Leptospirosis, an illness often spread in floodwaters via animal urine, is rarely a fatal disease and is easily treatable with antibiotics — but the Puerto Rican government refused to declare an outbreak, which could have furthered the illness' effects by failing to prompt greater surveillance and prevention efforts.
University of California San Diego medical professor Dr. Joseph Vinetz told CNN the number of deaths was “extraordinary”:
“Twenty-six deaths attributed to leptospirosis — that's extraordinary. There's no other way of putting it. ... The numbers are huge."
Late last month, Puerto Rico’s Department of Health said only four people died as a result of leptospirosis following Maria but added two more after CNN brought the 26 deaths to its attention.
The government's official death toll from the storm sits at 64 and doesn't include the two cases added by Puerto Rico's Health Department, pending a wider government review of the death toll. Independent estimates believe that number is widely underreported — and could number in the thousands.