Three more people have died after becoming infected with a mosquito-borne virus that is raging across Central America, South America and the Caribbean, killing hundreds.
Puerto Rican chief epidemiologist Brenda Rivera Garcia said Friday that the chikungunya virus had claimed two lives in greater San Juan, and a third in the north-eastern coastal town of Fajardo.
Health authorities in the country are investigating two other deaths to establish if they died due to chikungunya. This virus has infected hundreds of thousands and killed an estimated 113 across the Americas, after emerging in the region less than a year ago.
There is no vaccine for the virus, which is borne by the A. albopictus and aedes aegypti mosquito, and causes symptoms including fever, severe joint and muscle pains, and headaches.
Amongst the countries affected, Venezuala has 1,700 cases, Colombia 4,800 and the Dominican Republic the worst hit with approximately 500,000 cases.
Cases of infection have also been reported in Brazil and the US, with victims believed to have returned after travelling to infected areas.
The outbreak has caused huge economic damage in the region, with the cost of absenteeism from work as well as providing health care and pesticides to kill mosquitos enormous.
Chikungunya has been known for decades in parts of Africa and Asia.
The name is from the Makonde language in Tanazania, and translates as "that which bends up", in reference to the excruciating joint pain that causes those infected to contort with anguish.
The violence of the outbreak in South America is believed to be due to the lack of immunity in a population that has never been affected by the virus before, and the prevalence of the vector mosquito aeges aegypti.