AT LEAST 447 suspected cases and nine deaths due to typhoid fever have been recorded in Central Visayas, said the Department of Health (DOH) on Tuesday, June 28, 2022.

Dr. Eugenia Mercedes Cañal, cluster head of the Regional Epidemiological Surveillance Unit (Resu)-Central Visayas, told reporters that 218 cases of bacterial infection were reported in Cebu Province, 150 cases in Negros Oriental, 77 cases in Bohol, and two cases in Siquijor.

Deaths due to the disease were recorded in Lapu-Lapu City; the towns of Sibonga, Barili and Alegria, and the city of Danao in Cebu Province; and in the cities of Bayawan and Guihulngan in Negros Oriental.

The data, she said, were based on the total cumulative cases of typhoid fever logged from January 1 to June 22, 2022, with ages one to 10 being the most affected age group.

For the Jan. 1 to June 11, 2022 period alone, Dr. Ronald Jarvik Buscato, head of the National Aedes-Borne Viral Diseases Prevention and Control Program, noted a 76 percent increase in typhoid cases in the region to 350 cases and seven deaths from the previous year, when there were only 199 reported cases and three deaths.

In his breakdown as of June 11, 2022, Guihulngan City in Negros Oriental topped the list with 45 cases and one death, followed by Cebu City with 32 cases and no deaths, while the town of Barili had 25 cases and two deaths, the City of Talisay had 12 reported cases and no deaths, and Mandaue City had 11 cases and no deaths.

Typhoid fever is a life-threatening water- and food-borne disease caused by the Salmonella typhi bacteria, and any person infected with it will experience persistent fever, diarrhea, constipation, severe headache, abdominal pain and even vomiting.

People can get the disease due to poor sanitation and limited access to clean water.

Surge in cases

In the upsurge of cases of the disease in the town of Barili, Cañal clarified that most cases reported by the town were suspected cases and patients are still subject to further laboratory testing for confirmation.

The town has around 54 reported cases of the disease, of which 52 have undergone testing for confirmation of the bacteria.

Under the Public Health Surveillance, Cañal noted that patients with certain diseases can be categorized as suspected, probable, and confirmed cases.

“Our reported cases are also suspected cases. These in Barili and all over the region and our 447 cases are suspected cases,” Cañal said. “We say they are not confirmed cases because we are not able to isolate a causative organism such as the Salmonella typhi.”

Data from the Cebu Provincial Health Office (CPHO) from March 16 to June 25 showed that 98 persons fell ill to the disease with three deaths in 24 of Barili’s 42 barangays.

Cañal said typhoid fever can be diagnosed based on the analysis of samples from the patient’s blood, stool or urine and she recommended the use of rectal swab test kits to isolate the bacteria.

She said the agency had sent rectal swab and typhoid RDT kits to the Barili District Hospital and other localities for further diagnosis of admitted patients suspected to have the disease.

Probable cause

Despite the report that residents in Barili town used a water purifier for drinking but still contracted the disease, Cañal noted that any person can be diagnosed with the illness through the use of contaminated water for cleaning and washing of utensils, cooking, laundry and even for bathing.

The disease can also spread in areas or barangays that have shared toilets, especially in houses with extended families.

Cañal also emphasized that improper or mishandled food preparation can cause any person to contract the illness.

To prevent the spread of the bacterial infection, the health official reminds the public to practice proper hygiene especially in food handling, while keeping the surroundings clean and sanitary.

According to the Mayo Clinic, an infected person can spread the typhoid bacteria to others through the fecal-oral route.

“This means that Salmonella typhi is passed in the feces and sometimes in the urine of infected people. If you eat food that has been handled by someone who has typhoid fever and who hasn’t washed carefully after using the toilet, you can become infected,” the clinic said on its website.

Response

The DOH 7 is closely coordinating with the concerned local government units (LGUs) in the monitoring of the disease and providing technical assistance.

Buscato said the agency had already sent personnel to Barili to coordinate with the LGUs and the CPHO.

“Pagka-erupt sa report, the Provincial Health Office already went to the municipality (Barili). Unya ni-coordinate lang sila namo. We provided all the necessary medication,” Buscato said.

Buscato said based on the CPHO findings from its house-to-house investigation, most of the areas with reported cases had unsanitary conditions, which probably caused the spread of the disease.

“We are hoping to address those problems together with the LGUs. Perhaps everything will be formalized after June 30 because they requested that, while they are conducting their response, they’re still in the transition period,” Buscato said. “We will properly endorse or plan further ahead later when the new administration already takes over.”

Candidates who won in the May 9 elections will assume office on June 30.

As of Sunday, the Barili District Hospital and the town’s infirmary had exceeded their bed capacity.

The hospital has only a 25-bed capacity, but the number of admitted patients on Sunday had already reached 60, of whom 27 were typhoid-related cases.

The Barili Infirmary, on the other hand, has only a 10-bed capacity, but it already had 25 persons admitted with typhoid fever on Monday, excluding those that were admitted for other diseases.