LA PAZ, Bolivia (AP) — Hospitals in Bolivia’s eastern Santa Cruz region struggled Wednesday to keep up with an outbreak of dengue that has killed at least 26 people.

It marks the largest outbreak of the mosquito-borne disease since the COVID-19 pandemic. Most of the almost 7,000 cases detected since January have been in Santa Cruz, the country’s most populous region, where two of the most lethal variants of the illness have been detected.

“The hospital is full, there’s no more space, patients sleep in the hall in order to be admitted,” Fredy Rojas, a pediatrician at the Santa Cruz Children’s Hospital, told a local radio station. “Many children get here in serious condition and there isn’t enough time to reverse the situation.”

At least 26 people have died, Bolivia's health ministry said.

Dengue is endemic in Bolivia and proliferates in the country's east during its December-to-March rainy season. It causes flu-like symptoms that most people recover from, but also can rapidly deteriorate blood vessels, leading to internal bleeding, organ failure and even death.

Brazil, Paraguay and Bolivia have the highest incidence of the disease in South America, according to the World Health Organization.