Availability of safe drinking-water: the answer to XXXX outbreak? Nabua, Camarines Sur, Philippines, 2012.

@entity1 @entity3081 @entity1838 @entity294 @entity3752
BACKGROUND: In May 2012, there were increasing @entity294 cases and deaths reported from Nabua, Camarines Sur to the Philippines event-based surveillance system. An investigation was conducted to identify risk factors and determine transmission dynamics. METHODS: A suspected case was defined as a resident of Nabua with at least three episodes of watery @entity294 per day from 16 March to 22 June 2012. A confirmed case was defined as a suspected case positive for @entity1838 . An environmental investigation was conducted and rectal swabs and water samples sent to the national reference laboratory for bacterial isolation. A 1:2 case-control study matching for age and sex was conducted. Data were analysed using Epi Info. RESULTS: There were 309 suspected cases with two deaths, and the most affected age group was @entity1 under five years (45%). Eight cases were positive for @entity1838 Ogawa El Tor and one for Non-01. Water samples were positive for faecal coliforms and @entity3752 . The case-control study showed that cases had a higher odds than controls of using unchlorinated water sources (odds ratio [OR]  =  3.6; 95% confidence interval [CI]:1.6-8.5) and having toilets located within 20 m of a septic tank (OR  =  2.7; 95% CI: 1.4-5.3). In multivariate analysis, the only significant factor was drinking from piped water (OR  =  0.21; 95% CI: 0.09-0.49). DISCUSSION: In this @entity3081 outbreak, drinking-water from unchlorinated wells was a significant risk factor. Future @entity3081 control efforts should include not just improving water and sanitation systems but also intensified behaviour change campaigns.
