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¹ National Wildlife Research Center, Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, 4101 LaPorte Ave., Fort Collins, Colorado 80521-2154, USA
² Veterinary Public Health Section, California Department of Health Services, 1600 Capitol Ave., Sacramento, California 95814, USA
³ Santa Barbara County Public Health Department, 345 Camino del Remedio, Santa Barbara, California 93110, USA
⁴ Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, Georgia 30329-4018, USA
⁵ Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, 59 Chenell Dr., Concord, New Hampshire 03301-8548, USA
⁶ Corresponding author (email: stephanie.a.shwiff{at}aphis.usda.gov)

ABSTRACT:   The direct and indirect costs of suspected human rabies exposure were estimated for San Luis Obispo and Santa Barbara counties, California, USA. Clinic, hospital, and county public health records (1998–2002) were examined to determine direct costs for postexposure prophylaxis (PEP), and 55 (41%) former patients were contacted to voluntarily provide estimates of their indirect costs associated with receiving PEP. Additional costs due to public health and animal control personnel responses to rabid animals were collected, including diagnostic testing and wages. The mean total cost of a suspected human rabies exposure was $3,688, the direct costs per case were $2,564, and the indirect costs were $1,124 of that total. About one third of the total cost for suspected human rabies exposure was attributed to indirect costs (e.g., lost wages, transportation, and day-care fees), most of which were not reimbursable to the patient.
  Key words:  California, direct costs, economics, indirect costs, postexposure prophylaxis, rabies.

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