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GENEVA (Reuters) – Up to 200,000 Haitians could contract cholera as the outbreak which has already killed 800 is set to spread across the battered Caribbean nation of nearly 10 million, the United Nations said on Friday.

That would be double the 100,000 cases during a huge cholera epidemic in Zimbabwe between August 2008 and July 2009, which killed 4,287 people. The U.N. forecast of the number of cases in Haiti was based partly on the Zimbabwe toll.

In a strategy plan drawn up with Haiti's government and aid agencies, the U.N. said Haiti needs $163.9 million (101.5 million pounds) in aid over the next year to combat the epidemic, the first cholera outbreak in the country in a century. Cholera could also spread to the neighboring Dominican Republic, it said.

"The strategy anticipates a total of up to 200,000 people to show symptoms of cholera ranging from cases of mild diarrhea to the most severe dehydration," Elisabeth Byrs of the U.N. Office for the Coordination of Humanitarian Affairs (OCHA) told a news briefing in Geneva on Friday.

"Cases are expected to appear in a burst of epidemics that will happen suddenly in different parts of the country," she said.

The death toll from the outbreak rose to 800 on Thursday and at least 11,125 patients have been hospitalized since the outbreak began more than three weeks ago.

"The death rate isn't increasing but it is still much higher than usual, 6 to 7 percent. It should be much lower," World Health Organization (WHO) spokesman Gregory Hartl told the same news briefing.

CLASSIC RISK FACTORS

Haiti's epidemic was aggravated by flooding caused by Hurricane Tomas this month and added to a humanitarian emergency in the wake of the massive earthquake in January which killed more than 250,000.

The quake made some 1.5 million people homeless, and living conditions in the western hemisphere's poorest state leave people extremely vulnerable to the disease, which is spread by dirty water or food.

The entire population is at risk because no one has immunity to cholera.

The country has all the classic risk factors for the disease -- overcrowded camps for displaced quake survivors, a scarcity of safe drinking water, improper elimination of human waste and the contamination of food during or after its preparation.

Cases have been confirmed in five of the 10 departments, including the capital Port-au-Prince, with "high probability of spread through all the country within the coming months," according to the U.N. strategy document.

"Additionally, the population of the Dominican Republic with which Haiti shares the island of Hispaniola is at risk.

"Particular attention should be paid to cross-border areas and to the displaced, mobile and vulnerable populations as high-risk groups for disease outbreak and the spread of cholera," it said.

The response has been "swift and effective," preventing many deaths in Haiti, but more relief supplies and medical personnel are urgently needed in coming days and weeks, Byrs said.

"We continue to scale up operations in order to meet urgent needs, but if we do not have the supplies and the people to deliver them, the epidemic may outrun our efforts," she said.

Hartl said: "If you can prevent it, you've won two-thirds of the game." But if people do develop the disease, they can be saved if treated early with oral rehydration salts or antibiotics.

The challenge is to put across the "self-help message" that cholera can be prevented through good hygiene such as frequent hand washing and boiling water.

(Additional reporting by Jonathan Lynn; Editing by Susan Fenton)


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