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A month later she also found out she was pregnant, and that eventually led to a surprising revelation. The rashes hadn’t been caused by allergies, but instead by Zika, a virus known to cause serious birth defects.

Since 2015, the virus, which is spread by mosquitoes and sexual contact, has risen from relative obscurity to a worldwide menace. Puerto Rico marks the epicenter of the outbreak in the United States. As of Dec. 16, the commonwealth’s health department reported 35,648 confirmed cases, including 2,864 pregnant women. Federal health officials have declared a public health emergency here and anticipate 25 percent of the  population will have contracted the virus by the end of 2016.

The epidemic raises difficult personal questions for women like Mojica, who live on an island with strong religious undercurrents and a health care infrastructure bowing under the weight of fiscal debt. Is abortion acceptable or can faith overcome the fear? If a baby is born with disabilities like microcephaly, characterized by an abnormally small head, or cognitive impairments, how will families provide the care a child will need?

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(Image: Carmen Heredia Rodriguez/KHN)

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