Health Department warns of underreporting of extreme heat cases

Health Secretary Víctor Ramos Otero, who warned that extreme heat-related illnesses and deaths may be underreported and urged greater recognition of heat stroke cases.

By THE STAR STAFF

Health Secretary Víctor Ramos Otero warned Tuesday that extreme heat-related illnesses and deaths may be underdiagnosed in Puerto Rico, where 742 emergency room visits linked to heat exposure were reported between January 2025 and June 2026.

“It is important that these cases be reported to the Department of Health, but many times the reports that reach Forensic Sciences indicate dehydration or a heart attack, and those deaths are not being associated with heat stroke,” Ramos Otero said during a press conference.

The secretary reported that 240 heat-related emergency visits have been recorded in 2026, with the latest week reaching 20 cases, the highest weekly total during the period. The average since January 2025 is 9.51 visits per week.

The Bayamón region leads with 160 reports, followed by Caguas with 153 and Ponce with 102. Women accounted for 308 visits and men for 434. The age groups with the highest number of cases were people ages 20 to 29 and 60 to 69, with 114 visits each.

Ramos Otero identified symptoms of heat stroke as thirst, cramps, weakness, nausea, irritability, headaches, dizziness, confusion, seizures, loss of consciousness, hot or dry skin, and elevated body temperature.

He explained that treatment generally includes hydration and diagnostic tests, but stressed that healthcare providers must first suspect the condition in order to identify it.

The secretary noted that older adults and infants are among the most vulnerable groups, though healthy teenagers have also suffered heat-related collapses during outdoor sports activities.

“We have had healthy teenagers practicing basketball and volleyball in intense heat who have collapsed during the game,” he said.

A Health Department official warned that cases may be significantly underreported, possibly reaching “the thousands,” because heat exposure is not always identified as the cause.

Ramos Otero said Puerto Rico’s familiarity with warm weather can make it harder to recognize the dangers of extreme heat. He noted that the island experiences more than 100 days of extreme heat annually.

The Health Department will provide medical support at two major weekend events: the Internal Tourism Fair in Cabo Rojo and the Latin American Little League Series in Sabana Grande.

The secretary also reported 337 new influenza cases, 375 COVID-19 cases, eight respiratory syncytial virus cases, and 16 dengue cases. The 2025-2026 influenza season has recorded 73,206 cases, 218 confirmed deaths, and nine deaths under investigation.