Twenty-five more fatalities brought the toll from Haiti's cholera epidemic to 330 dead on Friday, as medical teams desperately sought to contain an outbreak that they warned could "spread like wildfire."
Nearly 5,000 patients have overwhelmed hospitals in the affected central regions of the country, and cases are now suspected just 30 miles (48 kilometers) from the capital Port-au-Prince, where 1.3 million people displaced by January's catastrophic earthquake are still living in squalid camps.
Days after cholera was confirmed in Haiti for the first time in decades, the death rate began to slow, although one week on it has jumped again, with health authorities announcing 25 new deaths and 65 more people hospitalized with the disease, for a total of 4,714.
Clinics were operating beyond capacity around the Artibonite River, which is believed to be carrying the deadly cholera bacteria across the country to the Caribbean coast at Saint Marc, the outbreak's epicenter some 60 miles (96 kilometers) north of Port-au-Prince.
International aid group Save the Children said the outbreak was threatening some 25,000 new mothers and their babies in the hundreds of temporary camps in and around the capital.
"In these conditions, cholera could spread like wildfire," Ribka Amsalu, the group's emergency health advisor in Haiti, warned in a statement that also said cases of the disease had crept closer to Port-au-Prince.
"News of cases closer to the capital is chilling. Mothers are scared, asking what they can do."
The group described sanitation conditions in the camps as "dire, with homes surrounded by rubbish and people having to cook, clean and wash in the same place."
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.
Authorities in the Dominican Republic, which shares the island of Hispaniola with Haiti, were watching events closely, and on Friday they tightened military control over the border to restrict entry by Haitians fleeing the outbreak.
Local media reported that the military conducted raids in the northern border town of Dajabon, and that at least 170 Haitians had been detained.
Authorities also canceled a market that operates on Fridays, after earlier incidents of violence among Haitians struggling to cross into the Dominican Republic.
The source of the outbreak remains unclear, although the UN peacekeeping force MINUSTAH is probing claims its septic tanks leaked into the Artibonite River and contaminated it with fecal bacteria.
At the Charles Colimon hospital in Petite Riviere, a small community along the Artibonite, up to 400 patients were packed in every available space — in the corridors, on floors and in tents surrounding the facility.
Aid agencies and the Haitian government are urging further steps to prevent the outbreak's spread, with anti-bacterial lotion and tools to prepare food without infected water.
Health dangers have been amplified by a lack of infrastructure in the poorest country in the Americas, said Waking Jean-Baptiste, a doctor liaising between the international medical agency Doctors Without Borders (MSF) and local staff at Charles Colimon.
"The problem is we only have one ambulance for the whole region, so we hear reports that there are many sick people who cannot reach the hospital," he told AFP.
Earlier this week MSF voiced optimism that the epidemic was being controlled.
But the World Health Organization warned the outbreak is far from over and Haiti should prepare for the "worst-case scenario" — cholera in the capital.
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