It’s likely both numbers could be higher because they don’t reflect other suspected but unconfirmed cases in remote areas.
Although government officials say they’ve distributed water purification tablets and bottled water throughout the island, by late October there were still places where residents said the help hadn’t arrived.
Two weeks after the hurricane, Gambo Rodriguez’s stepfather started vomiting and came down with a fever.
But a week after he was released from the hospital, Cosme de Jesus was bathing and helping his wife wash clothes on the side of the road.
The situation was slightly better in San Juan, where government figures showed 91 percent of customers had service, but on other parts of the island the percentage was as low as 62.
“All of them, because they don’t have water,” Diaz responded.
But even those with running water are struggling to boil it, Chaves Arana said.
There’s also no definitive testing for leptospirosis available in Puerto Rico; in order to confirm cases, samples have to be sent to a Centers for Disease Control and Prevention laboratory in Atlanta.
Most patients don’t develop the more serious symptoms associated with the disease, Deseda said, but because leptospirosis can cause kidney or liver failure in some people, public health officials are advising doctors to immediately treat any suspected cases.
They were hoping to work with the CDC to confirm suspected cases in the future, but hadn’t yet been able to do so.