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La Crosse encephalitis (LACE), a human illness caused by a mosquito-transmitted virus, is endemic in western North Carolina. To assess the economic and social impacts of the illness, 25 serologically confirmed LACE case patients and/or families were interviewed to obtain information on the economic costs and social burden of the disease. The total direct and indirect medical costs associated with LACE over 89.6 life years accumulated from the onset of illness to the date of interview for 24 patients with frank encephalitis totaled $791,374 (range = $7,521–175,586), with a mean ± SD per patient cost of $32,974 ± $34,793. The projected cost of a case with lifelong neurologic sequelae ranged from $48,775 to $3,090,798 (n = 5). For the 25 LACE patients, 55.15 (54.83%) of the 100.59 cumulative life years (CLYs) were impaired to some degree. Disability adjusted life years (DALYs) were calculated to measure the productive life years lost to LACE. Approximately 13.00 DALYs were accumulated over 100.59 CLYs of study. Projected DALYs for case patients (n = 5) with lifelong neurologic sequelae ranged from 12.90 to 72.37 DALYs. An Impact of La Crosse Encephalitis Survey (ILCES) was used to measure the social impact of LACE over time for case patients and their families. The ILCES scores demonstrated that the majority of the social burden of the illness is borne by the five patients with lifelong neurologic sequelae. The socioeconomic burden resulting from LACE is substantial, which highlights the importance of the illness in western North Carolina, as well as the need for active surveillance, reporting, and prevention programs for the infection.
Received May 28, 2003. Accepted for publication August 20, 2003.
Acknowledgments: We thank the Cherokee Tribal Council for permission to interview Native American case patients. The assistance of Eddie Welch of the Indian Health Services and Professor V. Kerry Smith of the Department of Agricultural and Resource Economics at North Carolina State University was invaluable. The help of Barbara Dietz, Laurel Dills, Eugene Powell, David Taylor and Dr. William Huffstutter is gratefully acknowledged.
Financial support: Partial support for this research was provided by contract CD0011 from the North Carolina Department of Health and Human Services.
Authors’ addresses: J. Todd Utz and Charles S. Apperson, Department of Entomology, Box 7647, North Carolina State University, Raleigh, NC 27695-7647. J. Newton MacCormack, Epidemiology Section, North Carolina Department of Health and Human Services, 1902 Mail Service Center, Raleigh, NC 27699-1902. Martha Salyers, Buncombe County Health Center, 35 Woodfin Street, Asheville, NC 28801-3075. E. Jacquelin Dietz, Department of Statistics, Box 8203, North Carolina State University, Raleigh, NC 27695-8203. J. Todd McPherson, Virology/Serology Unit, North Carolina State Laboratory of Public Health, 1918 Mail Service Center, Raleigh, NC 27699-1918.
Reprint requests: Charles S. Apperson, Department of Entomology, Box 7647, North Carolina State University, Raleigh, NC 27695-7647, Telephone: 919-515-4326, Fax: 919-515-3748, E-mail: charles_apperson{at}ncsu.edu.
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