The PHO has been closely working with RHU Oas since Monday. Last Wed, upon discussion of the situation with PHO, I have ordered (1) the flushing of the source and all other water collection facilities by Oas water authorities (2) use of boiling water by Oas households (c) chlorination at source by Oas water authorities and (4) checking of pipelines like what FPIC did to identify potential intrusion of dirt or waste.
December 16, 2010For : HON. JOEY SARTE SALCEDA
Governor
Through : Luis Domingo B. Mendoza, MD, MHA
Provincial Health Officer II
From : Marilyn A. Palattao, RN, MSPH
Supervising Public Health Nurse
Annie Rose A. Clarino, RN
CDD Coordinator
Carolyn G. Rojas, RN
Hepo
Subject : Update on Viral Hepatitis Suspects in Oas, Albay
cc: Hon. Gregorio H. Ricarte
Mayor – Oas
Dr. Marie Jane Revereza
RHU-Oas
Nestor F. Santiago, Jr., MD, MPHC, MHSA, CESO IV
Director IV, Center for Health Development 5
Aurora Teresa M. Daluro, MD
Regional Epidemilogist
Findings:
A. Cases
From morbidity 48th to 50th week there were a total of 69 viral hepatitis (Hepatitis A) suspects in Oas, Albay that had been investigated by the joint Oas RHU and PHO-PESU team.
Above total viral hepatitis suspects were identified in 19 barangays, but majority of cases were in barangay Iraya Norte (Table 1).
Age ranges from 4 – 59 years old. Median 23 years old with no fatality.
Majority (68%) of those affected were males (N=47/69).
All cases had sought consultation in government health facility (Oas Rural Health Unit and JBDMDH).
Majority of cases showed signs of jaundice (yellowish discoloration of the sclera}, fever, dark colored urine, abdominal pain, anorexia (decrease appetite), vomiting and body weakness.
An almost equal percentage of the clients had bought food and ice outside the school, working area and ambulant vendors.
Practices/habits showed that majority had no good handwashing habits.Above total viral hepatitis suspects were identified in 19 barangays, but majority of cases were in barangay Iraya Norte (Table 1).
Age ranges from 4 – 59 years old. Median 23 years old with no fatality.
Majority (68%) of those affected were males (N=47/69).
All cases had sought consultation in government health facility (Oas Rural Health Unit and JBDMDH).
Majority of cases showed signs of jaundice (yellowish discoloration of the sclera}, fever, dark colored urine, abdominal pain, anorexia (decrease appetite), vomiting and body weakness.
An almost equal percentage of the clients had bought food and ice outside the school, working area and ambulant vendors.
B. Environmental
On ocular investigation of the water sources, it showed that majority of the cases made use of the municipal water district (Level III). Flushing of Oas Water System was done last December 14, 2010 and bacteriological exam was done still awaits result.
C. Laboratory Results
Bacteriological examination of water samples at Balogo was positive for coliform ( E.coli) contamination.
Action Taken:
A. LGU/RHU
1. Informed the MHO on Hepatitis cases.
2. Conducted MTC of BHS/RHM.
3. Conducted epidemiological investigation/masterlisting.
4. Conducted individual/ERP counseling.
5. Informed the Oas Water System/Mayor/PHO.
2. Conducted MTC of BHS/RHM.
3. Conducted epidemiological investigation/masterlisting.
4. Conducted individual/ERP counseling.
5. Informed the Oas Water System/Mayor/PHO.
B. PHO-PESU
1. Close coordination with the RHU-Oas on the surveillance and monitoring of cases found.
2. Together with the RHU staff conducted the epidemiological investigation.
3. Supplied RHU with chlorine granules.
4. Coordination with the following agencies concerned:
- CHD5 for laboratory services
- RESU 5 for other disease containment measures
- Barangay council for identification and implementation of safe water collection from identified water outlets.
5. Assisted the RHU staff in case finding and disease containment measures.
6. Collected blood specimen and submit them to NEC.2. Together with the RHU staff conducted the epidemiological investigation.
3. Supplied RHU with chlorine granules.
4. Coordination with the following agencies concerned:
- CHD5 for laboratory services
- RESU 5 for other disease containment measures
- Barangay council for identification and implementation of safe water collection from identified water outlets.
5. Assisted the RHU staff in case finding and disease containment measures.
Recommendations:
A. LGU/RHU
1. Flushing of Oas Water System.
2. Chlorination of water source.
3. Conduct epidemiological investigation of suspected cases.
4. Mobilize health workers in concerned areas and other adjacent areas.
5. Massive health education activities in the community during barangay assemblies with emphasis on the following:
- Water collection for drinking water from the identified outlets of safe drinking water
- Water from the identified positive sampling points will only be used for activities other than drinking purposes
- Use of household chlorination and boiling for drinking purposes
- Proper handwashing technique
- Preparation of food in the home and avoidance of utilizing peddled foods, juices and other drinks.
- Preparation of chlorine stock solutions for household chlorination
- Proper waste disposal
6. Continue treatment and management of cases found.
7. Close monitoring and surveillance of suspects.
8. Coordinate closely with the municipal engineering office as to the steps to be undertaken in the repair of the service pipelines or other correctives measures instituted by the said office.
9. Meet the food handlers and conduct rectal swabbing.
10. Meet the water refilling station owners.
11.Coordinate with the private clinics and hospitals for suspects who seek consultations for inclusion in the report and for follow-up.
12. Rectal swabbing of ambulant vendors
B. PHO-PESU
1. Continuous surveillance and monitoring of cases.
2. Assistance to Oas RHU in technical support, medicines and chlorine granules and forms needed.
C. CHD 5 and Regional Laboratory
1. Laboratory services for water and food borne disease identification and confirmation.
Table 1. Barangay Identified with Hepatitis Suspects, Oas, Albay
December 3-16, 2010
source:
http://joeyssalceda.files.wordpress.com/2010/12/pesu-imrad-16-10.pdf
http://joeyssalceda.wordpress.com/2010/12/17/provincial-health-office-report-on-hepa-a-in-oas-albay/
2. Chlorination of water source.
3. Conduct epidemiological investigation of suspected cases.
4. Mobilize health workers in concerned areas and other adjacent areas.
5. Massive health education activities in the community during barangay assemblies with emphasis on the following:
- Water collection for drinking water from the identified outlets of safe drinking water
- Water from the identified positive sampling points will only be used for activities other than drinking purposes
- Use of household chlorination and boiling for drinking purposes
- Proper handwashing technique
- Preparation of food in the home and avoidance of utilizing peddled foods, juices and other drinks.
- Preparation of chlorine stock solutions for household chlorination
- Proper waste disposal
6. Continue treatment and management of cases found.
7. Close monitoring and surveillance of suspects.
8. Coordinate closely with the municipal engineering office as to the steps to be undertaken in the repair of the service pipelines or other correctives measures instituted by the said office.
9. Meet the food handlers and conduct rectal swabbing.
10. Meet the water refilling station owners.
11.Coordinate with the private clinics and hospitals for suspects who seek consultations for inclusion in the report and for follow-up.
12. Rectal swabbing of ambulant vendors
B. PHO-PESU
1. Continuous surveillance and monitoring of cases.
2. Assistance to Oas RHU in technical support, medicines and chlorine granules and forms needed.
C. CHD 5 and Regional Laboratory
1. Laboratory services for water and food borne disease identification and confirmation.
Table 1. Barangay Identified with Hepatitis Suspects, Oas, Albay
December 3-16, 2010
source:
http://joeyssalceda.files.wordpress.com/2010/12/pesu-imrad-16-10.pdf
http://joeyssalceda.wordpress.com/2010/12/17/provincial-health-office-report-on-hepa-a-in-oas-albay/
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