Officials warned Wednesday that Haiti should prepare for the worst as hundreds more patients packed into hospitals amid a deadly cholera outbreak that has claimed almost 300 lives.

A total of 4,147 people were being treated for the disease, said the head of Haiti's health department Gabriel Thimote, while eight new fatalities brought the death toll to 292.

The World Health Organization (WHO) warned the outbreak was far from over and Haiti should prepare for the disease to hit its capital Port-au-Prince, which is teeming with squalid tent cities after January's catastrophic earthquake.

"We cannot say it is contained," WHO's cholera chief, Claire-Lise Chaignat, told journalists in Geneva.

"I think we haven't reached the peak," she said, recommending that Haitian authorities prepare for the "worst case scenario" — cholera in the capital.

The acute intestinal infection is caused by ingesting food or water contaminated with the Vibrio cholerae bacteria, which is thought to have infected the Artibonite River, a major artery that runs through Haiti to the coast near Saint Marc — the outbreak's epicenter.

Although easily treated, cholera has a short incubation period — sometimes just a few hours — and causes acute watery diarrhea that can quickly lead to severe dehydration and death.

Some 1.3 million people displaced by the 7.0 quake are still crammed into thousands of makeshift camps, and aid agencies have voiced fears cholera could spread like wildfire in such conditions.

Fear of the disease is turning to anger, as Haitians begin to blame foreign aid workers and peacekeepers for the Caribbean nation's first ever outbreak of cholera.

Rumors have swirled this week that Nepalese troops with the UN peacekeeping mission in Haiti (MINUSTAH) were the source of the outbreak.

The mission rushed to deny the claims, insisting the mission "uses seven septic tanks" situated far away from the Artibonite River.

The installation of a vital treatment center in Saint Marc, meanwhile, had to be halted after some 300 residents confronted doctors and aid workers.

Fuelled by fear the facility would spread cholera to two nearby schools, residents of Saint Marc threw stones at medical workers of the international medical agency Doctors Without Borders (MSF).

The specialized treatment center was being set up outside the overwhelmed St Nicolas hospital here, where some 800 patients are already being treated with hundreds of new cases arriving each day, officials said.

Argentine troops with MINUSTAH stepped in to stop the protest, and on Wednesday they were overseeing the dismantling of the facility, some 60 miles (100 kilometers) north of Port-au-Prince.

"It was a big misunderstanding," Haitian doctor Yfto Maquette told AFP in the hospital's chaotic courtyard overflowing with patients who were supposed to have been moved to the new facility.

"The fact that we don't have the center is stopping us from effectively treating people," said an MSF official who declined to be named.

"We need to get the message out that cholera is a disease that we are very experienced in treating," he said.

Maquette pointed out there was still need for basic response tools for the crisis, saying the medical team "only has one ambulance to bring people into the hospital."

MSF, which has eight facilities open to treat cholera infections in the region, said however the fact fewer deaths were being reported was a good sign.

"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."

Mexico said Wednesday it has sent military cargo plane with 11 doctors and 2.2 tons of medical supplies to help Haiti tackle the cholera outbreak.

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.

But worryingly for doctors, a number of patients in the town of Arcahaie said they had drunk only treated water before falling ill.

The treated water, the main source of "clean" water for most of the population in the region, is taken from the Artibonite.

earlier related report

Cholera aid center shutdown after Haitian protest
Saint Marc, Haiti (AFP) Oct 27, 2010 –

Aid workers halted the installation of a vital treatment center in the epicenter of Haiti's cholera outbreak Wednesday after a violent protest by several hundred residents opposed to its proximity to two schools.

Argentine troops with the UN force in Haiti (MINUSTAH) intervened after residents of Saint Marc threw stones at medical workers with Doctors Without Borders (MSF) late Tuesday as they set up a specialized treatment center outside overwhelmed St. Nicholas hospital.

On Wednesday, MSF workers began dismantling the treatment center in response to the protests, as Argentine troops stood watch.

The facility was to have been used to take in the overflow of patients from St. Nicholas, but residents feared that its proximity to the schools would expose more people to cholera.

"The idea was to move the patients out of the hospital, but what we should have done first was to talk to the people in the community, to help them understand what we were doing," Haitian doctor Yfto Maquette told AFP in the hospital courtyard, where hundreds of patients waited for treatment.

"It was a big misunderstanding," he added.

"The fact that we don't have the center is stopping us from effectively treating people," said a MSF official who declined to be named.

"We need to get the message out that cholera is a disease that we are very experienced in treating," he told AFP in the chaotic yard full of sick people in cots under makeshift tarps had been waiting to be moved to the new facility.

Nearly 300 people have been killed in the outbreak and over 4,000 have been sickened by the virulent disease that is spread by contaminated water and food.

The source of the disease is thought to be water from the Artibonite River that runs to Haiti's Caribbean coast at Saint Marc, the outbreak's epicenter.

Among the young patients was four-year-old Jules Djelickson, who lay motionless on a cot, staring vacantly into the distance, as his mother Pacius Celette waved a grubby rag to keep flies off his face.

Asked about the MSF being shut down, she said: "The community is scared, but they don't have a choice, we need it."

Over 800 patients are being treated at Saint Nicolas hospital, where the Haitian flag flew at half-mast and 300 cases arrive each day.

Maquette pointed out there was still need for basic response tools for the crisis, saying medical teams "only have one ambulance to bring people into the hospital."

That problem was highlighted hours later at a nearby market in Pont-Sonde, along a bridge over the Artibonite, when a man suddenly collapsed on the side of the road, according to witnesses, after drinking water from the infected river.

Market traders joined by his frantic mother poured water into the man's mouth, though he appeared unable to swallow. He was eventually loaded onto a pickup truck to be taken to a closer, smaller hospital in Petite Riviere.

On the bridge over the sluggish, muddy river, 31-year-old Saint-Gilles Clement demonstrated what aid agencies have been urgently teaching residents in this most affected department.

"This is sanitizer," he told AFP with a smile, bringing out a small bottle of anti-bacterial lotion, pointing out that everybody needs to wash their hands with it many times a day.

"We don't shake hands here anymore," he added, calling over a friend to show off their new greeting: bumping elbows. "Like this we can stay safe."

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