Case Synopsis

An intern at the Pan American Health Organization (PAHO) in Washington, DC is conducting an economic impact assessment of a Chikungunya epidemic in the Caribbean. PAHO would like to promote preparedness amongst PAHO member states and forecasting the economic impact may encourage governments to increase disease mitigation efforts. Chikungunya had been spreading through the Caribbean for several months and concerns about the impact of an epidemic in Jamaica were heightened by its reliance on tourism. The intern must incorporate information from a variety of sources to forecast the burden of disease and cost of illness of a Chikungunya outbreak in Jamaica.

Case Objectives

  1. Define burden of illness and cost of illness and describe their roles in public health.
  2. Calculate a disability adjusted life year (DALY).
  3. Estimate the burden of illness associated with an infectious disease epidemic.
  4. Identify and value cost items relevant to an infectious disease epidemic.
  5. Identify, locate, and synthesize the information required to produce cost of illness estimates.Estimate the cost of illness associated with an infectious disease epidemic.
  6. Interpret cost of illness estimates and discuss the limitations associated with this measure.

Case Study Questions

  1. What type of information is required to develop burden of illness and cost of illness estimates?
  2. What sources provide accurate and up-to-date information for estimating burden of illness and cost of illness?
  3. What sectors should you consider when estimating the cost of illness?
  4. What assumptions are necessary to estimate the cost of illness?
  5. How can you investigate the impact of uncertainty on cost of illness estimates?
  6. What role does seasonal variation play in cost of illness estimates?


Chikungunya, infectious disease epidemic, Caribbean, Jamaica, burden of illness, cost of illness

Additional Author Information

Sydney Todorovich, MPH

Ciro Ugarte, MD, Director, Department of Emergency Preparedness and Disaster Relief

Ava John-Baptiste, PhD, Assistant Professor

Amanda Terry, PhD, Assistant Professor



Recommended Citation

Todorovich, S., Ugarte, C., John-Baptiste, A., Terry A. (2015). Chikungunya in the Americas: Estimating the Burden of Disease and Cost of Illness. in: Speechley, M., & Terry, A.L. [eds] Western Public Health Casebook 2015. London, ON: Public Health Casebook Publishing.