The Department of Health (DOH) noted the clustering of Cholera cases in the Municipality of Medina, a fourth class municipality with a 2017 projected population of 34,790, in the province of Misamis Oriental.  

On July 7, 2017, the Event-based Surveillance and Response (ESR) Unit of the Epidemiology Bureau of the DOH received a report regarding increasing diarrhea cases in the said municipality. On July 8, the local government unit of Medina declared an epidemic of cholera.  

In response to this health threat, the Regional Epidemiology Surveillance and Disaster Response Unit X (RESDRU X) of the DOH Regional Office No. X conducted initial investigation.  557 suspect cases were identified in 17 of 19 barangays of the municipality from June 1 to July 17, with cases noted to peak in June 29 to July 1.  Two deaths due to severe dehydration were reported.  Fifty percent of cases were female.  Ages of cases range from 6 months to 86 years old of age with a median of 21 years.  Aside from diarrhea, patients also presented other signs and symptoms that included abdominal pain (160, 29%), vomiting (157, 28%), body malaise (99, 18%), and anorexia (75, 13%).  Nineteen suspect Cholera cases tested positive for Vibrio cholerae on laboratory confirmation at RITM.

Eleven (11) barangays of the municipality are supplied by Medina Rural Waterworks and Sanitation Cooperative (MERWASCO).  Complaints from consumers were received by MERWASCO of reports on drinking water turning salty.  As a response to this complaint, rehabilitation of pipelines were proposed due to intrusion of sea water in the grounds leading to fast rust build-up in the pipelines.  The result of ocular investigation of health authorities showed water pipelines were almost 30 years old and are submerged in drainage water.  One intake box located in Purok 5, South Poblacion was near the rice fields and sea which become submerged in sea water during high tide.  Water samples were sent to a DOH-accredited laboratory in Cagayan de Oro City for testing.  

Aside from the case investigation, the DOH regional office augmented logistics (IV fluids, medicines, and folding beds) at hospitals, distributed Waterine and Aquatabs at RHU.  Further, DOH provided the DPD Kit used by MERWASCO for measurement of chlorine levels and facilitated testing of water samples at a DOH-accredited facility

On July 11, 2017, a team from the Field Epidemiology Training Program (FETP) of this agency was sent to the area to assist and the response.  Rectal swabs and stool specimens from suspect cases and water samples from different drinking sources were collected.  All specimens were sent to Research Institute for Tropical Medicine (RITM) for bacteriologic and viral identification.

Secretary Paulyn Jean Rosell-Ubial has instructed the Family Health Office of the National Disease Prevention and Control Bureau of DoH to coordinate with the region in the immediate conduct of a vaccination activity against Cholera in the affected area.  “I would like to inform everyone, particularly those living in the affected region, that the overall well-being and safety of all Filipinos remain the top priority of the health department. Rest assured that DOH is working to arrest this ongoing problem of rising incidence of Cholera,” she underscored.