SAN JUAN, Puerto Rico -- Doctors in Puerto Rico are warning that the U.S. territory does not have the resources to handle the fallout of a Zika epidemic as officials report an uptick in the number of fetuses with malformations that were carried by women infected with the virus.
The cases are among the first of what health officials believe could reach a couple hundred next year, sparking concerns about the lack of funds and specialists needed to care for children with severe birth defects on an island mired in a deep economic crisis.
"We are talking about babies that will have problems with hearing disorders, developmental disorders," said Dr. Nabal Bracero, who runs a fertility clinic. "And now, because of the complexity of Puerto Rico's financial situation, our health system is not ready for that."
So far, 13 dead fetuses belonging to Zika-infected mothers have been identified. Several of them presented signs of brain damage, and one was sent to the U.S. Centers for Disease Control and Prevention in Atlanta to be analyzed, according to Health Secretary Ana Rius.
It is unclear whether the 13 cases involved miscarriages or abortions. Jillian Oliveras, a spokeswoman for Puerto Rico's Health Department, said no further information would be released because of privacy laws.
Puerto Rico reported the first Zika-related microcephaly case acquired on U.S. soil in May, and a recent study estimates that up to 10,300 pregnant women on the island could be infected with Zika and that between 100 to 270 babies could be born with microcephaly.
"We are moving into what I call the perfect storm, which will be spring of 2017," Bracero said. "We will have a peak of cases with the least amount of resources."
Puerto Rico faces a nearly $70 billion public debt load it is seeking to restructure, and a federal control board is expected to soon take over the island's finances as a result of a recent U.S. rescue package. Government officials have warned there is barely enough money to keep providing essential services such as education, health and public safety.
The island's Health Department is currently identifying how many medical specialists there are and where they are located as it prepares for a surge in cases, said Dr. Miguel Valencia Prado, director of the department's Division of Children with Special Medical Needs.
The cost to treat a microcephaly case throughout a person's lifetime could range roughly from $3.8 million to $10 million, depending on the severity of the case, he said, adding that he was concerned given Puerto Rico's financial situation plus other limits as a result of being a U.S. territory.
"We cannot expand many services given a cap on Medicaid," he said, referring to a U.S. law that limits the amount of federal funding Puerto Rico receives. "We have to figure out how to make this work."
His concern comes as the CDC director warned Friday that the U.S. government has essentially run out of money to fight Zika amid funding delays, and that microcephaly cases will increase as a result. Previously, Republicans who delayed acting on a $1.9 billion request to fight Zika said none of the money should go to affiliates of Planned Parenthood in Puerto Rico.
Puerto Rico has a total of 17,871 Zika cases, including 1,517 pregnant women. A total of 144 people have been hospitalized, including 45 diagnosed with a temporary paralysis condition known as Guillain-Barre. Two people who had Zika coupled with other medical conditions have died, and a third person between 35 and 45 years old died in July after becoming infected with Zika and developing Guillain-Barre.
