"Our projections show that we could have around 200,000 cases of infection in Haiti over the next six to twelve months," PAHO regional advisor Ciro Ugarte told AFP.

"If the fatality rate (of four to five percent) is maintained... we may have 10.000 dead," said Ugarte, describing this as "the worst case scenario."

"The cholera epidemic cannot be stopped, especially in places where there is a lack of safe water supply, basic sanitation," he said. "The cholera could spread beyond Haiti, in the Dominican Republic and beyond."

More than 1,100 Haitians have died since cholera was first detected in the nation in mid-October. The number of people treated in hospitals and clinics has soared to 18,382.

The PAHO, a regional office of the UN's World Health Organization, has warned that cholera has taken hold and the troubled Caribbean nation should now expect hundreds of thousands of case over the next few years.

Health officials fear the cholera epidemic could spread like wildfire if it infiltrates Haiti's squalid refugee camps around the capital where hundreds of thousands of earthquake refugees live in cramped and unsanitary conditions.

The cholera outbreak -- the first in more than half a century in the impoverished Caribbean nation -- is bringing new chaos to Haiti after it was ravaged in a January quake that killed 250,000 people.

earlier related report
Haiti's Preval urges calm as cholera toll soars
Port-Au-Prince (AFP) Nov 17, 2010 - Haitian President Rene Preval pleaded for calm as the death toll from a cholera epidemic soared over 1,100 Wednesday and more desperately ill people sought treatment in overcrowded hospitals.

"Disorder and instability have never brought solutions to a country going through hard times," Preval said late Tuesday in a recorded message, hitting out at those fanning discontent.

"Gunshots, throwing bottles, barricades of burning tires will not help us eradicate cholera bacteria. On the contrary, it will prevent the sick from receiving care and to deliver medicine where it is needed."

Health experts are scrambling to teach Haitians how to ward off cholera as anger over the epidemic has erupted into violent street protests, the head of the US Centers for Disease Control told AFP.

Less than two weeks before elections to choose Preval's successor, political forces are being blamed for whipping up tensions in northern Cap-Haitien where two Haitians died -- one shot by a UN peacekeeper -- in Monday riots.

Haiti's health ministry said Wednesday that 1,100 people had now died since cholera was first detected in the nation in late October. The number of people hospitalized also grew to a total of 18,382.

The disease has also surfaced for the first time in neighboring Dominican Republic, with officials there are also appealing for residents to stay calm.

Dominican Health Minister Rojas Gomez said Wednesday that one person, who had crossed over the border from Haiti, had been treated for vomiting and diarrhea. He had been isolated and was being treated in hospital.

The Dominican Republic, a popular tourist destination, was in a "pre-epidemic phase," Gomez added in an interview with local television.

In a bid to keep the disease at bay, Dominican authorities have banned the Haitian traders from crossing the border to sell clothes and shoes in a popular border market.

Health officials fear the cholera epidemic could spread like wildfire if it infiltrates Haiti's squalid refugee camps around the capital where hundreds of thousands of quake refugees live in cramped and unsanitary conditions.

The cholera outbreak -- the first in half a century in the impoverished Caribbean nation -- is bringing new chaos to Haiti ravaged in a January quake, which killed 250,000 people and left 1.3 million homeless.

Thousands of protesters went on the rampage Monday in Cap-Haitien, setting a police station ablaze and threatening to torch a UN compound before being broken up by gunfire and tear gas.

The UN force, known as MINUSTAH, issued a statement linking the protests to presidential elections and calling on Haitians not to allow themselves to be manipulated by "the enemies of stability and democracy."

Six members of MINUSTAH were injured in a second protest Monday in the central city of Hinche in which some 400 angry demonstrators threw stones before being dispersed.

There are claims the cholera outbreak emanated from septic tanks at a nearby base for Nepalese peacekeepers where some believe infected feces leaked into a tributary of the Artibonite River, used by locals for drinking and bathing.

The desperate situation has left public health experts with little option but to focus on the bottom line: trying to stop the rash of fatalities from the bacteria-based disease that travels mainly through contaminated water.

"We felt that the best strategy with this outbreak was to focus on preventing death," said Jordan Tappero, who leads the CDC team on cholera response in Haiti.

The CDC is rotating more than 350 staffers in and out of the country on 30-day assignments, as they try to train locals and health officials in the fight against the fast-spreading disease.

Cholera "is a great hitchhiker. It travels by contaminated water, food or an individual who may be asymptomatic or developing symptoms," said Tappero.

He added because of that it was virtually impossible to pinpoint the origins of the cholera outbreak in Haiti.

MINUSTAH has said it has tested some of the Nepalese and found no trace of cholera, and health officials have said that although Haiti's cholera is a south Asian strain this is no smoking gun as the strain is very common.

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