PORT-AU-PRINCE, Haiti — A spreading cholera outbreak in rural Haiti threatened to outpace aid groups as they stepped up efforts Saturday hoping to keep the disease from reaching the squalid camps of earthquake survivors in Port-au-Prince.
Health officials said at least 208 people had died and 2,674 others were infected in an outbreak mostly centered in the Artibonite region north of the capital.
But the number of cases in towns near Port-au-Prince was rising, and officials worried the next target will be hundreds of thousands of Haitians left homeless by January's devastating quake and now living in camps across the capital.
"If the epidemic makes its way to Port-au-Prince, where children and families are living in unsanitary, overcrowded camps, the results could be disastrous," said Estrella Serrano, World Vision's emergency response health and nutrition manager.
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Officials confirmed at least five cholera cases in Arcahaie, a town close to Port-au-Prince, and four cases in Limbe, a small northern municipality. Ten cases were reported in Gonaives, the largest city in the Artibonite, according to Partners in Health, a U.S.-based humanitarian group.
The sick included 50 inmates at a prison in Mirebalais, just north of Port-au-Prince, Health Ministry director Gabriel Thimothe said.
Experts also were investigating possible cases in Croix-des-Bouquet, a suburb of the capital that could act as a transfer point of the disease because it has a widely used bus station, said Paul Namphy with Haiti's national water agency.
"This is a very mobile country," he said. "It can spread like wildfire."
Reports trickled in of patients seeking treatment in clinics closer to Port-au-Prince because the St. Nicholas hospital in the seaside city of St. Marc is overflowing, said Margaret Aguirre, an International Medical Corps spokeswoman.
One doctor in the capital reported that a 6-year-old girl from Port-au-Prince's southern Carrefour district tested positive for cholera, although government health officials were investigating and had not confirmed the case.
"The child was in very weak condition," Willy Lafond Edwight, a physician, told the Associated Press. "She couldn't stand up. She couldn't even talk.... I guarantee that if you find one case, many more cases will appear."
Cholera is a waterborne bacterial infection, and the water agency was nearly doubling the amount of chlorine in drinking water.
Aid groups are providing soap and water purification tablets and educating people in Port-au-Prince about the importance of washing hands.
The groups also began training more staff about cholera and where to direct people with symptoms. Cholera had not been seen in Haiti for decades, and many people don't know about the disease, which causes severe diarrhea and vomiting that can lead to dehydration and death within hours.
Red Cross spokeswoman Julie Sell said teams would begin teaching people in refugee camps how to prevent cholera starting Monday — five days after the outbreak.