At least 51 people have died and hundreds hospitalised following a major outbreak of cholera in southwestern Nigeria, health officials said on Tuesday.

Five people died in the Owan East local government area of Edo state on Sunday and 46 others died in the remote mining village of Kusa, 110 km (68 miles) north of the city of Ibadan where the first case was reported 11 days ago.

The deaths come three months after 50 people died in a similar outbreak in Edo.

Cases of the deadly disease have been on the increase in the past year in Africa’s most populous country, where most people live on less than a dollar a day.

“It has been confirmed that 46 people, including children, died in the outbreak of cholera in Kusa,” Lekan Kolade, Oyo state Health Ministry spokesman, said by phone from Ibadan.

More than 1,600 Africans died last year of cholera, an intestinal infection spread by contaminated food and water, according to the World Health Organisation figures.

WHO said 126 people died of the deadly infection in Nigeria, the world’s eighth biggest oil exporter, between October and November last year. Fifty of the deaths were in Edo state and 76 in the northern city of Kano.

Cholera causes vomiting and painless diarrhoea that lead to severe dehydration and death within 24 hours if treatment is not given promptly.

The disease can largely be prevented by washing hands before handling food and avoiding contaminated drinking water. Many of those who die could be saved by a simple mixture of water and rehydration salts.