As of August, the DOH identified 592 individuals who turned out to be positive of the disease out of the 2,739 examined in the endemic areas. "But the real situation is yet to be determined,” Raguro said in a statement, adding that what they are seeing is just the “tip of the iceberg.”

Treatment officer Nestor Sotelo said they are constrained by lack of funds for fuel and other operating expenses to conduct tests all over the province.

He said they have so far monitored only two cases out of the three fatalities this year, in San Jose in Malaybalay City and in New Kidapawan in Kibawe.

Ingestion of insufficiently cooked or raw fish is the only mode of infection of heterophyidiasis, according to the DOH. Adult worms and eggs of the intestinal flukes thrive in the intestines and will also spread to other organs like the brain, spinal cord, and the heart.

The DOH statement said those infected will suffer from upper abdominal discomfort or pain, gurgling abdomen, colicky abdominal pain, and diarrhea. Tissue reactions may lead to cardiac arrest for those with heart problems and also cause intra-cerebral hemorrhage in the brain. The statement said if it reaches the spinal cord, the disease may result in loss of motor and sensory functions where lesions are located.

The DOH said diagnosis may be clinical due to similarity with peptic ulcer disease (PUD) and acid peptic disease (ACD), history of bowel disturbance and consumption of raw or improperly cooked fish.

Sotelo said definitive test could only be done in the laboratory to check parasite eggs using fecal or stool analysis.

Sotelo said the disease is even more dangerous because unlike schistosomiasis which could infect through skin contact with unsanitary areas, the general public is at risk with the disease. "Because infection is through eating raw fish, it could infect anyone. If somebody eats uncooked fish that became host to the fluke, he could also be infected," he said.

Sotelo identified fish from both pond and brackish water or estuarine waters as susceptible to become hosts to the fluke. He said among the long list is bangus, tilapia, "mol-mol", kitong, lapu-lapu and hito. He also warned those who eat farm frogs to be at risk.

Sotelo said those who tested positive could take the schistosomiasis medicine as treatment.

He warned those who have the lifestyle of eating raw fish to take the test in health centers. The DOH advised proper or thorough cooking of fish as preventive measure.

They have also called for control measures, calling local health authorities to educate the population regarding proper eating habits. They also called for the banning of fish pond seeding using human and animal waste. The DOH also warned of feeding fish scarps and water used to clean fish to animals like dogs, cats, poultry and hogs.

On Sept. 29, medical technologists around Bukidnon will meet to study the disease. But Sotelo said the disease is not limited to Bukidnon. He said they have learned from experiences shared to them by health authorities in Davao City. (Walter I. Balane/MindaNews)

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