ALAMOSA, Colo. -- Health officials started disinfecting the city water system with a high concentration of chlorine Tuesday morning after a salmonella outbreak traced to the town's tap water sickened more than 200 people.

Because of the heavy amount of chemicals that will be washing through 50 miles of water lines, officials told residents not to do anything but flush the toilets during the first stage of the cleansing process.

That means residents cannot shower, bathe, drink or even touch the tap water until officials give the all-clear signal. Touching the water could cause skin rashes, eye irritation or lung irritation.

Resident Laurie Duarte showed a crew from Good Morning America how she's forced to heat up bottled water on the stove to wash dishes. She also didn't know when she'd be able to shower again.

"So what I plan on doing is warming up water again, the gallon water warming it up and doing it that way," Duarte said.

The Alamosa School District has canceled school until Monday, March 31, because of the restrictions on water uses.

"The Alamosa School District is no longer able to implement universal precautions as the City of Alamosa will be limiting water usage to flushing toilets only. Therefore, our students would not have access to running water for hand washing," the school district said.

The flushing will occur neighborhood by neighborhood. Residents will know the water is unsafe by signs posted in their neighborhood.

A red sign alerts them to high levels of chlorine, approximately 25 parts per million (ppm).

As soon as yellow notices are posted in a neighborhood, it means the water is safe to use for bathing and swimming. Chlorine levels during the "yellow stage" will be approximately 10 ppm, or two to three times greater than the maximum level acceptable for drinking water, but slightly above the level found in a swimming pool. At this time, residents should run their bathtub faucet -- 5 minutes on hot, then 5 minutes on cold -- or until they smell chlorine. Some people may experience skin, eye or nose irritation from chlorine at this level, but may bathe with caution, authorities said. Tap water should not be consumed or used to brush teeth during the second stage. This stage is expected to last up to 10 days, but may last longer depending on results of the flush.

After that, neighborhoods will be given green safety notices that will mean the water is safe to drink. But those green notices are not expected to show up for another three weeks. It will take the city at least a week for tests to confirm the water is safe to drink.

Even then, residents are encouraged to run all taps in their homes for at least two minutes to charge their system with drinkable water.

At the three distribution sites throughout town where residents can pick up free bottled water or fill up their containers with safe water, volunteers are also handing out sanitizing wipes because handwashing might be difficult.

Volunteers are also hand-delivering water to residents who have disabilities, are homebound, elderly, or that do not have transportation to water distribution sites.

Officials said Monday they had ruled out wastewater contamination, disgruntled workers and terrorism as sources of the salmonella bacteria.

The number of cases was 219, with 68 confirmed through lab tests, said state health department spokeswoman Lori Maldonado. Ten people have required hospital treatment, and one remained in the hospital on Monday. Test results Monday confirmed earlier findings of salmonella in the city's tap water.

The aquifer that's the town's water source appeared to be fine, said Lisa Stigall, a spokeswoman with the state emergency response team.

"There are many unknowns," Stigall said. "Many questions will be answered as they move through this process."

The first salmonella victim began showing symptoms around March 8, and state health officials became aware of the outbreak a week later, said Ned Calonge, the health department's chief medical officer.

Alamosa residents were told March 19 that they should not drink the water but that they could bathe in it if they didn't ingest it. Neighboring communities, businesses and the Colorado National Guard have trucked in bottled water and tankers.

Salmonella bacteria are typically spread by food, and waterborne cases are rare.

Salmonella can cause diarrhea, fever and stomach pain. Victims generally recover on their own, but the elderly, infants and people with impaired immune systems may require treatment.

Untreated, salmonella can cause death in vulnerable victims, the health department said.

The salmonella outbreak is unprecedented for the state and is rare nationwide. There have been five cases of salmonella linked to tap water across the United States in the past 20 years, state epidemiologist John Pape said.

Gov. Bill Ritter on Monday asked the Department of Health and Human Services for help from its experts.

"Local resources have become overburdened and may soon become exhausted," Ritter said in a letter to Health and Human Services Secretary Michael Leavitt.

Alamosa is about 160 miles south of Denver with roughly 10,000 residents.

Water Distribution

Water is being distributed at three locations throughout the city from 10 a.m. to 6 p.m. daily at:

The old K-mart building
Boyd Park
San Luis Valley Regional Medical Center

To date, approximately 8,000 gallons of water a day have been dispersed. Much of water distributed was in the single-use water bottles.

City Market donated 11,000 empty 1-gallon water containers and the Red Cross donated 3,400 containers. These empty containers will be distributed to City Market customers and at each of the water distribution sites. The donated containers will help considerably in the effort to transition to 100% bulk water use and will reduce the use of the single-use water bottles.

Additional Resources:

Information about salmonella outbreak is available at the CO-HELP line, 1-877-462-2911.
Alamosa residents with any questions about the bottled water order can call the Department of Public Health and Environment at 1-877-462-2911 or go to CityofAlamosa.org or watch Cable Channel 10.
Anyone interested in volunteering to pass out bottled water can call 719-589-6639 to speak with a volunteer coordinator or call the Red Cross at 719-587-3314.
If you disabled, homebound, or cannot travel to a distribution site to pick up water, call the Center for Disabilities leave at 719-589-2224 and leave your name, address and phone number.