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Rare Infectious Disease Spreading in Puerto Rico: Public Health Watch Report

Federal assistance for Puerto Rico in the aftermath of Hurricane Maria may not be around “forever,” but an infectious component of the storm's impact on the US territory may linger.

According to reports in multiple media outlets, including the Washington Post, clinicians on the storm-ravaged island have already identified at least 10 cases of leptospirosis, a water-borne infection. Given that as many as one-third of Puerto Rico's residents still do not have running water—some 4 weeks after Maria touched down—it is expected that more cases of the bacterial disease will emerge as residents have been forced to stand in line for access to communal water supplies. Leptospirosis is also spread via dogs and cats, livestock, and rodents—relevant considering a report by the, which suggests that garbage collection has not resumed on much of the island and that there have been sightings of dead animals in the streets in some areas.

All of which makes Puerto Rico a potential ground zero for a major outbreak of an infectious disease, experts say.

Notably, leptospirosis is relatively rare, which makes its appearance on the island all the more striking. The Centers for Disease Control and Prevention (CDC) estimates that there are fewer than 200 cases of leptospirosis annually in the country and its territories, with roughly 50% of those occurring in Hawaii. The largest reported outbreak in the United States occurred in 1998 when 775 people were exposed and 110 ultimately became infected.

It’s been less than a week since the first confirmed case in Puerto Rico. Meanwhile, at least 1 case of the bacterial disease has been reported in the US Virgin Islands.

The fact that Puerto Rico has also only recently emerged from another public health crisis, that of the Zika virus, arguably makes the effects of Maria all the more pronounced. Although both Florida and Texas identified locally-transmitted cases, the island territory reported nearly 35,000 such cases in 2016 alone, according to CDC figures. Officials in San Juan only declared the Zika outbreak over in June.

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