A cholera outbreak in Haiti which has left over 280 dead has yet to reach its peak, officials said Wednesday, warning the deadly disease could hit the capital, teeming with squalid tent cities.
"I don't think that it is contained. We cannot say it is contained," Claire-Lise Chaignat, the World Health Organization's cholera chief, told journalists, disputing reports from Haiti that the outbreak was tapering off.
"I think we haven't reached the peak," she said, recommending Haitian authorities prepare for the "worst case scenario" -- the spread of the disease to the capital Port-au-Prince.
Some 1.3 million people displaced by a January earthquake are still crammed into thousands of makeshift camps dotted around the capital, and aid agencies have voiced fears that cholera could spread like wildfire in such conditions.
More than 3,600 people have been infected in the sudden cholera outbreak in the impoverished Caribbean nation since last week, and the WHO's cholera experts remain mystified by the origins of the epidemic.
"We are very surprised to see the epidemic in Haiti. We have never found cholera there before," Chaignat told journalists in Geneva.
The acute intestinal infection is caused by ingestion of food or water contaminated with the Vibrio cholerae bacteria.
Although easily treated, it has a short incubation period of a few hours up to five days and causes acute watery diarrhea that can quickly lead to severe dehydration and death without treatment.
Haiti reported 25 more cholera deaths on Tuesday bringing the death toll to 284, with 3,612 reported infections.
In Arcahaie, a small coastal town south of the outbreak's epicenter in the central Artibonite River region, Jacklin Anore, 24, lay on a bed in a darkened room of the Nicolas Armand hospital with a bucket by his side.
Barely able to raise his head, hooked up on a rehydration drip, he intermittently spat into a rusted bed pan and whispered thanks to the nurse treating him.
Patients have died here, but as in the case in Saint-Marc further north where most of the ill have flocked, doctors said the number of new cases was easing.
Doctors Without Borders (MSF), which has eight facilities open to cholera infections in Artibonite and around the capital, said that despite the fewer deaths the need for vigilance remains.
"The fact that we are seeing fewer severe cases is positive," said Federica Nogarotto, the MSF field coordinator in Saint-Marc.
"It suggests that people are taking precautions and that there is a greater understanding in the community of the need to maintain strict hygiene and to seek medical assistance at the first sign of symptoms."
So far, the Americas' poorest country has managed to avoid the nightmare scenario of the epidemic taking hold in the unsanitary tent cities that cling to the hilly slopes of Port-au-Prince.
Haitian officials said Monday they believed the outbreak had been contained and was limited to central areas near its believed source on the Artibonite River.
But worryingly for doctors, a number of the patients in Arcahaie said they had drunk only treated water before falling ill.
The treated water, albeit taken from the infected Artibonite River, is the main source of "clean" water for most of the population, and is put into small blue plastic bags carted around town and distributed by hand.
Gabriel Thimote, director general of Haiti's health department, has said the water in the plastic bags -- which bear a label describing the contents as "purified" -- may not be safe to drink.
Rumors were swirling in Haiti Tuesday that cholera-carrying Nepalese troops with the UN peacekeeping mission in Haiti (MINUSTAH) were the origin of the outbreak.
The mission rushed to deny the claims, insisting the mission "uses seven septic tanks" situated far away from the river.
Haiti's more prosperous neighbor, the Dominican Republic -- with which it shares the Caribbean island of Hispaniola -- has meanwhile tightened border security to keep the disease at bay.
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