Typhoid Outbreak Due to Abscence of Chlorine Monitors

Eight-year-old Jessa Arquillano asked her parents for tasty food when she was sick.

That was her request just before she died on Saturday, a victim of typhoid fever in northwest Tuburan town.

Tuburan Mayor Aljun Diamante declared a state of calamity in his town, where Jessa was one of four deaths and over 600 cases of suspected typhoid in an outbreak that erupted last week.

Fecal coliform was found in the town’s three water sources, said Renan Cimafranca of the Regional Epidemiology and Surveillance Unit (RESU) in Region 7 yesterday.

Water samples were examined using rapid testing kits.

Cimafranca said he suspected that the bacteria, which is found in human or animal waste, was washed away by the rain and mixed with open springs in barangays Marmol and Kalangahan.

It affected other barangays because the water pipes were  interconnected, he said.

Contaminated water is the main suspect in the town’s rural water system, which lacks chlorine filters and relies on three spring sources.

Mayor Diamante confirmed that there were no chlorinators in the town’s spring-fed waterworks system, a condition he said existed before he was elected mayor.

“We just installed them now when the cases erupted,” he told CDN.

The mayor declared a state of calamity last March 2 because of the wave of cases of fever, severe diarrhea and headaches, which are symptoms of typhoid.

Patients come from 20 of Tuburan’s 54 barangays.

In Manila, Dr. Eric Tayag, director of the National Epidemiolgoy Center of the Department of Health, said  the DOH decided to declare an outbreak pending results of laboratory tests because the number of cases in the area had exceeded the average.

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Outbreaks are declared when cases are more than the five-year average for a particular place,” Tayag explained.

“We want to confirm the diagnosis that is why we are waiting for the laboratory test results.”  “There are strong suspicions that contaminated water is the source of the outbreak and we know that typhoid fever is water-borne” he added.

Jessa suffered fever for a week. She was admitted in Tuburan District Hospital last Friday, March 2.  She died the next day and was immediately buried in the public cemetery.

Cimafranca, head of the RESU in Region 7, confirmed that the four patients died of typhoid ilietis, a condition where the patient’s intestines sustain holes caused by the typhoid bacteria and hemorrhage.

He said the contaminated water supply was found in spring sources in barangays of Marmol, Alegria and Kalangahan, where Tuburan draws its water.

Tuburan is a second class municipality located 96.7 kilometers from Cebu City.

Cimafranca said the DOH already declared a “code red” in the crowded district hospital.

Typhoid fever is an acute, life-threatening illness caused by the bacterium Salmonella enterica.

People fall ill from drinking water or eating food contaminated by the human waste of another person infected with the bacteria.

Among the symptoms of typhoid fever are fever, diarrhea or constipation, los of appetite, and presence of blood in the stool.

Cimafranca said RESU and medical staff met with town officials last Saturday and urged them to install chlorinators in the water sources.

CDN visited the water source in Alegria, where a concrete water tank stores the collected water.

Water service was stopped Saturday, said Alan Batoon, who lives nearby. An improvised chlorinator was installed Sunday night by municipal workers.

Batoon said his two children fell ill after drinking the water. Residents were advised to buy mineral water or boil their drinking water for 10 minutes

Analytical Technology