The first outbreaks of contagious disease are beginning on the island of Puerto Rico 10 days after Hurricane Maria strafed the U.S. territory with a direct hit, according to The Daily Beast, even as the federal response lags and President Donald Trump attacks Puerto Rico and its elected officials on Twitter.

The Daily Beast’s Pablo Venes spoke to Puerto Rican mayors and health officials about the ticking infectious disease time bomb waiting to explode into a full-on public health crisis as citizens enter their second week without electricity, air conditioning, water, food or medication.

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“Ninety-five percent of the island is still without electricity more than a week after Hurricane Maria struck, including most hospitals. Only about half of the island’s 3.4 million population has drinking water. These two factors, plus unsanitary flood water inundating homes and towns, have created a public-health emergency,” wrote Venes.

Mayor Julia Navarro of Loiza, a city half an hour’s drive from San Juan, said residents are showing signs of Dengue fever, Zika virus and a runaway epidemic of conjunctivitis that has infected more than 300 people.

“I’m here because there are still murky waters clogged on my streets and residents have been showing symptoms of Zika, Dengue and conjunctivitis virus,” she said. “If I didn’t come here personally, I wouldn’t get any help.”

Victor Ramos — president of the College of Physicians and Surgeons of Puerto Rico — told the Daily Beast that the health crisis is just beginning.

“We still see communities were flood water is on their driveways and common playground areas,” he said, noting the flood water is a combination of rainwater and raw sewage. “This has to stop. The second someone comes in contact with flood water, their lives and are in danger.”

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The lack of running water means that opportunities for proper hygiene have largely disappeared, Ramos said, leaving the population vulnerable to cholera, hepatitis A, meningitis, and salmonella.

“Without water supply, residents rely on stocking water to wash their mouth and do the dishes. This water is often stored incorrectly and this gets infected rapidly,” he explained.

Outside the cities, where information is scarce due to the collapsed communications network, Ramos said the problems will be the most intense — in the areas that are the most difficult to access.

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Puerto Rico’s network of hospitals are struggling to keep up with patient demands, but with no water, dwindling food supplies and a scarcity of diesel for generators, most are barely hanging on.

The island nation of Haiti was decimated in a 2010 earthquake, but the deaths from cholera in the months that followed outnumbered the lives lost in the quake itself. Four years later, Haiti struggled with an outbreak of chikungunya, a mosquito-borne virus that attacks the brain, joints and connective tissues.

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Hospital ship the U.S.N.S. Comfort left port at the end of this week — 8 days after the hurricane — to begin its trip to the beleaguered island. It is expected to arrive next week, but as Venes noted, “For some, it will be too late.”