A multinational medical response has slowed deaths in a Haitian cholera epidemic that has killed more than 250 people so far, but the outbreak is likely to widen, a senior U.N. official said on Sunday.

“We must gear up for a serious epidemic, even though we hope it won’t happen,” Nigel Fisher, the United Nations humanitarian coordinator in Haiti, told Reuters.

More than 3,000 cholera cases have been reported so far in the poor, earthquake-hit Caribbean nation, which is experiencing its second humanitarian crisis since a catastrophic earthquake on January 12.

The U.N., Haiti’s government and aid partners have launched a major effort to try to contain the epidemic.

This involved setting up cholera treatment centers to isolate patients in the two worst affected central provinces, Artibonite and Center, and in the capital Port-au-Prince. The main outbreak areas straddle the Artibonite River watershed, suspected of being the main propagator of the deadly disease.

“We have registered a diminishing in numbers of deaths and of hospitalized people in the most critical areas ... The tendency is that it is stabilizing, without being able to say that we have reached a peak,” Gabriel Thimote, director-general of Haiti’s Health Department, told a news conference.

With a number of confirmed cases in Port-au-Prince and suspected cases reported in the town of L’Arcahaie and in the country’s northern second city of Cap-Haitien, Fisher said the expectation was that the outbreak would spread geographically.

Accumulated deaths since the cholera outbreak began around a week ago stood at 253, while cases totaled 3,015, mostly in the Artibonite region, Haitian health authorities said.

President Rene Preval on Sunday visited Saint-Marc, the coastal town at the center of the Artibonite outbreak zone whose hospital had been overwhelmed with patients suffering the acute diarrheal disease that can kill in hours through dehydration. It is transmitted by contaminated water and food.

Health workers were distributing kits of soap bars, water purification tablets and oral rehydration sachets to people on the Artibonite River watershed and also in Port-au-Prince.

SCIENTISTS SEE NEW QUAKE RISK

The detection of five “imported” cholera cases in Port-au-Prince, involving patients who had traveled south to the city from the central outbreak zone, has raised fears of the virulent diarrheal disease spreading in the capital.

Experts see as vulnerable to infection the inhabitants of Port-au-Prince’s sprawling, squalid slums and around 1.3 million quake survivors left homeless by the earthquake who live precariously in tent and tarpaulin camps across the city.

Scientific papers published by seismology experts in the journal Nature Geoscience on Sunday said the January earthquake may have been caused by an unseen fault and pressure could be building for another quake.

Fisher said the international medical response had enough antibiotics in-country to treat the cholera cases but would need to import more intravenous fluids to supplement supplies.

The 12,000-strong U.N. peacekeeping mission in Haiti was using its helicopters, trucks and soldiers to back the campaign against the epidemic and Cuba’s government was mobilizing several hundred doctors and nurses to help treat the sick. Medical NGOs from around the world were also helping.

The U.S. Centers for Disease Control and Prevention (CDC) had dispatched a team of experts to Haiti and the U.S. Southern Command had also offered assistance, Fisher said.

French-speaking Haiti shares the Caribbean island of Hispaniola with Spanish-speaking Dominican Republic. While no cholera cases have been reported on the Dominican side, the government there is taking precautionary measures, said the Pan American Health Organization (PAHO), the regional office of the World Health Organization (WHO).

Haitian Health Minister Alex Larsen has urged people to wash their hands with soap, avoid eating raw vegetables, boil all food and drinking water and avoid bathing in and drinking from rivers.

Fisher said a nationwide anti-cholera health education campaign was underway, using radio announcements in Creole and even SMS text messages sent to mobile phone owners.

If left untreated, cholera can kill in hours by dehydrating victims with severe diarrhea, but if caught early it can easily be treated by an oral rehydration solution - or a simple mixture of water, sugar and salt.

Haiti is due to hold U.N.-supported presidential and legislative elections on November 28, but Fisher said no decision had been taken by the Haitian authorities on whether the vote might have to be postponed.

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By Joseph Guyler Delva

PORT-AU-PRINCE (Reuters)