CEBU Province recorded 426 probable leptospirosis cases and 12 deaths from November 1 to 30, 2025, according to a report presented by Eugenia Mercedes Cañal, epidemiologist of the Regional Epidemiology and Surveillance Unit of the Department of Health (DOH) 7.
During the Provincial Board (PB) regular session on Monday, December 1, Provincial Board Member Stanley Caminero immediately raised concerns on who has the authority to declare an outbreak, urging that his position be formally relayed to DOH leadership. Caminero said the absence of confirmatory tests hampers crucial decisions despite rising deaths.
"That has been an argument — who will declare an outbreak? Is it the Department of Health, the local government unit (LGU), or the Provincial Capitol?" Caminero said. "If we cannot have the confirmatory tests, our declaration may lack the necessary substantiation, and so the question goes in circles. People are dying, yet our hands are tied."
Outbreak declaration explained
Cañal clarified that DOH only declares outbreaks when cases pose threats to national security, citing the pandemic as an example.
"DOH will never declare an outbreak within the locality; it will always be the LGU because of the intricacies, meaning budget allocations," she said.
She noted that a 2023 DOH memorandum authorizes LGUs and cities to declare local outbreaks, but stressed that the lack of confirmatory results from the Research Institute for Tropical Medicine (RITM) complicates decisions.
"I am strongly insisting that our Department of Health should have the capability to control these cases because we can access additional resources, funding, the Province, the LGU affected when there's a declaration of an outbreak. That's why this is a serious issue and it has been going on unattended for decades. Why do we have to always be at the mercy of RITM?" Caminero said, requesting that his statement be relayed to the head of DOH.
Cañal said she shared his sentiments.
All November cases still “probable”
Cañal said none of the 426 cases have been confirmed because RITM has yet to release confirmatory PCR and lepto-mat results.
Cañal explained that suspected cases involve individuals who only waded once in mud or a small puddle of water, while probable cases refer to those who were truly exposed to flooding.
"So, that is why all of our cases right now are probable cases, it's not even a confirmed case yet. From Board Member Caminero's point, wala pa tay confirmation, confirmatory report from RITM, so all are probable cases," Cañal said.
She noted that DOH 7 previously operated a molecular facility during the pandemic, but it has been displaced. She said DOH 7 Director Joshua Brillantes has ordered its expedited reestablishment to avoid dependence on RITM.
PB inquiry
In an invitation from the PB on Monday, Cañal appeared alongside Cebu Province Health Consultant Elisse Nicole Catalan to present the surge in cases. Catalan reported that Province-run hospitals recorded 175 cases from Nov. 1 to 30, nearly double the number recorded from January to October.
Breakdown of deaths and cases
LGUs with reported deaths: Talisay City – seven deaths, 117 cases; Danao City – two deaths, 108 cases; Balamban – three deaths, 56 cases;
LGUs with cases but no deaths: Liloan – 47; Consolacion – 36; Compostela – 18; Asturias – 12; Toledo City – six; Minglanilla and Tuburan – four each; Bantayan and Pinamungajan – three each; City of Naga and Sibonga – two each; Borbon, Carmen, Cordova, Medellin, Ronda, San Fernando and San Francisco – one each.
The total leptospirosis cases for 2025 reached 689, with 474 males and 215 females affected. The most vulnerable age group was 21 to 30 years old, with 187 cases.
DOH gag order
Cañal urged the media not to immediately publish LGU-specific numbers, explaining that Talisay City — the top contributor of cases — had not yet been officially briefed.
Caminero, however, questioned why LGUs were not being regularly updated, emphasizing that timely information is essential for local action.
Cañal clarified that DOH has been coordinating with affected LGUs but is bound by a gag order preventing disaggregated public releases.
"For clarification, we are in communication with all the LGUs that have been affected, especially those with the highest cases, especially Talisay. In fact, we just spoke with Dr. Bautista, the CHO of Talisay, about the number of cases," Cañal said.
"However, what worries us in the Department of Health is that we are given a gag order not to disaggregate the data. But if the media will ask for data, it will be regional data, meaning kung naa tay 600 cases, it will be published as such for Region 7. It will not be disaggregated into how many are there in Talisay," she added.
Surveillance challenges: cyberattack and hospital reporting
Cañal said surveillance operations were disrupted because:
1. Patients seek treatment directly in hospitals, bypassing rural health units.
2. The DOH information system remains offline due to a cyberattack, delaying case validation.
DOH now gathers data through direct email reports from hospitals.
DOH surveillance gaps and ways forward
Gaps identified
• Delayed case reporting
• Disrupted telemedicine and referrals
• Difficulty mapping hotspots
• Communication lapses with exposed individuals
• Poor sanitation and rodent control
• Weak integration of human–animal–environment data
• Public complacency
Proposed actions
• Strengthen community surveillance
• Ensure health system readiness
• Improve governance and inter-agency coordination
• Increase community engagement
• Tailor risk communication
• Provide livelihood and safety net support.
(CDF)