The $1.1 billion allocated by Congress last week to fight Zika will mean more money for states and localities to control and monitor for the mosquito-borne virus and for researchers to develop vaccines and diagnostic tests.
The money, which federal health officials said Monday would be doled out in coming months, will help shore up state and local governments that have spent largely out of their own budgets for educational outreach, mosquito control and protective agents such as repellent for pregnant women, who are considered most at risk.
Zika causes the birth defect microcephaly in the fetuses of pregnant women infected by the virus. Babies with the condition are born with small brains and heads and struggle to survive.
It's also believed to cause problems for some adults, such as vision issues and Guillain-Barre syndrome, a nervous system disorder that can lead to temporary paralysis. Researchers also are beginning to believe that even babies born without microcephaly may suffer problems after birth; some of the federal dollars will be used to track some of these children.
The CDC reports that there have been 3,625 cases of Zika in the mainland United States, and another 22,000 in U.S. territories such as hard-hit Puerto Rico. There have been 808 confirmed cases in pregnant women in the continental United States, with 21 babies born with birth defects and five pregnancy losses with birth defects.
In Maryland, there have been 101 cases, including 43 in Baltimore City and the five surrounding counties and 51 in the Maryland suburbs of Washington.
The federal officials said Monday that the virus continues to present a threat even though the weather has turned cooler in much of the country, reducing mosquito breeding and activity.
"Zika is the latest in unpredicted and unpredictable health threats," said Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention. "The more we learn, the more concerned we are."
As the extent of the threat emerged early this year, the World Health Organization declared Zika a public health emergency. President Barack Obama requested $1.9 billion in emergency funding seven months ago, but the request stalled amid partisan bickering. Congress finally approved $1.1 billion as part of a larger budget deal on Sept. 28.
During Monday's news conference, officials from the CDC, the National Institutes of Health and the U.S. Department of Health and Human Services, expressed frustration that lawmakers took so long to approve funding.
Frieden said Zika programs across the board will get less funding than initially budgeted, and that other public health initiatives raided to get Zika-related efforts off the ground will not be repaid.
Officials at the state Department of Health and Mental Hygiene said they are awaiting guidance on "possible amounts, uses and timing of the funding."
Baltimore City Health Commissioner Dr. Leana Wen said more funding is needed in places with the most vulnerable populations like Baltimore with its heavy concentration of people living in poverty.
"We hope funding will be targeted to areas of greatest need, and that includes Baltimore," she said.
People in these areas are more likely to live near vacant housing and unattended pools of water, which are prime breeding ground for mosquitoes, she said. Their houses are less likely to have air conditioning or screens to keep mosquitoes out. Poor women also face barriers to health care, Wen said.
With little federal financial support, spending on Zika in Maryland already has topped $1 million. That includes more than $500,000 spent by Baltimore City, which has done door-to-door outreach and put together 9,000 Zika kits for pregnant women that include repellent, larvicide and condoms because Zika can also be sexually transmitted.
The state spent $130,000 on its own kits, and $20,000 on educational seminars and mosquito control. With most counties relying on the state agriculture department to spray for mosquitoes, the state boosted the agriculture department's annual $2.7 million mosquito control budget by $420,000.
In the absence of formal funding, federal health officials borrowed funds from other programs, like those for Ebola, to get vaccine trials underway.
The University of Maryland is one of three sites that have begun testing a vaccine on humans developed at the National Institutes of Health. The new funding will ensure that if the trial is successful and shows the vaccine is safe and induces an immune response, it will go through more advanced trials in more heavily affected countries.
There are a total of nine vaccines in development through government labs, universities and private biotech firms.
There also has been some federal spending on testing for Zika and assistance to Puerto Rico and Florida, which is the only state with locally transmitted infections.
Christopher Garrett, a spokesman for the state health department, said the agency still must be prepared because Zika is transmitted not just by mosquito bite but through sexual transmission, and locally acquired cases remain possible.
The CDC widened its guidance last week for men who have been exposed to the Zika virus but have no symptoms. Officials now say couples should wait six months before trying to conceive if the man has been exposed to Zika. Its previous guidance recommended waiting two months. The agency also continues to expand travel warnings to more heavily affected countries.
Most localities have spent their own money on prevention. So far, the city and counties have received only about $15,000 each in federal funding through the state, Wen said.
To pay for its response, she said, the city diverted resources from other "key priorities," including a reduction for opioid-related programs at a time when overdose deaths are at records highs.
Of the 43 cases of Zika, 12 have been in Baltimore, Wen said. The rest are spread among the five surrounding counties.
"It's taken months and much begging to get this federal money so we can do our job," Wen said.