The cost of a regular, healthy pregnancy in the United States is already high, sometimes as much as $50,000 for those who deliver via C-section. But in states with Zika outbreaks, that number will climb when you figure in the two rounds of Zika testing and monthly serial ultrasounds the CDC
recommends for monitoring.
Right now, Zika is limited to southern states where the virus-spreading Aedes aegypti are most abundant, and that's where monitoring will stay concentrated. "But it's hard to say where Zika's boundaries are, because you only really need that one mosquito," says David Pigott, a spatial
epidemiologist at the University of Washington.
‘The CDC puts the range at anywhere from $1 million to $10 million per case to pay for special schooling, to modify their home and vehicles, and, critically, the loss of income for parents providing round-the-clock care.’
For pregnancies carried during a Zika infection, researchers estimate anywhere from 1 to 13 percent will result in a birth defect. The best-known is microcephaly, a condition in which a baby's head size is two standard deviations below the norm. But that's only part of the story.
"We have plenty of patients with microcephaly who are very healthy, with few neurological impairments," says Nassim Zecavati, a pediatric neurologist at Georgetown University Hospital. "But with Zika, the brain is not only small, but underdeveloped and malformed."
"We can easily say that there are certain tests these babies and children will require, like MRIs and EEGs," says Zecavati. "But the cost of diagnostic testing will pale in comparison to cost of the long term healthcare."
Unable to walk, speak, swallow, or even breathe on their own, they'll
need wheelchairs, feeding tubes, and breathing apparatuses. And they'll be more susceptible to pneumonia and infections, among other complications.
"A very, very conservative guess would be that the medical costs of Zika would be around $600,000 for these families," says Jorge Alfaro-Murillo, a research scientist at Yale's Center for Infectious Disease Modeling and Analysis.
The money families need to pay for special schooling, to modify their home and vehicles, and, critically, the loss of income for parents providing round-the-clock care. Alfaro-Murillo estimates the total lifetime costs, medical and indirect, will reach $4.1 million. The CDC puts the range at
anywhere from $1 million to $10 million per case. "That's a productivity loss for the country as a whole," says Alfaro-Murillo.
For families without millions of dollars sitting under their beds, Medicaid will probably cover the majority of the medical treatments. "About 20 percent of state budgets right now go toward Medicaid," says Gerard Anderson, a health economist at Johns Hopkins University.
But the system still provides little help for indirect costs. And the burden of a child with Zika-related birth defects is so high—on the medical system, on states, on families—that the CDC is recommending flat out the government make the "full range of contraceptive methods approved by the Food and Drug Administration (FDA), including long-acting reversible contraception" accessible to women at risk of contracting Zika.
"A copper IUD costs a dollar. And even the cost of a visit is an infinitesimal fraction of what it would be able to take care of even just a Zika-risk pregnancy." Those costs shrink away to nothing in comparison to the price of a generation of Zika-affected babies.