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Puerto Rico is reporting nearly 120 Zika cases, including at least five pregnant women. That's a concern because of Zika's possible link to severe birth defects. NPR's Greg Allen reports the U.S. territory is working with federal health officials to protect Puerto Ricans.
GREG ALLEN, BYLINE: It's lunchtime in Bayamon, a bustling San Juan suburb that's also a center for health care. It's home to dozens of hospitals and clinics.
MONICA FIGUEROA: (Speaking Spanish).
ALLEN: Monica Figueroa, a nurse who works at the Metro Pavia Clinic, is outside getting lunch at a food truck.
FIGUEROA: (Speaking Spanish).
ALLEN: She says she's pregnant in her second trimester and knows all about Zika.
FIGUEROA: (Speaking Spanish).
ALLEN: "It's a virus," she says, "you can get from a mosquito," and she's wearing repellent. But she says her friends aren't paying much attention to Zika. Compared with other tropical diseases carried by mosquitoes like dengue and chikungunya, the symptoms of those infected with Zika are usually mild. Only about a fifth of those infected actually get sick. But at least one person with Zika in Puerto Rico has developed a neurological disorder - Guillain-Barre - which may be linked to the disease. Zika is especially concerning for pregnant women because it may cause birth defects - in particular, microcephaly, a condition in which babies are born with smaller than usual heads. Arlene Coto is in her last trimester and worried. She had just come from seeing her doctor.
ARLENE COTO: (Speaking Spanish).
ALLEN: She says her doctor tells her not to be alarmed. At home, she says, she takes steps to protect her family from mosquitoes.
COTO: (Speaking Spanish).
ALLEN: "We have to fumigate and use repellent," Coto says. But like many in Puerto Rico, she doesn't have screens on her windows. That's something the island's government, with help from federal authorities, is working to address.
JOHNNY RULLAN: We have to do what we didn't do in 30 years in 45 days.
ALLEN: Johnny Rullan is a CDC-trained epidemiologist and a former Puerto Rican secretary of health who's now advising the government on its Zika response. The government is installing screens in the island's high schools and plans to make screens available for the homes of pregnant women. While Zika is new to Puerto Rico, the island has extensive experience with other tropical diseases, like dengue, which infects thousands of Puerto Ricans each year. Faced with a few dozen Zika cases, the island's government has done something it's never done with dengue. It declared a public health emergency. Rellan says for good reason. Pregnant women are being infected now.
RULLAN: People don't understand that the battle is going to be in October. If babies start being born with microcephalia in October, November, December, we lost the battle.
ALLEN: Rellan says more than 90 percent of pregnant women in Puerto Rico receive nutritional services through government-run centers. All clients will be screened for Zika. Any woman who's infected, Rellan says, will be closely monitored. Puerto Rico isn't facing Zika alone. A team of researchers has been dispatched from the Centers for Disease Control. Dana Thomas, an epidemiologist with the CDC is working in the office of Puerto Rico secretary of health to monitor Zika's spread. When chikungunya hit the island in 2014, it was during the rainy season. She says it took just four months for the disease to spread throughout Puerto Rico. Because the majority of people don't show symptoms, Thomas says, tracking Zika is more problematic. The worst may still be ahead.
DANA THOMAS: So we picked this up, sort of, in what's technically our dry season, so the question is, what will happen come April and May as we have more rain and potentially more mosquitoes?
ALLEN: Complicating Puerto Rico's fight with Zika is the island's financial crisis. To deal with its massive debt, Puerto has laid off thousands of public employees in recent years, including many in public health. To help the island meet the challenge, the Obama administration is asking Congress for nearly $500 million, money that would be used to shore up the health care system and support Puerto Rico's fight against Zika. Greg Allen, NPR News, San Juan, Puerto Rico.
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