Deaths from Haiti's cholera epidemic approached 300 on Tuesday, and health experts said the illness would "settle" in the poor Caribbean nation, joining other endemic diseases like malaria and tuberculosis.
The week-old epidemic of the deadly diarrheal disease has so far mostly affected the central Artibonite and Central Plateau regions, with an accumulated 295 deaths and 3,612 cases registered to date, Haitian health authorities said.
Although the number of new deaths and cases has slowed slightly from earlier days, a United Nations-led international medical response is fighting to prevent the outbreak from penetrating Haiti's capital Port-au-Prince, which is crowded with 1.3 million homeless survivors of a January 12 earthquake.
The epidemic has jolted the Western Hemisphere's poorest nation with another crisis 9-1/2 months after the catastrophic quake that killed more than half a million people.
It also comes a little over a month before the country is due to hold presidential and legislative elections on November 28. Despite the disease outbreak, the polls were still set to go ahead as scheduled, Pierre-Louis Opont, the director general of Haiti's provisional electoral council, told Reuters.
Announcing updated case figures at a news conference, the Haitian health ministry's director of epidemiology Roc Magloire said that of five cases previously reported in the capital, only one had been confirmed by laboratory tests to be cholera.
Nevertheless, the UN, the government, and its foreign aid partners are expecting the disease to spread further in its epidemic phase. They have launched a combined treatment, containment and prevention strategy for the whole country.
"The next news for us and for you is when geographically, new pockets of the epidemic ... emerge, in Port-au-Prince or elsewhere," Dr. Michel Thieren, the Pan American Health Organization's (PAHO) top official in Haiti, told Reuters.
Suspected cases have been reported in Nord and Sud provinces, but are pending laboratory results.
Thieren said however a slight slowing in the rate of new deaths and cases was being observed in the main outbreak area of Artibonite, which he called encouraging and attributable in part to an aggressive multinational medical response.
With the epidemic reestablishing cholera in Haiti after a long absence, the disease would now become endemic, joining illnesses like malaria, tuberculosis and HIV AIDS which have been afflicting impoverished Haitians for years, Thieren said.
"It's normal that we should expect a settlement of cholera in Haiti nationwide over the coming months," he added. But it was hard to predict exactly how the epidemic would spread.
DOMINICAN REPUBLIC ON ALERT
The UN has said a nationwide outbreak with tens of thousands of cases is still "a real possibility".
The international humanitarian operation has rushed doctors, nurses and medicines to the rural central zone straddling the Artibonite River, the suspected source of the disease which is transmitted by contaminated water and food.
Special cholera treatment centers are being set up in the main outbreak zone, in Port-au-Prince and elsewhere, to isolate patients. A public education campaign is urging the country's 10 million people to wash their hands regularly with soap, avoid eating raw vegetables, and boil food and drinking water.
If left untreated, cholera can kill in hours by dehydrating victims with severe diarrhea, but if caught early it can easily be treated with an oral rehydration solution -- or a simple mixture of water, sugar and salt.
Health Minister Alex Larsen announced the government would train 30,000 health workers to join the anti-cholera campaign across the nation in the coming months.
PAHO, the regional office of the World Health Organization, has said there is a "high risk" of the cholera spreading across the border of the island of Hispaniola to Dominican Republic.
The border has not been formally closed but on Monday Dominican Republic authorities canceled the regular farm market normally held in the northern frontier town of Dajabon, and prevented hundreds of Haitians from crossing to attend it.
PAHO has also alerted other states in the Caribbean about the epidemic, the first of cholera in the Americas since a 1991 outbreak in Peru, and was seeking resources to fight it from members like Brazil, Cuba, the United States and Canada.