RESEARCH ARTICLE Cost-Effective Control of Infectious Disease Outbreaks Accounting for Societal Reaction

Background Studies of cost-effective disease prevention have typically focused on the tradeoff between the cost of disease transmission and the cost of applying control measures. We present a novel approach that also accounts for the cost of social disruptions resulting from the spread of disease. These disruptions, which we call social response, can include heightened anxi-ety, strain on healthcare infrastructure, economic losses, or violence. Methodology The spread of disease and social response are simulated under several different interven-tion strategies. The modeled social response depends upon the perceived risk of the dis-ease, the extent of disease spread, and the media involvement. Using Monte Carlo simulation, we estimate the total number of infections and total social response for each strategy. We then identify the strategy that minimizes the expected total cost of the disease, which includes the cost of the disease itself, the cost of control measures, and the cost of social response