Puerto Rico's health secretary declared an epidemic on Monday following a spike in dengue cases.
The U.S. territory of 3.2 million people has reported at least 549 cases so far this year, compared with a total of 1,293 cases for all of last year. The majority of cases have been reported in the capital of San Juan.
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More than 340 people have been hospitalized for the mosquito-borne virus, according to the island’s health department.
Puerto Rico last declared a dengue epidemic in 2012.
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More than 5 million dengue cases were reported worldwide last year, with nearly 80% of them occurring in the Western Hemisphere, according to the World Health Organization. The region has reported some 3 million cases so far this year, with health officials noting that higher rainfall along with humidity and heat linked to climate change have contributed to a rise in cases.
The virus can cause crushing headaches, fever, vomiting, a rash and other symptoms. While most infected people don’t get symptoms, severe cases can lead to plasma leakage and death.