life-year saved), and a rapid response saved more lives than improved surveillance. CONCLUSIONS: Strategies to reduce deaths from anthrax attacks are cost-effective only if large exposures are certain. A faster response is more beneficial than enhanced surveillance.<p /> <p>Language: en</p>
LA  - en
SN  - 0272-989X
UR  - http://dx.doi.org/10.1177/0272989X06286794
ID  - ref1
ER  -