Emergency management teams and utilities along the East Coast are bracing for what could be a $1 billion punch as Hurricane Sandy's 100 mph winds barrel toward the heavily populated region between the Carolina coast and Cape Cod.

The Category 2 storm, which has killed 21 in the Caribbean, including 11 in Cuba and 9 in Haiti, and is now hitting the Bahamas. It may combine with other, rain-heavy weather systems to create what meteorologists are calling a "perfect storm" that could wreak havoc from North Carolina to Massachusetts early next week. Sandy will likely maintain its hurricane status as it passes over the Bahamas and may bring tropical storm conditions along Florida’s southeastern coast by early Friday.

“We are taking the forecast seriously."

— Laura Southard, Virginia Department of Emergency Management

Jeff Masters, a meteorologist for Weather Underground, called the hurricane a "perfect storm," and predicted early next week that it could cause $1 billion or more in damage.

In Virginia, where the storm may make landfall as early as this weekend, officials from the state’s Department of Emergency Management are advising residents to make preparations in advance and to closely watch local forecasts.

“We are taking the forecast seriously,” VDEM spokeswoman Laura Southard told FoxNews.com. “We are in close contact with the National Weather Service and the National Hurricane Center, so we’re getting the best information we can.”

More On This...

Residents in the storm’s expected path, Southard said, should have a three days’ supply of water on hand, or one gallon per person per day, enough for drinking, cooking and some bathing.

“They should have at least a 3-day supply and food that doesn’t need electricity to prepare it,” she said.

To combat extended power outages, Southard suggested residents purchase battery-powered radios and extra batteries.

“Pay attention,” she said. “Expect that there’s going to be some effect and go ahead and make some preparations.”

Southard said state officials likely will add more employees at its emergency center in Richmond beginning on Saturday.

“It looks like things are coming together,” she said. “And it never, ever hurts to be prepared.”

In New York, Consolidated Edison is warning its 9 million customers in Westchester County and New York City to stay away from any downed power lines if and when the storm strikes the Empire State.

“Treat any downed line as if it’s alive,” Con Ed spokesman Christ Olert told FoxNews.com. “Stay away.”

Olert advised residents to charge portable devices in advance and to have extra batteries on hand in the event of outages.

“We’re watching it and we’ll be prepared,” Con Ed spokesman Chris Olert told FoxNews.com. “We’ll have extra crews available and, if need be, we’ll go to 12-hour shifts.”

The U.S. National Hurricane Center said the storm was located about 60 miles southeast of Eleuthera late Thursday afternoon as it neared Cat Island in the central Bahamas. The storm was moving north at 20 mph, with maximum sustained winds of 105 mph. It was expected to remain a hurricane as it moves through the Bahamas. A tropical storm warning has been extended northward as far as Flagler Beach and a tropical storm watch was issued for the northeastern Florida coast.

"It'll be a rough couple days from Hatteras up to Cape Cod," said forecaster Jim Cisco of the National Oceanic and Atmospheric Administration prediction center in College Park, Maryland. "We don't have many modern precedents for what the models are suggesting."

On Ragged Island in the southern Bahamas, the lone school was flooded, "we have holes in roofs, lost shingles and power lines are down," said Charlene Bain, local Red Cross president. "But nobody lost a life, that's the important thing."

People across the Bahamas formed long lines to stock up on water, canned goods, flashlights and other items, leaving grocery store shelves nearly empty.

Steven Russell, an emergency management official in Nassau, said that docks on the western side of Great Inagua island have been completely destroyed and that the roof of a government building was partially ripped off.

"As the storm passes over Eleuthera and Cat Island, they should get a pretty good beating," he said. "There are sections of Eleuthera we are concerned about."

The massive Atlantis resort went into lockdown mode after dozens of tourists left Paradise Island before the airport closed, said George Markantonis, president and managing director of Kerzner International, which manages the resort. He said the resort is now less than half full, but all its restaurants, casinos and other facilities are still operating.

White House officials, meanwhile, said President Obama has been briefed on Hurricane Sandy and urged people within the storm’s projected path to monitor local weather reports. Federal emergency management officials have been working with local authorities to prepare, spokesman Jay Carney said Thursday.

The Associated Press contributed to this report.