Afghan capital on verge of cholera epidemic with 2,000 cases reported so far

More than 2,000 suspected cases of cholera have been detected in the Afghan capital in recent weeks, and at least eight people have died, a health expert said Tuesday, warning that the city is on the verge of an epidemic.

The Health Ministry on Monday confirmed up to 300 cases, but claimed they have been dealt with and there had been no fatalities. It said there was no risk of the disease spreading.

"An epidemic is about to break out here. Over two thousand cases have been reported so far that would meet the case definition of cholera," said Fred Hartman, an epidemiologist and technical director for a U.S. Agency for International Development-backed program, the Rural Expansion of Afghanistan's Community-based Health Care.

Hartman, who has combatted cholera outbreaks around the world for 30 years and has been directly involved with efforts to contain the disease here, told The Associated Press that 8-9 people had died in the past two weeks, and warned the disease could spread quickly throughout the city's 4 million population.

"There are always deaths with cholera," he said.

Hartman said the government was well-equipped to deal with the outbreak and had set up an emergency task force to ensure that hospitals have the necessary equipment and medicine to treat patients.

"For an undeveloped, war-torn country, Afghanistan's ministry of health has been able to respond very well," he said.

Hartman said the disease had been detected in wells around the city, the source of drinking water for most of the city's residents, as well as irrigation ditches.

Cholera is a major killer in developing countries, where it is spread mainly through contaminated food or water. The bacterium attacks the intestine and causes severe diarrhea and dehydration.

The warning was in stark contrast to Health Ministry official Ahmid Shah Shukomand's claim Monday that the outbreak had been contained.

"We had about 200 to 300 cases, but they were discharged from hospitals after treatment," Shukomand told The Associated Press.

Shukomand on Tuesday reiterated those comments, and said even those few hundred people suspected of having cholera have not been confirmed to have the illness.

He said authorities had launched a campaign urging people to boil drinking water, wash vegetables before eating them and regularly wash hands. Health Ministry workers have chlorinated wells throughout the city, he added.

Hartman said that during most outbreaks, once cholera has been confirmed, individuals suspected to have the disease are not tested, but immediately treated symptomatically.

"You are always going to get what's called the 'funny number syndrome' during outbreaks where there are varying numbers of cases," he said. "After a while, you stop testing people and just treat them."

A spokesman for UNICEF, the U.N. children's agency, Edward Carwardine, said the last cholera outbreak in Kabul was in 2003 when there were 7,000 suspected cases. But he said the government was fast to respond and the disease quickly disappeared after wells were chlorinated.

In 2001, 114 people died from a cholera outbreak in Afghanistan's north, according to the World Health Organization's Web site. It had not information on the latest cases.

DANIEL COONEY, Associated Press Writer