Hospitals and clinics in the affected areas have been overwhelmed
A cholera outbreak has killed at least 196 people in Haiti, officials say.
They say 2,634 people have been hospitalised in the central Artibonite and Central Plateau regions by the illness, which causes diarrhoea, acute fever, vomiting and severe dehydration.
There are fears the outbreak could reach camps housing the survivors of January’s quake in Port-au-Prince.
Medics also say the neighbouring Dominican Republic should be alert to the risk of cholera.
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Officials believe the cholera outbreak was caused by people drinking infected water from the Artibonite river.
The director general of Haiti’s health department, Dr Gabriel Thimote, said on Friday that the worst-affected areas were Douin, Marchand Dessalines and areas around Saint-Marc, about 100km (60 miles) north of Port-au-Prince.
Local hospitals were “overwhelmed”, and a number of people were being evacuated to clinics in other areas, he added.
At one point earlier this week, hundreds of people were laid out in the car park of St Nicholas hospital in Saint-Marc, with intravenous drips in their arms to treat dehydration, until it began to rain and they were rushed inside.
CholeraIntestinal infection caused by bacteria transmitted through contaminated water or foodSource of contamination usually faeces of infected peopleCauses diarrhoea, vomiting, severe dehydration, and can kill quicklyEasily treated with antibiotics; not usually fatal
Some patients at the hospital said they became ill after drinking water from a public canal, but others said they had been drinking purified water.
Local doctor Jhonny Fequiere told the BBC that he had seen 28 patients die and said his hospital in Marchand Dessalines was struggling to cope.
“We are trying to take care of people, but we are running out of medicine and need additional medical care. We are giving everything we have but we need more to keep taking care of people,” he said.
The victims range in age, but the young and the elderly appear to be the worst-affected.
Later on Friday, the first two cholera cases outside the Artibonite were confirmed in Arcahaie, a town closer to Port-au-Prince, the Associated Press news agency reports.
It says that experts were also investigating possible cases in Croix-des-Bouquet, a suburb of the capital.
Tens of thousands of survivors of the devastating earthquake are still living in crowded tent cities in and around Port-au-Prince with poor sanitation and little access to clean drinking water.
David Darg, a medical relief worker in Haiti, told the BBC he had visited an area near Saint-Marc which – according to local residents – was the source of the outbreak.
“We started heading out along narrow roads lined with villagers begging for water,” he said.
“By now, they’d been seeing people dying in their communities and knew not to drink water from the river, which ordinarily would have been their main source of water.”
This is the first time in a century that cholera has struck the Caribbean nation, the World Health Organization said.
The Artibonite department was not badly damaged in the earthquake but thousands of people who lost their homes have moved into camps or are living with relatives there.
“We have been afraid of this since the earthquake,” said Robin Mahfood, president of Food for the Poor.
The agency was preparing to airlift donations of antibiotics, oral dehydration salts and other supplies to the affected areas.
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