Port-au-Prince: Haiti`s cholera outbreak slowed but fear shot through squalid tent camps where hundreds of thousands of quake refugees remain stuck, as the UN warned the epidemic could fester for years.
The disease that emerged last week in the first cases for a century has killed 259 people, though Haitian officials express confidence the outbreak is contained, with six deaths Monday over the first toll of 135 on Thursday.
Gabriel Thimote, director general of Haiti`s health department, said however the overall number of infections had risen from 3,115 to 3,342 over the past 24 hours, mainly along the Artibonite river north of the capital -- thought to be the source of the epidemic.
The UN, quickly tempering such optimism, warned however that cholera, which can kill with alarming haste, dangerously dehydrating the body in a matter of hours, now has a strong foothold in this desperately poor country.
"A nationwide outbreak with tens of thousands of cases is a real possibility," said a UN statement as aid agencies stepped up efforts to keep it out of the myriad camps that throng the capital Port-au-Prince.
The massive January earthquake that killed over 250,000 people also left 1.3 million more homeless in the desperately unsanitary tent cities.
The improvised living finds open pools of human waste near where the displaced bathe, do laundry and share meals in close quarters -- ideal conditions for cholera, primarily passed through contaminated food and water, to take control.
Amid the makeshift homes in the overflowing Champs de Mars camp, across the street from Haiti`s crushed national palace, the dread of cholera is palpable.
"We know what to do to protect ourselves, but children are left to their own devices," said 24-year-old Elvia. "They don`t wash themselves correctly and, look, the toilets are right in front of the tents where we live."
Five cholera cases have been confirmed in the capital but UN officials said those people traveled in from outside and were quickly diagnosed and isolated.
"Based on experience with epidemics elsewhere, it would be irresponsible to plan for anything but a considerably wider outbreak," warned Nigel Fisher, UN Humanitarian Coordinator in Haiti.
The UN said five cholera treatment centers are being set up in Artibonite with extra doctors and epidemic management experts sent to the region. Six centers were also to be set up as a precaution in the capital.
Jon Andrus, deputy director of Pan American Health Organization (PAHO), the regional branch of the World Health Organization (WHO), told reporters in Washington that the disease was likely to remain in Haiti for years to come.
"The surge of cases will come down but there will probably be cases in the future, now that the bacteria is well established in the environment," he said.
Contamination of the Artibonite River, an artery crossing Haiti`s rural center that thousands of people use for much of their daily activities, is believed to be the source of the epidemic.
Most of those infected have been admitted to hospitals and health centers around Saint-Marc, a major town several hours northwest of the capital.
Doctors Without Borders has installed a field hospital in Saint-Marc to treat patients and Oxfam has sent emergency specialists to Artibonite to set up water, sanitation and hygiene facilities for up to 100,000 people.
Haitian officials said the government was launching a anti-cholera campaign for the local community and in schools, and was being helped by the WHO and US health authorities to improve fresh water facilities.
At the Champ de Mars camp, neighbors stumbled upon sick Carline, 28, who had shut herself in her tent with her young toddler Carlo, also ill.
"I`m not sick," she insisted, her voice feeble from her ailment and two days without food. But Carline acknowledged she had "severe" vomiting and diarrhea -- both symptoms of cholera.
"I am worried but not alarmed by the situation in the camps," said Thimothe, as he also called for more clean-up in putrid outhouses and other locations filled with feces and mud.
On Port-au-Prince streets, where crumbling buildings are plastered with campaign ads for the 19 presidential candidates in next month`s election, expectation of government help is low.
"They do nothing," jeered Charles Abdias, a 33-year-old taxi driver, waving dismissively at posters strung up on walls next to a rancid open sewer. "They speak of cleaning it all up, but look at how people live."