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At the Zika epidemic's 2016 height, 10 percent of Puerto Rican women were testing positive for the disease. But when Hurricane Maria slammed the island in September 2017, crippling its health care system, the focus shifted to hurricane recovery, and labs no longer sent testing samples to the Centers for Disease Control and Prevention. Beth Murphy takes a look at Zika in post-hurricane Puerto Rico.
The Zika outbreak in 2016 hit Puerto Rico hard, infecting 40,000 people.
But following the devastation wrought by Hurricane Maria one year ago, the island's health officials claim that there have been no new cases of the mosquito-borne virus.
In this story by the GroundTruth Project, in collaboration with Reveal from the Center for Investigative Reporting, Beth Murphy explores whether the hurricane really swept away Zika, and, if not, what's being done for moms and babies at risk?
It's part of this week's Leading Edge series, which focuses on science and medicine every Wednesday.
Stefan Rodriguez was born with severe birth defects caused by the Zika virus. Now 18 months, he will never be able to walk or talk.
He's having seizures now.
His mom Valerie tested positive at the height of the Zika epidemic in 2016, when all pregnant women in Puerto Rico were tested for free.
Dr. Carmen Zorrilla:
The Zika epidemic really increased the number of birth defects in places where we had Zika. It's irrefutable.
Dr. Carmen Zorrilla is a longtime OB-GYN at University hospital in San Juan. She says few of the island's 4,000 Zika babies have problems as devastating as Stefan's, but Zika can cause many other developmental issues, too, like eyesight and hearing problems.
And this is why I believe that testing during pregnancy is so important.
In the first nine months of 2017, testing identified another 1,500 pregnant women with Zika. Then, in September, Hurricane Maria slammed into Puerto Rico. Maria destroyed the island and crippled the health care system, including many of the systems set up to respond to Zika.
We had a catastrophe. We stopped the testing. The health care system collapsed.
While the island's health care system came back to life, the Zika testing program didn't.
They concluded, Department of Health concluded that there is no Zika, the epidemic ended the day of the hurricane.
Assistant Secretary of Health Concepcion Quinones de Longo claims the Zika testing program has been back up and running and says there is no current evidence of the virus.
Dr. Concepcion Quinones de Longo:
So far, we are not detecting new cases of Zika.
She also says within three weeks of the hurricane, her department sent Zika samples to the CDC lab in Atlanta for analysis.
But, in an e-mail, CDC officials refuted that, saying: "The Puerto Rico Health Department didn't send Zika tests to the CDC after Hurricane Maria."
There was no Zika testing done since September 2017, since the hurricane. So we have no way of knowing if we are still having transmission or not.
Doctors began questioning why the Health Department was misrepresenting the Zika response and risk.
Dr. Alberto De La Vega is chief of the high-risk pregnancy unit at University Hospital.
Dr. Alberto De La Vega:
This is an island with a lot of economic problems. Zika is bad business. So the economic burden is huge.
Physicians say they fear the Puerto Rican government is more interested in protecting tourism than public health. There's even evidence that the hurricane created more breeding grounds for mosquitos.
Scientists from a private research group placed mosquito traps around San Juan neighborhoods. If they catch more than three of the Zika-carrying species per trap, the Zika risk is considered significant.
Scientist Marian Ortiz says these days when they study what's in the traps, the numbers are three times that.
Dr. Marian Ortiz:
There were more breeding sites because of the debris from the hurricane. And so we saw places where we never saw larvae before. Because of the rain, there were many more breeding sites now available.
With public health officials claiming no new cases on the island, Dr. Zorrilla took matters into her own hands. She teamed up with the CDC to start a new testing program for pregnant women.
We're going to testing to all the pregnant women in our clinic during every trimester.
I hope it's gone. I would love to have not to work with it. I want to be ready. I want the evidence. If there's no Zika, fantastic. If there's Zika, let's work on this.
With a team of doctors, she continued testing through spring, summer and now into the fall, with alarming results.
The percentage of pregnant women testing positive for Zika today is almost as high as it was at the height of the epidemic in 2016. In this new study of 280 women, 9 percent tested positive.
When Stefan's family celebrated his first birthday, they decided on a superhero theme and dressed him like Clark Kent.
He's our little superhero. He's amazing.
For Stefan, there is no cure. For the rest of the population, there is no vaccine; 26,000 births are expected this year, with no formal Zika testing program in place.
For the "PBS NewsHour," I'm Beth Murphy in San Juan, Puerto Rico.
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