The latest two victims died from leptospirosis, an infection that can spread after floods through contaminated water, Public Safety press officer Karixia Ortiz told CNN. The cause of death is also included in the latest list of certified deaths just released by Puerto Rico's Department of Public Safety.
Puerto Rico has announced at least 76 cases of suspected and confirmed leptospirosis, including several deaths, in the month after Hurricane Maria, according to Dr. Carmen Deseda, the state epidemiologist for Puerto Rico.
The spiral-shaped Leptospira bacteria, which are found in the urine of rodents and other animals, can spread after floods through drinking water or infection of open wounds, according to the World Health Organization.
Leptospirosis can be treated with antibiotics, and many people recover on their own. But a small number may develop dire complications such as meningitis or kidney or liver failure, according to the Centers for Disease Control and Prevention.
Lack of clean drinking water
Since the hurricane hit in September, many in Puerto Rico have not had access to clean drinking water or electricity. As of Wednesday, a quarter of households did not have access to clean drinking water, according to data from Puerto Rico's Autoridad de Acueductos y Alcantarillados
The Federal Emergency Management Agency has attempted to cover that shortage with bottled water deliveries, but some desperate residents have been drinking from whatever water sources they can find, such as rivers or creeks. Doctors and public health experts are worried that that the water crisis would lead to further health problems.
"There is a public health crisis here," Catherine Kennedy, a vice president at National Nurses United, told CNN from Puerto Rico. "They need water. And we haven't seen much of FEMA."
In early October, President Donald Trump told Puerto Rican officials they should be "very proud" that the death toll wasn't as high as in "a real catastrophe like Katrina," referring to the 2005 hurricane that destroyed New Orleans.
"Every death is a horror," Trump said, "but if you look at a real catastrophe like Katrina and you look at the tremendous -- hundreds and hundreds of people that died -- and you look at what happened here with, really, a storm that was just totally overpowering ... no one has ever seen anything like this."