Mosquito-borne dengue fever is reaching epidemic stages across the Caribbean, with dozens of deaths reported and health authorities concerned it could get much worse as the rainy season advances.
The increase in cases is being blamed on warm weather and an unusually early rainy season, which has produced an explosion of mosquitoes.
Health officials say the flood of cases is straining the region's hospitals.
In the Dominican Republic at least 27 deaths have been reported, while Puerto Rico is facing what officials say could be its worst dengue outbreak in more than a decade.
Health officials in the United States fear the virus, which had disappeared from the US mainland, could regain a foothold there.