Five cases of cholera were confirmed early Sunday in the capital of earthquake-shattered Haiti as the death toll from the disease climbed to 200.

Imogen Wall, a spokesperson for the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) in Haiti, told broadcaster CNN that the confirmation of the cases in Port-au-Prince was “a very worrying development.” Health experts have expressed concern over the impact of widespread infections in the capital or the nearby refugee camps, where hundreds of thousands of survivors from the January quake still reside in rough conditions.

“If the wave of disease reaches Port-au-Prince, where families are living in overcrowded, unhygienic camps, then it will be disastrous,” said aid worker Estrella Serrano.

The five cases in the capital are believed to be people who came to Port-au-Prince for treatment, but were infected at the epicentres of the outbreak in more northern areas of Haiti.

Some 3,000 people were being treated in hospitals, sickened with fever, vomiting and diarrhoea, in the Lower Artibonite region, 80 kilometres north of capital Port-au-Prince.

The outbreak prompted the government to declare a health emergency across the country late Friday and institute sweeping measures to halt the spread of the disease.

More than one million people have been living in tents in refugee camps since the January 12 earthquake in which more than 200,000 people died. Access to clean drinking water at those sites is limited and delivering supplies can be difficult.

Cholera is an intestinal infection caused by bacteria transmitted through faecal contamination of water or food. The main symptoms are diarrhoea and vomiting, which can quickly lead to severe, sometimes fatal, dehydration.

A health and sanitation aid worker in Haiti told the German Press Agency DPA that the outbreak appears to have occurred in a relatively affluent area, raising concerns for other areas with poor sanitation.

Federica Nogarotto, Doctors Without Borders’ field coordinator in St Marc, Haiti, where the outbreak was centred, said there were “significant numbers” of cholera patients at the city’s St. Nicholas Hospital, which lacks “the capacity to handle a cholera emergency.” “The most important thing is to isolate the cholera patients there from the rest of the patients, in order to best treat those people who are infected and to prevent further spread of the disease,” Nogarotto said.

Experts are baffled by the cholera outbreak, Haiti’s first in decades and one that occurred while international health agencies have beefed up presence in the country.

Haitian authorities fear that recent heavy rains had caused latrines to overflow and displaced contaminated water into the Artibonite River.

Keywords: cholera

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