SAN JUAN, Puerto Rico (CBSMiami) – The government of Puerto Rico has acknowledged and declared a dengue epidemic on the Caribbean island nation.

According to CBS News, Puerto Rican Health Secretary Lorenzo Gonalzez said at least six people have died, including two children younger than 10 years old.

Puerto Rican authorities said a total of 4,816 cases have been reported, including 21 cases of the deadly hemorrhagic dengue. According to the National Institute for Health, dengue hemorrhagic fever happens when a person catches a different dengue virus after being infected by another strain sometime before.

The Centers for Disease Control and Prevention said 342 new cases of dengue were reported in one last month, double the number of cases during the same period last year, according to CBS News. Dengue usually flares up from August to January.