Oren Dorell and Atabey Nuñez

USA TODAY

LOIZA, Puerto Rico — Massive damage to Puerto Rico's water system from Hurricane Maria poses a looming health crisis for island residents exposed to contaminated water, health workers and environmentalists warn.

Doctors and nurses who traveled to Puerto Rico since the hurricane hit Sept. 20 said they treated widespread symptoms related to unclean water, ranging from vomiting and diarrhea to conjunctivitis (pink eye), scabies and asthma. At least 74 suspected cases of leptospirosis, a dangerous bacteria, have been reported, including two deaths.

The federal Centers for Disease Control and Prevention said Wednesday it is conducting ongoing tests on suspected leptospirosis samples.

Gov. Ricardo Rosselló's office said 82% of the island's water meters are now active, but many residents say they still have no running water or the water they have is unsafe.

Many people are still collecting water from mountain springs and creeks that run alongside roads. Some know they should boil this water, and others don’t.

Puerto Rico health officials did not comment about the water and health problems.

Morovis Mayor Carmen Maldonado said that despite the governor’s claims, none of the 13 neighborhoods in her city has water service, and the water utility known as AAA is not doing enough to provide it.

“The humanitarian crisis that so many speak of is what we are living daily in Morovis, while the AAA refuses to look for alternatives,” Maldonado said in a statement.

“We’re worried that in places even that have running water whether that water is safe,” said Erik Olson, health program director at the Natural Resources Defense Council.

His group reported in May that Puerto Rico’s water system had the worst record under the Safe Water Act, with 70% of the people living with water that violated standards set by the U.S. law.

And now the situation is worse, Olson said.

“The drinking water system in Puerto Rico was already very fragile,” Olson said. “When you lose water pressure, what can happen is if there’s groundwater contamination with sewage or flooding, that water can get into those pipes.”

In the coastal municipality of Loiza, 20 miles east of the capital San Juan, municipal officials are providing water to 29,000 residents with tanker trucks and going house-to-house with bottled water, said Israel Morales Alicea, the town's communications adviser.

Alicea said he is not worried about a health crisis because with each delivery, municipal workers emphasize the importance of drinking bottled water.

Iricelis Ortiz, 42, said municipal officials have yet to pass through her neighborhood, so residents organized a committee to ask the city for what they need.

Ortiz worries that the bad-tasting, blue-colored water that runs in her pipes is unsafe. She and her aunt use it only to clean clothes and dishes, and to shower. They had tried boiling it, but “it tasted weird,” Ortiz said.

Bottled water can be hard to find and gets expensive, said her aunt, Maria Ortiz, 66. “If you are lucky to find some, a pack of 24 water bottles that used to be $3.99 now is about $7.50,” she said.

Medical workers who volunteered across the island report similar patterns of symptoms almost everywhere.

“Over the past two weeks, we’ve seen a continuous stream of adult and pediatric patients with gastrointestinal illness, most often involving fever, vomiting and diarrhea,” said Christopher Tedeschi, an emergency medicine physician at New York-Presbyterian/Columbia University Medical Center, who returned last Thursday from Puerto Rico. “It’s hard to say the source — or more likely sources — of the illness, although contaminated food and water are very likely.”

Tedeschi said his team treated more than 1,000 patients in the town of Manatí, 30 miles west of the capital. They also met with dozens of residents who either didn’t have access to clean water or weren’t sure if their water was safe.

“While boiling is an easy way to decontaminate water, most people I spoke to either didn’t (have) electricity or cooking gas to get that done,” he said.

Llamara Padró, a nurse at New York's Upstate University Hospital, who volunteered with a group of 40 nurses organized by the American Federation of Teachers (AFT), said they treated people with gastrointestinal symptoms and conjunctivitis. They also saw patients with scabies and asthma, which she suspected was related to sleeping in damp, moldy houses with damaged roofs.

“It’s right now a public health crisis,” said Padró, whose group worked in more than a dozen communities across Puerto Rico.

“They have no electricity, have no way of purifying water," Padró said. "People are using PVC pipes and collecting water that is contaminated by dead animals, sewage and leptospirosis that comes from rat feces.”

The teachers’ union has raised more than $300,000 to send thousands of household gravity-operated water filters and a few larger filtration pumps that run on electricity to the island. But AFT President Randi Weingarten said the effort is no substitute for a coordinated federal response.

Alicia Schwartz, a home-care nurse in New York City, described treating people with a fungus on their skin from sleeping in moldy conditions.

In the town of Orocovis, Schwartz said her group saw a resident whose uncle died from leptospirosis after collecting water from a mountain stream.

“They learned their lesson. They stopped” using water from the stream, she said.

But many others continue.

“That day we were visiting that town we had to stop numerous times, because people were collecting water from the streams on the side of the road,” she said.

Dorell reported from Washington

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