Manila Mayor Francisco “Isko Moreno” Domagoso ordered municipal health workers to conduct door-to-door community visits Wednesday to combat a sharp surge in leptospirosis cases following recent monsoon flooding.

The city reported 89 new leptospirosis infections Wednesday, up from 38 on Tuesday, bringing the weekly total to 197 cases.

Five residents have died from the bacterial infection this week, including two deaths recorded Wednesday.

Domagoso warned that infections will likely continue climbing over the coming days due to the disease’s two-week incubation period, as residents exposed to floodwaters during the 17 to 18 August southwest monsoon begin exhibiting symptoms.

“We need to reverse the situation: Instead of waiting for patients to seek us out, we must actively look for those who were exposed to floodwaters and are showing symptoms,” Domagoso said during a broadcast address.

The rapid rise in patients has strained local medical infrastructure. At Ospital ng Maynila, the emergency room was treating 69 patients Wednesday morning, exceeding its 40-bed capacity.

Approximately 20 percent of emergency room admissions involve non-Manila residents seeking care from surrounding municipalities.

To relieve pressure on emergency departments, municipal officials activated the 17-bed Manila Infectious Disease Control Center at Santa Ana Hospital and ordered additional hospital wards opened across the city’s seven district medical centers.

The city secured 389,000 doxycycline capsules for preventive distribution, bolstered by a 300,000-capsule allocation from the Department of Health and 40,000 capsules donated by private donors.

Domagoso urged all residents who waded through floodwaters to collect the antibiotic free of charge at any of the city’s 44 health centers or district hospitals, even before symptoms appear.