WASHINGTON, D.C. - U.S. Senators Cory Booker (D-NJ), Bob Menendez (D-NJ), and Bill Nelson (D-FL) today raised concerns to the Centers for Disease Control and Prevention (CDC) about its lack of staff on the ground in Puerto Rico and the U.S. Virgin Islands following devastating hurricanes that tore through the areas earlier this year.

In a letter to CDC Director Brenda Fitzgerald, the Senators urged the agency to deploy additional manpower to the hurricane-ravaged islands and cited a gaping disparity between the number of CDC workers deployed to Louisiana and other affected areas following Hurricane Katrina (roughly 200) and the number of CDC workers deployed to the islands following Hurricanes Irma and Maria (approximately 70).

“We are concerned that there are not enough staff on the ground assisting with the public health response and recovery efforts, therefore we encourage the agency to deploy additional staff throughout the islands,” the Senators said in the letter.

The Senators said that the dire conditions on the island, including displaced residents, rivers contaminated with raw sewage, and hospitals that aren’t fully operational, have created “a breeding ground for multiple public health crises.”

“Chronic conditions that were once manageable with the necessary health infrastructure are now urgent health concerns,” the Senators said.    

The lawmakers also sounded the alarm about the potential outbreak of diseases, due to exposure to contaminated water and standing water throughout the islands.

Full text of the letter is below.

November 6, 2017

The Honorable Brenda Fitzgerald, M.D.

Director

Centers for Disease Control and Prevention

1600 Clifton Road

Atlanta, GA 30329

Dear Director Fitzgerald:

We write today regarding the Centers for Disease Control and Prevention’s (CDC) efforts in Puerto Rico and the U.S. Virgin Islands in the aftermath of Hurricanes Irma and Maria.  We are concerned that there are not enough staff on the ground assisting with the public health response and recovery efforts, therefore we encourage the agency to deploy additional staff throughout the islands.

Hurricanes Irma and Maria have devastated Puerto Rico and the U.S. Virgin Islands, causing widespread power outages and shortages of food, safe drinking water, medicine, and other necessities.  In addition, thousands of people have been displaced from their homes, rivers are contaminated with raw sewage, and many hospitals are not yet fully operational.  These and other dire conditions on the island are a breeding ground for multiple public health crises.

People on the islands suffering from chronic disease are now having trouble accessing the care they need in the hurricanes’ aftermath. For example, there have been many anecdotal reports of patients with kidney disease who are having difficulty accessing their lifesaving dialysis treatments.[1]  Several media outlets have also shared stories of island residents with respiratory conditions who have rationed their oxygen supply for fear that they will not receive more when needed.[2]  Chronic conditions that were once manageable with the necessary health infrastructure are now urgent health concerns.    

We are also seeing signs of potential disease outbreak.  For example, there are currently more than 70 suspected cases of leptospirosis, which is a bacterial disease that is caused by exposure to floodwaters and other contaminated water.[3]  Left untreated, it can cause meningitis, liver failure, kidney damage, and even death.[4] In addition, while it is likely that the strong winds of the hurricane eliminated many of the existing mosquito populations on the islands, public health officials have expressed concern that the standing water throughout the islands will lead to epidemics of mosquito-borne illnesses, such as dengue, chikungunya, or the Zika virus.[5]

The various public health threats in Puerto Rico and the U.S. Virgin Islands require robust CDC response efforts on the ground.  This is not only necessary, but consistent with previous natural disasters.  In the aftermath of Hurricane Katrina, for example, as many as 200 CDC staff were deployed to the affected states to assist with disease surveillance, sanitation efforts, and public information and health risk communication.[6]  It is our understanding that as of November 2, 2017, approximately 53 CDC staff have been deployed to Puerto Rico and 16 CDC staff have been deployed to the U.S. Virgin Islands.  We respectfully request that the CDC immediately deploy more agency staff to Puerto Rico and the U.S. Virgin Islands to reach every community in need and mitigate the public health threats facing the islands.

Sincerely,


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[1] Frances Robles, “Puerto Rico’s Health Care Is in Dire Condition, Three Weeks After Maria,” The New York Times, Oct.10, 2017, https://www.nytimes.com/2017/10/10/us/puerto-rico-power-hospitals.html; Vann R. Newkirk II, “Puerto Rico's Dire Health-Care Crisis,” The Atlantic, Oct. 29, 2017, https://www.theatlantic.com/politics/archive/2017/10/puerto-ricos-health-care-crisis-is-just-beginning/544210/.

[2] Daniela Hernandez, “In Puerto Rico, Health Concerns Grow Amid Lack of Clean Water, Medical Care,” The Wall Street Journal, Oct. 4, 2017, https://www.wsj.com/articles/in-puerto-rico-health-concerns-grow-amid-lack-of-clean-water-medical-care-1507137646.

[3] Daniella Silva, “Puerto Ricans at Risk of Waterborne Disease Outbreaks in Wake of Hurricane Maria,” NBC News, Oct. 26, 2017, https://www.nbcnews.com/storyline/puerto-rico-crisis/puerto-ricans-risk-waterborne-disease-outbreaks-wake-hurricane-maria-n814461.