BANGKOK, 1 October 2008 (IRIN) - More than 200,000 people have fallen ill from waterborne diseases and 23 have died in the past 19 days of heavy flooding in north and north-east Thailand, government health authorities said.

Twenty-three people drowned, more than half children or the elderly, and a total of 230,588 were treated for trench foot, skin rashes and diarrhoea, Siriporn Kanchana, the Thai Public Health Ministry Deputy Permanent Secretary, told IRIN.

The disease outbreaks and deaths were reported in 24 of 76 northern, north-eastern and central provinces experiencing heavy floods since early September.

An increase in the number of patients and death toll has challenged health authorities to work against time in a bid to curb disease outbreaks. They are increasingly concerned because of reports of more monsoon rains expected as tropical storm Mekkhala heads towards northern Thailand, having already hit Vietnam.

Villagers living near foothills and waterways in 25 provinces, mostly in the north-east, have been warned of severe flooding, said the Meteorological Department.

The heavy monsoon rains could worsen the flood situation in several provinces already suffering for more than two weeks now.

"The [medical] situation is very concerning and epidemiologists are studying measures to prevent the death toll caused by waterborne diseases, particularly Leptospirosis," Siriporn told IRIN.

Outbreaks of Leptospirosis, also know as Rat's Disease, are usually caused by exposure to water contaminated with the urine of infected animals or direct contact with the animals.

So far there have been no reports of Leptospirosis in flooded provinces; however, conditions are ripe for such a deadly outbreak. In a bid to prevent deaths from Leptospirosis or other waterborne diseases, as well as from snake bites, more than 100 mobile medical units and surveillance teams are monitoring the situation in five northern and north-eastern provinces experiencing heavy flooding, according to Siriporn. These include Lopburi, Phitsanulok, Ayutthaya, Prachinburi and Khon Kaen Provinces.

Leptospirosis can be fatal if not treated. Common symptoms include listlessness, loss of appetite, vomiting, flu-like symptoms, weight loss, diarrhoea and muscle pain. It can develop into more severe illnesses through infections of the kidney and red blood cells, which then lead to anaemia, Siriporn said.

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