When Maryland health officials began planning a defense against Zika months ago, one of the first calls was to Summit Chemical Co. for supplies of a long-acting larvicide to stop virus-carrying mosquitoes from breeding in standing water.
The Baltimore company's bacteria-based larvicide — available in small doughnut-shaped disks called Dunks — was handed out to pregnant women most at risk if infected by the virus. The disks also were included in Zika kits containing other items, such as bug spray and condoms, that cost the state more than $130,000.
The state Department of Health and Mental Hygiene also signed a $20,000 contract with the Baltimore-based consulting firm Pandit Group to conduct educational outreach, and gave an extra $420,000 to the Department of Agriculture to boost its annual $2.7 million mosquito control budget. Academic institutions, and at least one related biotech firm, have won funding to work on vaccines that could eventually be publicly marketed.
The Zika threat has led to economic opportunities for some businesses in Maryland and elsewhere as the state and federal governments have launched efforts to prevent spread of the virus. Millions have already been spent or committed in Maryland, and that's just a fraction of the billions Zika is expected to cost the United States, as well as Central and South America, where there have been far more cases.
Public health officials and researchers consider Zika prevention more of an investment than an expenditure. Not defending against the virus could be even more costly. Medical care and lost productivity from infections in six states in the South could exceed $2 billion if only 2 percent of the region's population becomes infected, according to economic modeling done recently at Johns Hopkins Bloomberg School of Public Health.
Dr. Bruce Y. Lee, associate professor of international health who did the modeling, said the overall economic impact from Zika is tough to estimate because the virus is still spreading and experts are still learning about it. Still, he wanted to know at what point the costs would exceed the $1.9 billion in federal funding requested by President Barack Obama for Zika prevention, which has stalled in Congress. The money would go toward vaccine development, education and other preventive measures.
Zika typically results in mild symptoms such as rashes, pink eye and fever in about 20 percent of adults infected. But the World Health Organization declared the virus a public health emergency in February because it causes microcephaly, a devastating birth defect that stunts the development of the brains and heads of fetuses. The virus also is linked to a small number of cases of Guillain-Barre syndrome, which can causes temporary paralysis.
Some federal money has been diverted from Ebola research to be used instead on Zika, and efforts to develop a vaccine are underway at the University of Maryland, the Johns Hopkins University, and at other academic institutions, pharmaceutical and biotech companies and government labs
Those costs can be easily assessed, but others are tougher, Lee said.
"Someone gets pink eye from Zika and they miss one day of work, and it doesn't seem like a lot, but it adds up," said Lee, who included such losses in his estimates. "What's harder to capture in the midst of an epidemic is how worried people are and how much businesses might lose. Those are extra costs."
Tourism and business has surely already been impacted in heavily affected areas, he said. The U.S. Centers for Disease Control and Prevention has issued travel warnings for almost four dozen countries where the virus is active, as well as a rare domestic warning for the Miami area, where the nation's only cases of local transmission from mosquitoes have been reported.
There have been six locally acquired cases and 1,955 travel-related cases in the mainland United States, according to the CDC. There also have been 22 cases of sexual transmission. About 510 women were pregnant. In Maryland, there have been 57 cases, all travel-related.
Globally, the World Bank estimated the costs to the hardest-hit countries in Central and South America at $3.5 billion just this year.
"Unless the virus is promptly contained, the human and longer-term effects of the disease and their economic impacts will increase," the bank said in a statement.
In the final tally, Zika could be more costly than other mosquito-borne diseases, including malaria, which sickens more than 200 million people annually and is a leading cause of death in developing countries. Annual costs for treatment and lost productivity are an estimated $12 billion, according to the U.S. Centers for Disease Control and Prevention
Dengue, the fastest-growing mosquito-borne virus, comes in second at about $8.9 billion for those direct costs, according to Donald Shepard of Brandeis University, who has published research on the virus. Adding in surveillance and mosquito control boosted the costs to $46.5 billion, he said.
"Yes, Zika is likely to be more costly," he said. "Zika is already disrupting travel. ... Zika may affect economies beyond those who contract the disease."
Maryland officials say they will continue to spend to control those impacts. The state Department of Agriculture, for example, is working with the Anne Arundel Health Department on extra spraying where there may be disease-carrying mosquitoes. Health officials also are going door to door to offer information on mosquito control.
Sonia Pandit, Pandit Group CEO, said the firm has led more than 175 events with community organizations, schools and centers that offer classes for pregnant women. Others are planned.
"Although there has not been a case of Zika due to local transmission in our state to date, it is clear that Marylanders have gotten Zika from travel or sexual activity," Pandit said. "It is vital to continue raising awareness about Zika so people know what preventive measures they should take to not only protect themselves from getting the virus, but also to help prevent others from getting infected."