CHARLESTON, WEST VIRGINIA (REUTERS) - Restaurants and shops were reopening on Sunday in parts of West Virginia where the water supply was poisoned by a chemical spill, although up to 300,000 people spent a fourth day unable to use tap water for anything besides flushing toilets.
State government officials, the utility company West Virginia American Water and the National Guard were continuing to test the water supply on Sunday after as much as 28,000 litres of an industrial chemical leaked into the Elk River on Thursday.
It could still be several days before people in nine counties and Charleston, the state capital and largest city, can once again use the water from their faucets for drinking, cooking and bathing.
A dozen restaurants in Charleston had been allowed to reopen by Sunday afternoon by the Kanawha-Charleston Health Department after assuring officials that they have secured a source of potable water.
"It feels very expensive," said Ms Keeley Steele, who bought hundreds of bottles of water in order to reopen her comfort-food restaurant, the Bluegrass Kitchen, in Charleston on Sunday. "This is all coming at such a huge cost."
Nearly 200 groceries, supermarkets and drugstores also have been allowed to reopen across the affected area.
Hotels were allowed to continue operating as long as they steer clear of using tap water, although several hotel owners said they were only honouring existing reservations to reduce the expense of shipping out linens for cleaning.
Officials have so far declined to estimate the economic cost of the spill.
Frustrations, however, continue to mount, with West Virginians lamenting the toll the outage has taken on their health and personal hygiene.
"It feels like we've all been living on junk food these past couple days," Ms Josephine Ritter, a 40-year-old hairstylist, said outside a recently reopened 7-Eleven convenience store in Charleston. "You can't cook or clean or anything. It's just bottled water and potato chips every day."
The emergency began last week after a spillage from a tank belonging to Freedom Industries, a Charleston company that makes chemicals for the mining, steel and cement industries, authorities said.
The spill happened about a mile upriver from a West Virginia American Water treatment plant. President Barack Obama declared it an emergency, and the Federal Emergency Management Agency has sent dozens of tractor trailers loaded with clean water.
Water tainted by the spilled 4-methylcyclohexane methanol, or Crude MCHM, smells faintly of licorice.
Contact with the water can cause nausea, vomiting, dizziness, diarrhea, rashes and reddened skin. More than 70 people had visited emergency rooms with these symptoms by Saturday, according to the state's health department.
Nearly 1,000 people have called the West Virginia Poison Center since the spill to say they or someone in their household had been exposed, Ms Elizabeth Scharman, the centre's director, said on Sunday.
The "vast majority" of those people reported symptoms of some kind, she said. While there is little data on the chemical's effect on humans, she said most symptoms were easily treated and that rashes and feelings of nausea would soon fade.
"It's not a highly toxic chemical, it's an irritant chemical," she said, adding that less than 10 people had required being admitted to a hospital.
More than 60 people had also called to say their livestock or pets had been exposed.
Mr Earl Ray Tomblin, the governor of West Virginia, and other officials said at a press conference on Saturday evening that efforts to flush the chemical from the water supply were showing some progress.
Most of the water samples tested on Saturday were found to be within safety limits. But officials say they need to see all samples register within safety limits over at least a 24-hour period before they can consider lifting the tap water ban.
The governor and other officials said they would hold another press conference at 4.30pm EST (5.30am Singapore time) on Sunday.
Meanwhile, some West Virginians are anticipating a disheveled start to the new work week.
"I'm not looking forward to going back to work on Monday without a shave or shower," said Mr Clark Mills, a 51-year-old contractor in Charleston. He has sent his family to stay with relatives in an unaffected part of the state while he waits out the problem.
"I have a 6-month-old baby," he said. "We can't live like this."