A deadly cholera outbreak which has claimed more than 200 lives in Haiti could spread to the cramped and vulnerable tent camps of the nation's capital, health officials fear.
The epicenter of the outbreak, which is the country's worst health crisis since January's quake, has so far been focused in a rural valley in the nation's central Artibonite region, which is about 150 kilometres north of the capital.
However, at least five new cases have been reported in a town called Arcahaie, which is about 50 kilometres from the capital. Another four cases have been identified in Limbe, a small northern municipality.
At least 2,600 people have been sickened by the outbreak.
New cases have also been found in other communities, and medics have been working to identify a suspected case in Croix-des-Bouquet, which is a suburb of the capital of Port-au-Prince.
There have also been confirmed cases at a prison north of the capital, said Health Ministry direction Gabriel Thimothe.
But the real concern is that the capitol city itself will be hit by the outbreak, where thousands are still homeless and living in packed, squalid conditions.
Maintaining hygiene in the refugee camps and providing clean water for the many thousands living there has been a herculean task since the Jan. 12 quake. Now, things could get worse.
"It will be very, very dangerous," said Claude Surena, president of the Haitian Medical Association. "Port-au-Prince already has more than 2.4 million people, and the way they are living is dangerous enough already. Clearly a lot more needs to be done."
The World Health Organization says crucial supplies -- including 10,000 boxes of water purifiers -- are being rushed into the camps.
So far, the death toll stands at 208, according to UN spokesperson Imogen Wall.
"It's concentrated in Artibonite right now and we're doing our best to keep it that way," Wall said.
In the coastal city of St. Marc, about 100 kilometres north of the capital, supplies can't arrive fast enough.
The Associated Press reported that a medical centre in the city was packed with the sick, some of whom were forced to wait for attention on feces-stained mattresses.
Dr. Roasana Casimir said that patients are showing signs of extreme dehydration. One 55-year-old patient, Jille Sanatus, was so dehydrated that it was a challenge to treat him.
"He's completely dehydrated, so it's difficult. It's hard to find the vein," said Casimir, who has been working almost non-stop since Wednesday.
About 30 minutes after that conversation, the patient was dead.
Sanatus' son said that the family had been drinking water from a river near their home in the central plateau region.
Cholera, which is spread through contaminated water, causes severe vomiting, diarrhea and rapid dehydration. Cholera was not common in Haiti before the quake, meaning that many Haitians have no resistance to the illness.
"We have all the things in place for something we know will get bigger," said Jon Andrus of the Pan American Health Organization.
The Artibonite region was the destination for thousands of refugees after the quake forced residents to flee. However, the region is desolate and lacks many essential services, further compounding the difficulties of dealing with the outbreak.
Alison Frehlich, from the Canadian Red Cross, told CTV News Channel from Ottawa on Saturday that supplies are being trucked to the hardest hit region from Port-au-Prince, where relief workers have been stationed since January.
Frehlich also stressed the importance of community outreach projects focusing on hygiene and avoiding contaminated water.
"We have volunteers ready out in the community, spreading the word," she said, adding that washing hands and other basic sanitation practices can go a long way to preventing the spread of cholera.
"Everybody is pulling together to do their best."