Open defecation eyed in N. Cotabato cholera cases

MANILA, Philippines - Health authorities are eyeing open defecation as the possible cause of the increase in cholera cases in five barangays in Alamada, North Cotabato this month.

Citing reports of a team of disease and environmental sanitation experts sent by the Department of Health (DOH) to the town of Alamada, DOH spokesman Lyndon Lee Suy said people in the area still practice open defecation and this could have contaminated their water supply.

“If we are going to look at the transmission of cholera, it is fecal-oral route, and mostly from water. That’s the problem if you do open defecation. Your water sources could be contaminated,” Lee Suy said in a press briefing. 

It was found that the residents’ primary sources of water are a stream and deep wells. 

Lee Suy said an increase in the cases of acute watery diarrhea was recorded starting May 12 in the villages of Dado, Lower Dado, Pigkawaran, Rangayen and Barangiran.

He said although these areas do not have history of cholera, it is possible that an infected person defecated in the open and contaminated the water.

The DOH had documented 1,083 cases of acute watery diarrhea, although not all of them have been confirmed to be cholera.  

Rectal swabs were collected from 44 individuals and four of them have tested positive for cholera so far. 

Lee Suy said this is enough to consider the cases as cholera. 

“Actually there were more cases of amoebiasis than cholera.  But why are we working on the premise that it is cholera?  The outcome will be more severe with cholera and when we are working on cholera, it will also cover amoebiasis,” he said.

Of the 1,083 cases, eight deaths were recorded, five of them children below eight years old. Most of the cases come from Barangay Dado. 

“We are still validating the real cause of deaths. But chances are they may be associated with cholera rather than amoebiasis as dehydration will be more severe among cholera cases,” Lee Suy said.

The health official refused to say that the increase in cases constituted an outbreak, noting medically, they do not yet warrant the declaration of an outbreak at this point.

He said they hope to see cases to start going down in the next few weeks as contingency measures are being implemented in the communities. 

The DOH team has been assisting their local counterparts in the diagnosis and management of cases. It distributed oral rehydration solution and supplied the residents with water.

“If residents don’t want to avail of our supplies, they should boil their drinking water. We also encourage them to observe personal hygiene and sanitation, especially hand washing,” Lee Suy said.