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

In a commentary published on October 12, 2017 in the New England Journal of Medicine, Contagion® Editorial Advisory Board member, Carmen D. Zorrilla, MD, Department of Obstetrics and Gynecology and the Maternal-Infant Studies Center, University of Puerto Rico School of Medicine-San Juan, noted, “The potential development of infectious disease outbreaks and reactivation of dengue, Zika, and chikungunya epidemics is one major concern… This hurricane might well increase the mosquito population, and people may not pay attention to prevention messages or be willing to modify behaviors that affect their seeking of food, water, and gasoline or repairing of their homes.”

Last week, Contagion® reported that both the Infectious Disease Society of America (IDSA) and HIV Medicine Association (HIVMA) issued a joint statement calling for dedicated aid in Puerto Rico to “minimize the health effects of the hurricanes.” Specifically, they cited the hazards posed by water-borne pathogens, food-borne illnesses, and mosquito-borne infections.
Political leaders seem to be listening to these calls for action. Earlier this month, for example, President Trump asked Congress to approve $29 million in federal funding for aid to Puerto Rico. It would be part of a much larger, $36.5 billion package for hurricane relief that would also cover damage in Florida, Texas, and the Virgin Islands; however, as of this writing, the request has not yet been approved. According to, the House of Representatives recently approved a $4.9 billion aid package, although total recovery costs for Puerto Rico alone have been estimated at $90 billion. And, according to, Senator Marco Rubio (R-Florida) has written a letter to the US Department of Health and Human Services advocating for urgent action in Puerto Rico to address ongoing “public health concerns.”

Will it be enough, and will it happen before an infectious disease reaches epidemic proportions on the island? Only time will tell.
Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.
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