LINGAYEN, Pangasinan — The possibility of a leptospirosis outbreak remained in Central and Northern Luzon, as the Department of Health on Friday reported 18 fatalities from the flood-borne disease in the two regions.

The DOH said 13 people have died from the disease in Central Luzon, including eight in Nueva Ecija, and five others in Pangasinan.

Dr. Eduardo Janairo, regional director of Center for Health and Development in the Ilocos, said the number of leptospirosis cases in the province has been increasing, but not in the "impending outbreak areas" of Dagupan City and Mangaldan and Binmaley towns.

"It's good that there have no new cases in those three areas today, that's why we could not declare an outbreak yet. [But] there's still a possibility and it will depend on our monitoring," he said.

As of Friday, 119 leptospirosis cases had been recorded in 12 Pangasinan towns and cities since Oct. 2 when Typhoon "Pepeng" began dumping rains and flooded the province. Most of the cases came from Mangaldan (31), Dagupan City (20); and Binmaley (16).

Janairo said an outbreak was still possible because his office had found out that many people still did not know about the disease and how to prevent it.

On Thursday, Dr. Michael Canto, spokesperson of the Region 1 Medical Center in Dagupan City, said he had observed an "erratic" trend in the number of leptospirosis patients the hospital had been admitting.

"Sometimes, it's up, sometimes, down. I think this is because there are still many places in the province that have not been told about the disease," he said.

Janairo said leptospirosis cases in the province could still increase because this week is the height of the incubation period of the leptospira bacteria, which are transmitted through contact with soil or floodwaters contaminated with urine of rats or other infected animals.

"The incubation period is from three days to one month. So the average period is two weeks. Remember, two weeks ago, we had the floods," Janairo said.

He also said that most of the leptospirosis cases in La Union, where an outbreak had been declared in three towns, were farmers. "This may be because farmers usually work in the rice fields barefooted," he said.

In the last two days, health workers had been disinfecting floodwaters, mud, garbage and carcasses of dead animals to kill the leptospira bacteria, he said.

In Cagayan, the Center for Health Development in Cagayan Valley reported 19 cases of leptospirosis in the region.

In Pampanga, health officials expressed alarm over the increase in leptospirosis cases in flooded provinces after 13 people died out of 117 cases in Central Luzon. Of the number, Nueva Ecija had 61, Bulacan 22, Tarlac 21, Pampanga nine, and Aurora four.