MANILA, Philippines – Doctors fanned across cramped evacuation centres in the Philippines as the death toll from five days of flooding reached 23 Thursday (August 2nd), AFP reported.

Large farming towns north of Manila and heavily populated coastal areas remained under waist-deep floods. Health officials warned of a possible outbreak of leptospirosis, a bacterial disease spread by infected rat urine in flood waters.

"People are living in dire situations in evacuation centres and disease outbreaks are what could push the toll even higher," warned Carmencita Banatin, head of the department of health's emergency management unit.

"We have rushed medicines and doctors to evacuation centres to begin immunising and stave off any explosion of diseases," she told AFP.

The National Disaster Risk Reduction and Management Council in Manila said nine more people died due to drowning and accidents related to Typhoon Saola, raising the toll to 23 overnight.

Saola caused tidal surges that swept over seawalls and flooded huge parts of Manila on Wednesday. Close to 180,000 people were evacuated from 90 towns and 22 cities, many of them crowding into school gyms converted into temporary shelters.