Respiratory syncytial virus continues to climb across Puerto Rico. The Department of Health counted 62 RSV cases in epidemiological week 42, covering Oct. 18-24, 2026 - a 51.2% jump from the week before and the fifth consecutive week of rising infections. ^[1][2] The 2026 total now stands at 1,275 cases, with 512 hospitalizations and one death associated with the virus. ^[3][4][5] Children under five account for roughly 80% of infections. ^[6] The October trajectory shows the acceleration building: an earlier Health Department report logged 37 new cases with the cumulative total at 1,170, and week 39 added 28 more, bringing the total to 1,130 with 449 hospitalizations as of Oct. 3. ^{[7][8][9][10][11]} Mayagüez, Metro, Bayamón and Caguas carry the island's highest cumulative incidence rates, and Arroyo leads all municipalities. ^[12][13] In response, Health Secretary Dr. Víctor M. Ramos Otero signed Administrative Order 2026-655, which authorizes RSV immunization or monoclonal antibody prophylaxis for infants whose mothers did not receive the prenatal RSV vaccine. ^[14][15] The Department of Health recommends hand washing to slow the spread. ^[16]