Manila team arrives to investigate biggest typhoid wave in C. Visayas

Why so many typhoid cases in so short a period in one town?

A three-member team of epidemiologists from the Department of Health in Manila arrived in Tuburan, northwest Cebu, to investigate the outbreak of the water-borne disease that neared the 1,000 mark yesterday, making it the highest recorded volume in Central Visayas.

“We are here to help not just in controlling the problem but to prevent its reoccurrence,” said Dr. Rowena Capistrano, senior epidemiologist of the National Epidemiological Center (NEC).

She said the team would spend 10 days in Tuburan to take samples from patients and water sources in a wider area, testing water supply even in barangays not affected by typhoid.

The origin of the contamination and its scope is still not determined.

“This is the largest (outbreak) I’ve ever seen. The water system is very vulnerable because there were no chlorinators,” said Renan Cimafranca of the Regional Epidemiological and Surveillance Unit (RESU) of the Department of Health in Central Visayas (DOH-7).

What the DOH considers a normal level of typhoid incidence is five cases in a single day for the whole region. Beyond that, it would declare an outbreak.

In Tuburan, within a week alone, the RESU recorded 915 typhoid cases, with 139 patients admitted in the Tuburan District Hospital as of yesterday.

Four deaths, mostly children, were recorded.

Capistrano said the wave of typhoid cases was definitely not related to the Feb. 6 earthquake. Some local officials earlier raised the theory that the powerful quake disturbed water pipes and caused leaks where bacteria could have seeped in.

Seven patients from Tuburan town were transported to Vicente Sotto Memorial Medical Center (VSMMC) in Cebu City yesterday, a total of 42 admissions there.

But RESU-7 coordinator Cimafranca said the wave of cases is slowing down.

“The trend is already to starting to decrease,” he told Cebu Daily News yesterday.

He said less than 100 patients were registered in the outpatient department of the Tuburan District Hospital with less than 50 patients admitted. In Cebu province and Central Visayas, Tuburan has recorded the highest incidence of typhoid.

He said RESU recorded 600 cases of typhoid fever in Alegria town, southwest Cebu with 36 patients admitted early last year.

The 25-bed Tuburan District Hospital has been crammed with patients since Saturday.

Hospital chief Dr. Esteban Ligaray said they set up additional beds in the hallways while the staff offices and conference rooms were converted into wards.

Ligaray said the situation is under control with assistance from the DOH-7 and the Provincial Health Office. They have enough medicine and supplies to treat patients, he said.

Patients are given antibiotics like chloramphenicol and contrimoxazole.

The NEC team from Manila came with five doctors from the East Avenue Medical Center and the San Lazaro Hospital in Manila.

Dr. Capistrano said the team will verify other suspected typhoid cases, determine the risk factors in the community and make recommendations to the Tuburan municipal government.

“We will not leave until we establish the proper monitoring of cases in the area. Our main concern is the investigation,” she said.

Patients must be regularly monitored for 14 days to one month, the duration of the disease. Typhoid fever is caused by the parasite called Salmonella typhi, which can be found in contaminated food or water.

Capistrano said the simplest solution is to chlorinate the water supply and boil drinking water.

“People should observe proper hygiene practices like washing hands regularly,” she added.

Symptoms of typhoid fever are continuous fever up to one week, headache, abdominal pain, diarrhea, skin rashes, jaundice and, in extreme cases, psychosis.

Cebu Gov. Gwendolyn Garcia will visit Tuburan town today to distribute relief aid in the town’s gym.

She said the medicine and services in the hospital are free and that each affected household will receive 10 kilos of rice. /With Correspondent Carmel Loise Matus