Calculating the burden of disease of avian-origin H7N9 infections in China

Abstract

ObjectiveA total of 131 cases of avian-originated H7N9 infection have been confirmed in China mainland from February 2013 to May 2013. We calculated the overall burden of H7N9 cases in China as of 31 May 2013 to provide an example of comprehensive burden of disease in the 21st century from an acute animal-borne emerging infectious disease.DesignWe present an accurate and operable method for estimating the burden of H7N9 cases in China. The main drivers of economic loss were identified. Costs were broken down into direct (outpatient and inpatient examination and treatment) and indirect costs (cost of disability-adjusted life years (DALYs) and losses in the poultry industry), which were estimated based on field surveys and China statistical year book.SettingModels were applied to estimate the overall burden of H7N9 cases in China.Participants131 laboratory-confirmed H7N9 cases by 31 May 2013.Outcome measureBurden of H7N9 cases including direct and indirect losses.ResultsThe total direct medical cost was ¥16 422 535 (US$2 627 606). The mean cost for each patient was ¥10 117 (US$1619) for mild patients, ¥139 323 (US$22 292) for severe cases without death and ¥205 976 (US$32 956) for severe cases with death. The total cost of DALYs was ¥17 356 561 (US$2 777 050). The poultry industry losses amounted to ¥7.75 billion (US$1.24 billion) in 10 affected provinces and ¥3.68 billion (USD$0.59 billion) in eight non-affected adjacent provinces.ConclusionsThe huge poultry industry losses followed live poultry markets closing down and poultry slaughtering in some areas. Though the proportion of direct medical losses and DALYs losses in the estimate of H7N9 burden was small, the medical costs per case were extremely high (particularly for addressing the use of modern medical devices). A cost-effectiveness assessment for the intervention should be conducted in a future study.

H7N9: Preparing for the Unexpected in Influenza

“…At present, there are no incentives for agricultural officials to conduct routine surveillance for H7N9 in poultry given the absence of disease in infected poultry and the potential for culling and market closure that may occur with positive results. Studies estimate the economic costs of LPM closures to range from $US 0.59 billion to 8 billion (34,35). For human health, the absence of adequate poultry surveillance is a blind spot in global efforts to monitor and prepare for emerging novel influenza threats.…”

Downregulating Viral Gene Expression: Codon Usage Bias Manipulation for the Generation of Novel Influenza A Virus Vaccines

“…Therefore, cost-effective and efficacious influenza vaccines that protect these susceptible animal populations are an important niche to target for future vaccine development. In 2013, losses in the poultry industry due to IAV H7N9 in China included culling of flocks, decreased sales of live poultry and market-stall rentals, which cost upward of US$1.8 billion dollars [99]. Other than the cost of losing infected populations, all IAVs are maintained in the avian reservoir, and swine serve as a ‘mixing vessel’ wherein swine, avian and human IAVs can reassort to generate novel IAV strains with pandemic potential [25].…”

H7N9: a low pathogenic avian influenza A virus infecting humans

“…The outbreak of H7N9 infections on mainland, as well as in Taiwan and Hong Kong, China, has posed a great burden for the society. On the basis of the most recent data [54 ], the total direct medical cost of H7N9 as of May 31, 2013 is 16 422 535 CNY (2 627 606 USD). For the mean cost of each patient, the cost per day increase correspondingly as the severity of the illness increases.…”