CHARLESTON, W.Va. -- More than 500 people have gone to area hospitals to report symptoms they believe are a result of the Elk River chemical spill.
About half of those people went to the hospital after West Virginia American Water Co. and state officials first started telling people to flush contaminated water out of their pipes.
"What was kind of interesting on this was the number of people that went to the hospital after they started using the water and it was 'cleared,'" said Janet Briscoe, director of epidemiology and emergency preparedness for the Kanawha-Charleston Health Department.
"When you would think, you know, your water's fine, you wouldn't be having water-related illness," she continued.
Since an unknown amount of chemicals leaked into the Elk River Jan. 9, 533 people have been "evaluated" at 10 different area hospitals, said Allison Adler, state Department of Health and Human Resources spokeswoman.
During the same time frame, 26 people were admitted and released from six hospitals, she said.
"As DHHR surveyed hospitals for this information, "patients evaluated" is defined as individuals presenting to the emergency department with symptoms they report as being associated with the Elk River Chemical Spill," Adler said in an email.
The state Poison Control hotline has received more than 2,500 calls: 2,008 related to affects on people, 100 related to animals and another 447 just looking for information, Adler said.
These numbers spiked right after the spill, and again when people were told they could start flushing, said Dr. Rahul Gupta, head of the Kanawha-Charleston Health Department.
West Virginia American Water and the state started telling some customers Jan. 13 they could flush their pipes.
Since the morning of Jan. 14, 256 people have gone to emergency rooms and 13 people have been admitted, Briscoe said.
In a recent "community conference call," Dr. Letitia Tierney, head of the state Bureau for Public Health, pointed to a variety of reasons that did not involve chemicals as to the number of people going to the hospital.
"We're in the middle of flu season and virus season. Many of us haven't been able to consistently wash our hands with soap and water," Tierney said, according to a press release from the office of Gov. Earl Ray Tomblin.
She also pointed to anxiety and sediment stirred up in the pipes from the flushing process and potential health concerns.
While those are possible, Gupta said the chemical leak must be considered.
"It's very unusual to have that many people unconnected by any others means than this, the water, to be presenting with similar symptoms in the same time frame to the Emergency Rooms in the same region, or cohort," Gupta said.
Gupta and Adler said skin irritation is the most common complaint seen by patients reporting their symptoms are connected to the spill. It's common for someone with an allergy or hypersensitive skin to see such a reaction if the skin comes into contact with an unusual chemical or substance, Gupta said
Others report symptoms include eye irritation, nausea, vomiting and stomach pain, Gupta said.
Gupta and others said more time and evaluation is needed before the chemical leak can be definitively tied to any of the reported symptoms. The health department is working with state and federal agencies to study the potential short- and long-term health effects of the spill, Briscoe said.
Information is limited on the two chemicals believed to have been involved in the spill, crude MCHM and "PPH, stripped."
At first officials thought as much as 7,500 gallons of crude MCHM, used in coal processing, was the only chemical that leaked from a faulty storage tank near the Elk River.
Earlier this week Freedom Industries, the company that owns the leaky container, told officials they also believe as much as 300 gallons of "PPH, stripped" was also contained in the tank.
Late Thursday state health officials said initial water tests couldn't detect any levels of the second chemical. The state tested 30 samples, with the ability to detect any amount more than 2 parts per million.
The U.S. Centers for Disease Control and Prevention recommended any level of crude MCHM below 1 part per million was safe for use.
The CDC has not issued a similar level for the "PPH, stripped" but believes the relatively small amount that might have leaked and chemical data available "do not suggest any new health concerns."
Officials plan to go back and test more samples for "PPH, stripped" at a 1-part-per-million detection level, according to a news release.
West Virginia remains in a state of emergency.