Puerto Rico's mayor of San Juan has sharpened her attacks against Donald Trump, blaming his administration for "structural negligence" that led to thousands of deaths in the wake of Hurricane Maria.

Carmen Yulín Cruz said the president was responsible for the federal government’s slow response to the deadly hurricane estimated to have killed nearly 3,000 people, during an interview with CNN's Anderson Cooper on the one-year anniversary of the storm.

"This is President Trump’s Katrina," the mayor said, referring to the catastrophic hurricane that struck the US in August 2005. "He can spin it all he wants — 3,000 people died on his watch."

Ms Cruz has frequently criticised Mr Trump ever since Hurricane Maria’s impact was felt across the US territory, while the president has said he earned a "10 out of 10" for his government’s disaster recovery efforts. He's also denied the revised death count from the storm of 2,975, claiming the study commissioned by the Puerto Rican government was a conspiracy created by Democrats to make him "look bad".

The mayor's latest comments arrived shortly after the deadly Hurricane Florence struck the Carolinas, Virginia and other parts of the country. Mr Trump travelled to impacted regions during the week after warning that the storm would be "tremendously big and a tremendously wet" hurricane.

The president was restrained during his visit to North Carolina on Wednesday, serving as consoler-in-chief while touting the storm's damage.

Bringing aid to Puerto Rico Show all 20 1 /20 Bringing aid to Puerto Rico Bringing aid to Puerto Rico Crew chief Kenney shelters under the blade of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit preparing to take off during recovery efforts following Hurricane Maria, in Isla Grande, Puerto Rico, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit takes off behind Crew Chief Alexander Blake and his fellow soldiers during recovery efforts following Hurricane Maria, in Morovis, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Crew member Bynum stands in tropical rain as a HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit prepares to take off during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico UH-60 Blackhawk helicopter pilot Chris Greenway receives a hug from a woman thanking him for water as he works with the First Armored Division's Combat Aviation Brigade during recovery efforts following Hurricane Maria, in Verde de Comerio, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico A man carries a case of water away from an HH-60 Blackhawk helicopter after soldiers working with 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Crew chief Alexander Blake from 101st Airborne Division's "Dustoff" unit loads water into a helicopter during recovery efforts following Hurricane Maria, in Isla Grande, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo Reuters Bringing aid to Puerto Rico An HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field to avoid lightning during recovery efforts following Hurricane Maria, in Manati, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents hold their hands aloft to signal that they need water as UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade fly past during recovery efforts following Hurricane Maria, near Ciales, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Tropical rain splashes on a runway as HH-60 Blackhawk helicopters from 101st Airborne Division's "Dustoff" unit wait for weather to clear during recovery efforts following Hurricane Maria, in Isla Grande, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Pilot Eldwin Bocanegra Torres speaks with residents isolated by landslides in the mountains after unloading water and food from a helicopter during recovery efforts following Hurricane Maria, near Utuado, October 10, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents stand in front of wind-damaged trees as they wait for soldiers in UH-60 Blackhawk helicopters from the First Armored Division's Combat Aviation Brigade to deliver food and water during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico The contents of a home are seen from the air during recovery efforts following Hurricane Maria near Utuado, October 10, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Thomas looks out of the window of an HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit, loaded with relief supplies, during recovery efforts following Hurricane Maria in Isla Grande, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico A message written on the rooftop is seen from the air during recovery efforts following Hurricane Maria near Humacao, October 10, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico A HH-60 Blackhawk helicopter from 101st Airborne Division's "Dustoff" unit lands in a field during recovery efforts following Hurricane Maria in San Sebastian, October 6, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Sergeant First Class Eladio Tirado, who is from Puerto Rico, looks for a landing spot for a UH-60 Blackhawk helicopter from the First Armored Division's Combat Aviation Brigade, during recovery efforts following Hurricane Maria near Ciales, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Boys carry water away from an HH-60 Blackhawk helicopter after soldiers working with the U.S. Army's 101st Airborne Division's "Dustoff" unit dropped off relief supplies during recovery efforts following Hurricane Maria, in Jayuya, October 5, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Sergeant First Class Eladio Tirado from the First Armored Division's Combat Aviation Brigade, who is from Puerto Rico, speaks with residents as he helps during recovery efforts following Hurricane Maria, in San Lorenzo, October 7, 2017 Reuters/Lucas Jackson Bringing aid to Puerto Rico Residents peek through a fence at helicopters from 101st Airborne Division's "Dustoff" unit that had parked in a locked field during recovery efforts following Hurricane Maria, in Lares, October 6, 2017 Reuters/Lucas Jackson

His response to the latest storm appeared to show the president’s greater care and concern for Americans in the mainland US, Ms Cruz suggested.

"You see the contrast right now,” she said. "Thank God the situation is different in North Carolina and South Carolina. But you see the president’s attention: he doesn't go there to throw paper towels."

Carmen Yulin Cruz shakes hands with a humbled US President Donald Trump after he criticised her leadership in the the aftermath of Hurricane Maria (Jonathan Ernst/Reuters)

Ms Cruz added, "Today, 3,000 Puerto Ricans opened their eyes, and because they didn't have insulin, they didn't have appropriate medical care, they didn't have dialysis, and they didn't have access to their medication, they died."

The president has sparred directly with Ms Cruz, who previously told The Independent that he has personally attacked her "just out of spite".

In one instance, the mayor was invited to participate in a White House conference call to discuss relief efforts, only to be reportedly be told not to speak.