PAHO Warns Cuba Faces ‘Very High’ Disease Risk as Mosquito Outbreaks Collide With Blackouts and Food Shortages

On a sweltering afternoon in Santiago de Cuba, nurses at a provincial hospital moved patients by flashlight as the power cut out for the third time that day. In the pediatric ward, mothers fanned feverish children with cardboard while a diesel generator sputtered to keep a single neonatal incubator and a handful of IV pumps running.

“Almost every family on this block has been sick at least once since last year,” said one nurse, who asked not to be identified because she was not authorized to speak to the press. “Fever, pain in the joints, headaches. Sometimes we don’t even have the tests to know which virus it is.”

Her account matches a warning now laid out in stark terms by regional health officials.

PAHO: Cuba’s health risks ‘very high’

On March 6, the Pan American Health Organization (PAHO) published a 42-page Public Health Situation Analysis on Cuba linking overlapping epidemics of mosquito-borne disease with an energy crisis, food shortages and the lingering impact of recent hurricanes. The analysis, dated March 6, 2026, is one of the most detailed public assessments to date of how a health system once held up as a regional model is straining under simultaneous pressures.

PAHO concludes that the risk from vector-borne and water-, and food-borne diseases in Cuba is “very high,” based on both the likelihood of transmission and the severity of consequences. Other health threats—including chronic conditions, maternal and neonatal complications, malnutrition and mental health—are classified as “high” risk.

Three arboviruses driving the alert

At the core of the report is a surge in three arboviruses: chikungunya, dengue and Oropouche.

Chikungunya

Since July 2025, Cuba has registered 51,217 suspected chikungunya cases, 1,959 laboratory-confirmed infections and 46 deaths across 13 of the country’s 15 provinces, the report says. In just the first four epidemiological weeks of 2026, authorities documented another 1,457 suspected cases, 114 confirmed infections and two deaths.

Regional officials say Cuba’s incidence of chikungunya in 2025 was the highest in the Americas, placing the island at the center of a wider resurgence that prompted PAHO to issue a hemispheric chikungunya alert in February.

Dengue

Dengue, a long-running problem in the Caribbean, has not eased. For 2025, Cuba reported 30,692 suspected dengue cases, 441 laboratory confirmations and 19 deaths, with about 2.5% of cases classified as severe dengue.

PAHO notes that dengue virus serotypes 3 and 4 are circulating, with some detection of serotype 2—a pattern that can increase the risk of more serious disease in previously infected people.

Through the first two weeks of 2026, authorities registered 202 suspected dengue cases with no deaths, but a higher proportion labeled severe and spread across 10 provinces, suggesting continued transmission.

Oropouche

Oropouche virus, which causes a febrile illness resembling dengue or chikungunya, is described as more complex. PAHO tallies 28 laboratory-confirmed Oropouche cases in Cuba between epidemiological weeks 1 and 29 of 2025 across 12 provinces, including Havana, Pinar del Río, Camagüey and Santiago de Cuba. Four patients developed serious neurological complications: three cases of meningoencephalitis and one of encephalitis.

Those figures, the report notes, do not capture the wider epidemic described in other official summaries. An emergency brief published earlier this year—drawing on Ministry of Public Health data—reported 23,639 suspected Oropouche cases and 626 laboratory-confirmed infections in Cuba as of Jan. 30, 2025, including dozens of Guillain-Barré syndrome and encephalitis cases. Subsequent summaries cited roughly 29,000 cases over the course of the outbreak.

PAHO warns Oropouche has established local transmission in a population that is “immunologically naïve,” increasing the risk of rapid spread and severe complications.

Cuban officials acknowledge a ‘multi-virus’ outbreak

Cuban authorities formally acknowledged the scale of the crisis in late 2025. In October, the Ministry of Public Health declared a “multi-virus arboviral outbreak” involving dengue, chikungunya and Oropouche. On Nov. 12, President Miguel Díaz-Canel used the term “epidemia” to describe transmission of the three viruses and urged a national mobilization similar to the country’s response to COVID-19.

“The current epidemiological situation of dengue, chikungunya and Oropouche is complex,” Health Minister José Ángel Portal Miranda said in a televised address that month, citing increased mosquito indices and calling for intensified fumigation and community clean-up campaigns.

Storm damage and blackouts amplify health threats

PAHO’s report argues the outbreaks are inseparable from broader shocks to living conditions and basic services.

Hurricane Melissa made landfall in eastern Cuba on Oct. 29, 2025, as a Category 3 storm with sustained winds exceeding 195 kilometers per hour and more than 400 millimeters of rain in some areas. The storm exposed more than 3 million people to hurricane-force conditions, forced about 735,000 evacuations and damaged more than 215,000 homes and 1,860 schools, according to the analysis.

Melissa struck provinces such as Santiago de Cuba, Granma, Holguín and Guantánamo, where water and sanitation systems were already fragile. Flooding and housing destruction created widespread standing water and displaced families into crowded shelters—conditions that can accelerate mosquito breeding and increase the spread of water-borne infections.

The hurricane followed two major storms the previous year, Oscar and Rafael, and a series of earthquakes. PAHO describes the convergence of disasters, combined with an ongoing economic downturn, as an “unparalleled crisis.”

Fuel shortages ripple through food, water and hospitals

A fuel shortage that worsened in late 2025 has driven rolling blackouts nationwide. In February, the government adopted an Energy Contingency Plan that cut diesel allocations to key sectors.

The report says agricultural fuel supplies were cut by about 60%, paralyzing roughly 70% of tractors and reducing weekly land preparation from 15,000 hectares in 2024 to less than 3,000 hectares by February 2026. The plan projects a 40% drop in short-cycle crops, raising the risk of deeper food insecurity in a country that imports more than 80% of its food. Food inflation has surpassed 200%, and distribution of state-regulated basic food baskets has been intermittent.

More than 80% of Cuba’s water pumping and treatment systems depend on electricity, PAHO says. Hospitals and clinics rely on unstable grid power and aging generators to operate operating rooms, laboratories, cold storage for vaccines and blood products, and life-support equipment.

PAHO estimates about 5 million Cubans live with chronic conditions requiring regular monitoring and medication, including heart disease, diabetes and cancer. In 2021, noncommunicable diseases accounted for 61.1% of deaths in Cuba. The analysis warns energy rationing has already forced reductions in CT scans and other diagnostic imaging, limited some laboratory testing, and shifted more care toward basic primary-level services.

Maternal, neonatal and mental health at risk

Maternal and neonatal programs—long a point of pride for Cuban officials—are described as particularly vulnerable. The report says more than 32,000 pregnant women currently in the system face delays in obstetric ultrasounds and emergency referrals as fuel constraints limit ambulance services. Neonatal intensive care units, dependent on reliable electricity for incubators and ventilators, are described as highly exposed to blackouts.

“Recent gains in maternal and neonatal outcomes are at risk of reversal,” the document concludes.

PAHO also flags mental health and gender-based violence risks. Cuba’s suicide rate in 2021 was 9.2 per 100,000 inhabitants, among the highest in the Americas. A national survey conducted in 2019 found 26.6% of women had experienced intimate partner violence, but only 3.7% sought institutional help.

Repeated disasters, prolonged blackouts and overcrowded conditions are likely worsening stress, anxiety and depression and could raise the risk of domestic and gender-based violence, the report says—trends that remain difficult to quantify amid stigma and limited reporting.

Questions of undercounting and constrained surveillance

Independent and exile media have amplified accounts of families reporting high fever, vomiting, rashes and severe joint pain, only to be advised at clinics to return home and manage symptoms with hydration and over-the-counter painkillers. Some allege deaths related to arboviruses and treatment delays are being undercounted.

The government has rejected accusations of data manipulation and says it has been transparent while acknowledging shortages of medicines and diagnostic reagents.

PAHO’s analysis does not directly address underreporting allegations but notes that laboratory capacity is constrained and that some surveillance data are based on clinical diagnoses rather than confirmed testing.

Aid response and regional implications

Human rights groups, including the Observatorio Cubano de Derechos Humanos, have called on the government to declare a national sanitary emergency, arguing that the combined arbovirus outbreak and shortages meet that threshold. Authorities have instead framed the response as part of ongoing civil defense and health-system management.

International partners are moving to support the response. PAHO has sent multidisciplinary missions to Cuba since 2024 to investigate Oropouche and other outbreaks, strengthen surveillance and update clinical protocols. With donor funding—including the United Nations Central Emergency Response Fund and the European Union—the organization has delivered emergency health kits, medicines, diagnostic supplies, tents, water purification tablets and 16 to 45 kilovolt-ampere generators to support key health facilities.

Regional health officials note Cuba’s crisis is unfolding amid record-breaking dengue transmission and expanding chikungunya and Oropouche circulation across Latin America and the Caribbean. The U.S. Centers for Disease Control and Prevention has issued travel notices for affected countries, including Cuba, and has reported Oropouche infections in travelers returning to North America and Europe.

A system running on improvisation

For many Cuban health workers, daily life has become a series of workarounds. In the Santiago de Cuba hospital, staff time the most electricity-intensive tasks between scheduled blackouts and depend on relatives to bring food when the hospital kitchen cannot operate.

“When the light goes, we think first of the babies,” the nurse said, glancing toward the neonatal unit. “We try not to let the mothers see that we are also afraid.”

PAHO does not predict how the crisis will evolve. It calls for urgent reinforcement of vector-control campaigns, improved epidemiological and laboratory surveillance, and sustained support for essential health services—particularly for pregnant women, newborns and people with chronic diseases.

What is clear from the analysis is that Cuba’s ability to manage its triple mosquito threat is now tied to the stability of its power grid, its food system and its battered infrastructure—and that the health indicators that once defined the island’s international image are no longer guaranteed.