GOSTIVAR, July 19 (BV) – Patients with almost identical symptoms have poured into hospitals in the western North Macedonian city of Gostivar in recent days, reporting diarrhoea, vomiting, stomach pain, fever and general weakness.
The number of cases quickly exceeded the usual summer incidence of gastrointestinal infections, raising questions over whether the city is facing an epidemic and what may have caused it.
According to figures released by health institutions and local media, between 1,000 and 1,500 people have sought medical assistance. Microbiologist Nikola Panovski estimated that several thousand more residents may have experienced symptoms without visiting a doctor.
Despite the scale of the outbreak, health authorities have not yet determined whether the cause is drinking water, a virus, bacteria, parasites, contaminated food or another source.
Suspicion Falls on the Water Supply
Public attention focused on Gostivar’s drinking water soon after the first wave of illnesses was reported.
Prosecutors opened a case related to water quality, while health and municipal institutions began laboratory testing and epidemiological investigations.
The ruling VMRO-DPMNE party accused the local authorities, led by a coalition involving SDSM, DUI and Arben Taravari, of endangering public health through irresponsible management.
The party alleged that pumps had been installed in wastewater to increase pressure in the drinking-water network.
That claim has not been confirmed by a final institutional finding. Investigators must determine whether any technical intervention took place, whether it could have contaminated the supply and whether it was connected to the mass gastrointestinal illness.
“We demand a full investigation and accountability for everyone whose actions endangered citizens’ health,” VMRO-DPMNE said.
As political accusations intensify, laboratory results are expected to show whether the water was the source of the outbreak or only one of several possible causes.
Panovski: An Epidemic Exists Whether Declared or Not
Microbiologist Nikola Panovski said Gostivar was already experiencing an epidemic of gastroenteritis.
He argued that the large number of people developing the same symptoms within a short period should have prompted a more decisive response from epidemiological services.
“There is an epidemic of gastroenteritis in Gostivar. There are 1,500 registered cases with the same symptoms and at least another 5,000 people who did not seek medical help,” Panovski wrote on social media.
He called on epidemiologists to act, saying the identification and declaration of an epidemic was a professional public-health matter rather than a political issue.
His estimate of unregistered cases has not been officially verified, but it highlights the possibility that hospital data represents only part of the true spread of the illness.
SDSM Calls for an Official Epidemic Declaration
The opposition SDSM party called on the authorities to declare an epidemic, saying such a step would allow faster coordination and more effective measures.
“Thousands of citizens are ill, and the situation requires a serious and responsible response. Declaring an epidemic is not a political issue but a matter of public health,” the party said.
An official epidemic declaration could allow more intensive monitoring, additional preventive measures, clearer institutional coordination and regular public updates.
The Health Ministry, however, says more information is needed on the cause and transmission pattern before such a decision is made.
Klekovski: Far More Interviews Are Needed
Health Minister Sasho Klekovski said an epidemic would not be declared before epidemiologists determined what caused the illnesses.
He said several institutions were involved in the investigation and that multiple possibilities were being examined, including heavy metals, parasites, bacteria and viruses.
The biggest problem, he said, was the limited number of completed epidemiological interviews. At the time of his statement, only 19 residents had been questioned.
“We need many more interviews to identify the cause and connect the possible sources of infection,” Klekovski said, urging residents to cooperate with health teams.
Epidemiological questionnaires are intended to establish what patients ate and drank, where they had been, when their symptoms began and whether they had contact with other sick people.
Without enough such data, investigators may struggle to identify the common link between hundreds or thousands of patients.
Food Seen as a Less Likely Source
Klekovski said his unofficial assessment was that it was unlikely more than 1,000 people had been poisoned by the same food.
He also noted that cases appeared over several days, reducing the likelihood of a single food-related poisoning incident.
However, he stressed that the final assessment should come from the Public Health Centre and the Institute of Public Health, rather than politicians, public utility managers or government officials.
That means neither water, food nor a viral infection can be fully ruled out before laboratory testing and epidemiological tracing are completed.
Hospital Under Heavy Pressure
The large influx of patients placed Gostivar hospital’s infectious diseases, paediatric and emergency departments under significant pressure.
Most patients were aged between 18 and 60, though children were also among those affected.
The hospital increased staffing levels and adjusted capacity in the departments facing the greatest demand.
Patients received symptomatic treatment and medical assistance. No deaths have been reported, but the scale of the illness has caused public concern and placed additional pressure on the health system.
Public Health Becomes a Political Battleground
Rather than prompting a unified institutional response, the outbreak has also developed into a political confrontation.
VMRO-DPMNE has accused the local authorities of administrative failure and potentially dangerous interventions in the water-supply system. SDSM has demanded an epidemic declaration and a more effective response from national institutions.
Caught between the competing claims are residents asking a simple question: Is the tap water safe, and what caused so many people to become ill?
Political allegations cannot replace laboratory evidence. If investigators establish that institutional negligence or human error played a role, individual and command responsibility will also have to be examined.
If the cause proves to be a virus spreading through the population, the focus will need to shift towards hygiene measures, isolation of affected people and preventing further transmission.
The Answer Lies in the Data
The source will most likely be identified through a combination of laboratory results, water and food testing, patient samples and hundreds of detailed epidemiological questionnaires.
Until then, the cause remains unknown, and all categorical claims — including assertions that the water supply was responsible — should be treated as unconfirmed suspicions.
The Gostivar outbreak is also a test of how effectively institutions communicate during a public-health crisis. When official information is delayed or incomplete, the gap is often filled by speculation, political accusations and fear.
For residents, the laboratory findings will be more than a medical result. They will also answer whether the system responsible for supplying safe water and protecting public health functioned properly — or failed when it was needed most.