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Contaminated water source seen as culprit in Gamay diarrhea outbreak

By Philippine Information Agency (PIA 8)
November 14, 2007

TACLOBAN CITY, Leyte  –  The Gamay diarrhea outbreak in Gamay, Northern Samar could be due to contaminated water source. This is the report of the DOH- RDCC-OCD Team which was formed and was dispatched to provide technical assistance and to conduct epidemiological investigation on November 11, 2007 via chopper from the Philippine Airforce Tactical Operation 8.

The team composed of Director Tiogenes Baluma of DOH Region 8, Dr. Nicolas Bautista who is the Regional Epidemiologist, Nurse Boyd Cerro who is the Epidemiology Nurse, Engr. Alejandro Rivera who is the Supervising Sanitary Engineer and OCD Director Salvador Estudillo coordinated with the NDCC for the transport of the needed medical supplies and manpower to Gamay.

The findings of the Team showed that there were 147 (used to be 154 but Director Baluma said that several names were entered twice) diarrhea cases who consulted the Gamay District Hospital from October 22 to November 11. Eighty cases were admitted, from ages one month to 78 years old.

Most of the affected age group are the one to four years old; one case died and most of the cases came from Barangay Burabod. One hundred twenty one of the cases drank water fro the Burabod water source.

Director Baluma said that the water source from Barangay Burabod was from a developed spring. Four jetmatic pumps were connected to the improved spring and were located outside the perimeter of the improved spring.

The report stated that several months before the epidemic, the barangay officials decided to construct a water reservoir which was again attached to the improved spring. This was operationalized on October 17. Water from the spring, without chlorination, was pumped into the reservoir, every 7:00 o’clock in the morning and at 5:00 o’clock in the afternoon, and distributed to the barangay through communal faucets.

In between, the water pump was turned off. People living near the source claimed that they utilized the water from the reservoir only for washing and bathing and only water from the four jetmatic pumps were used for drinking. However, houses far from the source were utilizing water for drinking from the reservoir.

A spring adjacent to the water source was also improved and was utilized by the residents for laundering of clothes. It was noted that the people washing their dirty clothes were also pouring their dirty water into the spring.

The report added that based on key informants interview, residents claimed that the level of the nearby spring used for laundering goes down when the electric pump was used.

In the report, the Team observed that the symptoms of the diarrhea outbreak were cholera-like in character. The outbreak could be due to the contamination of the water source. The use of an electric pump to pull out water to the newly constructed reservoir created a negative pressure inside the spring sources thereby suctioning water from the nearby springs used for laundering thereby contaminating the improved spring.

The presence of septic tanks from the houses less than 15 meters away from the water source can also be a factor for the contamination of the source, the report said.

Personal hygiene and home chlorination was emphasized until a system in chlorinating the water for drinking is in place, the Team recommended.

The actions taken, according to the Team’s report to Health Secretary Duque, are provision of medicines, IV fluids and medical supplies to the hospital and Rural Health Units of Gamay and Lapinig; provision of technical assistance in the consultation and conduct of epidemiological investigation; provision of chlorines for home chlorination (stock solution); augmentation of medical manpower to the hospital; advisory for local sanitary inspectors on how to improve water system; conduct of water sampling and coordination with OCD and other agencies.

On November 9, Dr. Mary Ann Avalon, the Provincial Health Officer of Northern Samar reported to the Region of 100 diarrheal cases of whom 60 were admitted at the Gamay District Hospital. Most of the cases came from 8 barangays of the municipality. Along with the report was the request for augmentation of manpower to the hospital and fluids and medicines to meet the increase demand of services.

A DOH- Provincial Health Team Physician was immediately requested to proceed to Gamay on November 10, 2007. Medicines and IV Fluids were immediately procured.