A 57-year-old man who became ill while in Immigration and Customs Enforcement custody in California died Wednesday as a result of a coronavirus infection, the first virus-related death of an ICE detainee in the United States.

San Diego County health officials confirmed that the man was hospitalized in late April after showing virus-related symptoms at ICE’s Otay Mesa Detention Center, which has the county’s largest outbreak cluster. As of Wednesday, at least 140 detainees at the facility, which is run by CoreCivic, have tested positive for the disease caused by the coronavirus, according to ICE data.

ICE officials confirmed that Carlos Escobedo Mejia was hospitalized April 24 and tested positive for the disease the same day at a hospital in National City, Calif. He died less than two weeks later. The preliminary cause of death was “undetermined,” according to a news release.

“Fatalities in ICE custody, statistically, are exceedingly rare and occur at a fraction of the national average for the U.S. detained population,” ICE officials said.

CoreCivic spokeswoman Amanda Gilchrist said the facility was in close contact with ICE about Escobedo Mejia’s condition and “immediately notified” the agency when he died.

“We extend our heartfelt sympathy to this individual’s loved ones,” Gilchrist said.

The detainee’s sister said Escobedo Mejia came to the United States decades ago with his family after war broke out in his home country of El Salvador. ICE took him into custody after the U.S. Border Patrol arrested him in January near Campo, Calif., and authorities placed in him in the Otay Mesa facility.

Escobedo Mejia, who told ICE he had diabetes and high blood pressure — both potential risk factors for complications from coronavirus infection — later spent days vomiting and complaining of pain, according to his sister, Rosa Escobedo Mejia. At one point, he stopped eating, according to a recorded interview with his sister that was released by advocates.

“They lock them up like animals,” Escobedo Mejia said. “Everyone was getting infected.”

A judge on April 15 denied bond for Escobedo Mejia, who was in removal proceedings, deeming him a flight risk, according to ICE.

The ICE detention center, operated by private prison contractor CoreCivic, and others like it across the country in Virginia, Texas and Louisiana have become the targets of lawsuits and protests as coronavirus infections have risen among the captive populations. More than 700 immigration detainees have tested positive for the virus since the outbreak began in February, according to ICE data.

Amid concerns about the outbreaks among confined people, U.S. District Court Judge Dana Sabraw, of the Southern District of California, ordered ICE to release dozens of “medically vulnerable” detainees — those who are over the age of 60 or have preexisting health conditions — after the American Civil Liberties Union filed a lawsuit seeking to protect those in custody.

The federal government said in court filings that it has released two people and that the number should rise to 72 by the weekend, using the medically vulnerable standard. ICE and CoreCivic have identified more than 130 detainees who fit that definition — or about one in five of the ICE detainees in custody there.

The infected detainees are placed in “cohorts” or isolated together away from healthy detainees. Otay Mesa has tested 181 ICE detainees as of Tuesday.

The ACLU argued that the risk of exposure is grave for detainees, who cannot practice social distancing. The conditions of confinement violate their rights to be safe and well in government custody, and releasing individuals is the safest option, said ACLU attorney Monika Y. Langarica. She said Escobedo Mejia’s death is exactly the kind of thing advocates were hoping to prevent.

“We did everything we could to prevent this, but the government has been on put on notice and they failed to act,” Langarica said.

ICE and CoreCivic said in court filings that they are following guidelines from the Centers for Disease Control and Prevention by providing personal protective equipment when needed, disinfecting surfaces, supplying soap to every housing unit and isolating those who are sick. The agency reported that 39 ICE employees at detention centers nationwide have tested positive for the coronavirus, but that count does not include infections among private contractors.

ICE reported that nearly 1,500 detainees have been tested nationwide. The agency said they have released dozens of people since March to reduce the detainee population.

California has released hundreds of state inmates to prevent outbreaks, while prisons in Texas and elsewhere are struggling to contain the spread of the virus. The outbreak at Otay Mesa represents the largest single cluster in San Diego County, officials said.

Local attorneys say that the facility’s response is inadequate and that it is reflected in the sharp surge of infections in recent weeks.

Attorney Nanya Thompson’s client tested positive inside Otay Mesa weeks after developing a violent cough and body aches. The woman, who suffers from hypertension, was given Tylenol and water and was told to rest in a room adjacent to the infirmary, Thompson said. The woman, in her 40s, is not on the list to be released from the facility.

“She’s freaked out,” Thompson said. “In the detention setting, it’s impossible to prevent it from spreading.”

Samuel Andara, who was a detainee at Otay Mesa, was not sick at the time but sued the government to secure his release as a way of avoiding the virus. Andara had been a nurse in his native Venezuela and is acutely aware of the dangers the virus poses, according to his attorney, Kirsten Zittlau. Andara was able to leave the facility last month after posting a $15,000 bond with help from donations.

“It’s just been horrifying,” said Zittlau, who has two clients inside the facility, one of whom has symptoms of covid-19, the disease the virus causes. “When you create all the circumstances for a death trap, it was just a matter of time that something like this would happen.”

Dulce Garcia, executive director of the advocacy group Border Angels, said she receives daily calls from people inside Otay Mesa afraid they are going to die. The organization has worked with an alliance of activists to donate masks for the detainees, but the donation was rejected.

“They do not have enough tests in there. Only those with signs of a fever are being tested,” Garcia said. “We had been lucky no one had died yet. But now, this is just the beginning.”