Puerto Rico Country Report
In November, a US judge approved the first consensual debt restructuring deal, a positive indicator towards resolution of Puerto Rico's ongoing fiscal crisis; in May 2017, the island's government filed for bankruptcy protection on its USD70-billion debt. Reconstruction efforts under Governor Ricky Rosselló of the New Progressive Party continue in Puerto Rico following Hurricane Irma and Hurricane Maria in 2017. The island has faced interruptions to basic services, and struggled to rebuild its infrastructure, which poses operational challenges including blackouts and has led to thousands leaving the island. In September 2018, Rosselló sent a letter to US President Trump requesting reconsideration of statehood, which remains unlikely. The US Congress has the final say onthe island's status, with the Puerto Rico Admission Act of 2018 unlikely to gain the necessary support under a US Republican administration.
Governor Ricky Rosselló ran on a platform that, in part, emphasised making the island a more attractive investment destination and has recently sought to simplify the island's tax incentive system. Major operational disruptions followed from Hurricane Maria's in September 2017, and severe infrastructure disruptions remain, which saw prolonged power outages into 2018. Thousands of police officers participated in so-called sickout protests staged daily from late December 2017 through January over unpaid wages for overtime hours following Hurricane Maria. Concerns over corruption were highlighted by allegations of mismanagement at the island's electric utility.
The risk of terrorist violence remains moderate on the island, with no major incidents reported in 2018. The Fuerzas Armadas de Liberación Nacional (FALN) independence group, formerly active in the 1970s and 1980s, conducted hundreds of improvised explosive device attacks against soft targets, like retail outlets, eateries, hotels, airports, and offices, along with harder targets, like FBI offices, courts, and police stations. In the early 1980s, Los Macheteros attacked a government building with anti-tank grenade launchers and destroyed nine fighter aircraft at the Muñiz Air National Guard Base.
Diseases transmitted by insects or animals
The mosquito-borne diseases Dengue, Chikungunya, and Zika are all endemic to Puerto Rico.
Dengue is present in Puerto Rico. The island has experienced epidemics of Dengue periodically since 1963, with the most recent outbreak in 2010. Symptoms of Dengue include fever, headache, muscle and joint pain, fatigue, nausea, and rash. Dengue Hemorrhagic Fever (DHF) is a potentially deadly complication that is characterized by high fever, the enlargement of the liver, and hemorrhaging.
The island also experiences periodic locally-acquired outbreaks of Chikungunya. Symptoms of chikungunya include high fever, joint and muscle pain, rash, headache, nausea, and fatigue. The virus is rarely fatal but lingering joint pain can last for several weeks, even months, after the initial recovery.
Although cases remain relatively few, locally-acquired cases of Zika are not uncommon. According to the Caribbean Public Health Agency (CARPHA), the risk of contracting the Zika virus in the Caribbean region has fallen significantly and is now considered to be low. Case rates of the disease, detected in the region for the first time ever in late 2015, spiked in summer 2016 before falling sharply in 2017-2018. While the virus is usually relatively benign, links between the Zika virus and severe birth defects, as well as the potentially fatal neurological disorder Guillain-Barre syndrome (GBS), have been established.
Leptospirosis is present in Puerto Rico. Leptospirosis is a disease caused by Leptospira bacteria spread via the urine of infected animals. The infection causes flu-like symptoms, including high fever, joint and muscle pain, rash, headache, nausea, and fatigue. Severe cases of Leptospirosis may result in symptoms of Weil's disease, including kidney or liver failure, meningitis, and respiratory failure. Leptospirosis can be treated with antibiotics.
Diseases transmitted by food, water, or through the environment
Nearly three percent of travelers to the Caribbean are affected by Ciguatera, a type of fish poisoning caused by the consumption of contaminated fish, chiefly: barracuda, grouper, moray eel, amberjack, sea bass, sturgeon, parrot fish, surgeonfish, and red snapper. Symptoms of Ciguatera begin to appear 1-3 hours after consumption and include nausea, vomiting, diarrhea, stomach pain, and in some cases neurological symptoms such as a tingling sensation, tooth pain or feeling as if the teeth are loose, itching, a metallic taste in the mouth, and blurred vision.
Hepatitis A and typhoid fever, both spread via contaminated food and water, are also present in Puerto Rico.
Gastrointestinal infections, including diarrhea, can be contracted in Porto Rico. This is contracted by ingesting bacteria, protozoa, and viruses, and can be transmitted by an infected person not practicing proper body hygiene and via food and water. Transmission rates tend to rise each year during the rainy season.
There is the risk of contracting a parasite or bacterial infection when bathing in bodies of freshwater such as lakes and ponds.
Diseases transmitted by contact with infected people
Puerto Rico has recorded one of the highest HIV/AIDS infection rates in the US. More than 50 percent of cases are acquired through the use of intravenous drugs.
Vaccines required to enter the country
No vaccinations are required to enter Puerto Rico.
Vaccines recommended for all travelers
Routine vaccinations: Consult your doctor to ensure all routine vaccinations - such as for diphtheria, tetanus, polio, tuberculosis, influenza, measles, mumps, pertussis, rubella, varicella, etc. - are up to date (include booster shots if necessary).
Vaccines recommended for most travelers
Hepatitis A: The vaccine is given in two doses, six months apart, and is nearly 100 percent effective. The WHO recommends the vaccine be integrated into national routine immunization schedules for children aged one year or older.
Typhoid fever: The typhoid fever vaccine can be administered via injection (administered in one dose) or orally (four doses). The vaccine is only 50-80 percent effective, so travelers to areas with a risk of exposure to typhoid fever, a bacterial disease, should also take hygienic precautions (e.g. drink only bottled water, avoid undercooked foods, wash hands regularly, etc.). Children can be given the shot beginning at two years of age (six years of age for the oral vaccine).
Vaccines recommended for some travelers
Hepatitis B: The WHO recommends that all infants receive their first dose of vaccine as soon as possible after birth, preferably within 24 hours. The birth dose should be followed by two or three doses to complete the primary series. Routine booster doses are not routinely recommended for any age group.
Malaria: There is currently no malaria vaccine. However, various antimalarial prophylactics are available by prescription and can reduce risk of infection by up to 90 percent. Different medications are prescribed depending on the risk level and the strains of the virus present in the destination. Antimalarial tablets need to be taken throughout the trip to be effective and may need to be taken for as long as four weeks following the trip.
Rabies: The rabies vaccination is typically only recommended for travel to remote areas and if the traveler will be at high risk of exposure (e.g. undertaking activities that will bring them into contact with dogs, cats, bats, or other mammals). The vaccination is administered in three doses over a three-to-four week period. Post exposure prophylaxis is also available and should be administered as soon as possible following contact with an animal suspected of being infected (e.g. bites and scratches).
Earthquakes are common. The island is situated near a fault line and regularly experiences regular low-level seismic activity, although major earthquakes are possible. Puerto Rico is located on the limit between the North American and Caribbean plates, including at least eight fault zones. The largest recorded earthquake in the vicinity of Puerto Rico measured 7.1 magnitude on the Richter scale in 1918. A magnitude 6.4 earthquake struck roughly 56 km (35 mi) north of the island in 2014, resulting in structural damage in parts of northwestern Puerto Rico. Tsunamis may also follow major earthquakes and other geological events (e.g. underwater landslides, volcanic eruption). Two deadly tsunamis hit the island in 1867 and 1918 following major earthquakes.
The country is vulnerable to tropical cyclonic storm systems originating in the Atlantic Ocean. The Atlantic hurricane season runs from June to November, with the peak hurricane season from late August to early September. Severe tropical systems have the potential to cause widespread property and infrastructure destruction. In 2017, Hurricane Maria caused catastrophic damage in Puerto Rico totaling more than USD 90 billion. The US government measures Maria as the third costliest hurricane to strike its territory, and the most destructive to hit Puerto Rico. Maria also destroyed the island's power grid, wiping out more than 80 percent of its utility poles, and caused disruptions to essential services (e.g. health and telecommunications) into 2018. Moreover, dam failures and river flooding caused mass evacuations in the island's interior. While the official death toll from the hurricane is 64, it is estimated that more than 4000 people died in the aftermath of the storm.
Rainfall associated flooding
Thunderstorms and downpours are common during the rainy season, which lasts from April through November, with peak precipitation in the months of August through October. Deadly flooding and landslides, and consequent travel disruptions and evacuations, are possible during this period. The southern coastal areas of Puerto Rico generally receive less rainfall than other parts of the island (63-114 cm [25-45 in] mean annual rainfall), while the environs of El Yunque National Forest receive significantly more rain (292-445 cm [115-175 in] mean annual rainfall).
Puerto Rico maintains three federally funded interstate highways which are supplemented by several regional highways and municipal roadways.
Roads and infrastructure, such as power stations and dams, have faced severe disruptions since Hurricane Maria struck the island in September 2017. Residents have faced prolonged power disruptions and reduced health care services into 2018, although an influx of disaster relief funds from the US federal government has alleviated some of these concerns. The local government has pledged USD 652 million to repair roads in the years following Maria's landfall.
Climatic conditions in Puerto Rico - The northern two-thirds of the main island (the Atlantic side), including much of the highlands, is classified as a Tropical Rainforest and receives roughly a quarter of its annual rainfall during tropical storms or hurricanes. The Caribbean-facing coast of the island tends to remain slightly warmer than the Atlantic coast and central highlands year-round. The southern region is classified as a Tropical Monsoon Climate and monthly temperatures remain above 18°C (64°F) year-round.
The rainy season lasts from April to November, with the highest temperatures generally observed in September (averaging 32°C [89°F]). The corresponding dry season lasts from December to March (lowest temperatures generally observed in February, with lows averaging 21°C [70°F]). The hurricane season spans from June 1 to November 30.
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