JOHANNESBURG, 11 December 2008 (IRIN) - The South African government is considering "managing" the influx of Zimbabweans, said a government spokesman after its border area with Zimbabwe was declared a cholera disaster area.

"We are looking into the issue," Themba Maseko responded to a question on whether the country would control the number of possibly infected Zimbabweans entering South Africa.

The World Health Organisation (WHO) has warned that with the rainy season starting, and more people likely to cross the border as the Christmas season nears, there is a greater risk of "further spread of cholera if strong measures are not taken".

The cholera death toll in Zimbabwe has risen to 783, with 16,403 suspected cases, and the WHO has also expressed concern over the "serious regional implications, with cholera cases crossing into South Africa and Botswana".

Approximately half the cases in Zimbabwe have been recorded in Budiriro, a densely populated suburb on the western outskirts of the capital, Harare. Other major concentrations of reported cholera cases include Beitbridge, on the South African border, and Mudzi, on the border with Mozambique.

The outbreak in Zimbabwe could surpass 60,000 cases, according to an estimate by the Zimbabwe Health Cluster, a group of health providers, non-governmental organisations and the Zimbabwean ministry of health and child welfare, coordinated by the WHO.

South Africa's Limpopo Province, which shares its northern border with Zimbabwe, has declared Vhembe district, including Musina, the border town between South Africa and Zimbabwe, a disaster area.

The province has so far treated 664 people with cholera, while eight people, including six Zimbabweans, have died of cholera in South Africa. Declaring a disaster will speed up the release of funds for treatment and medical care, "as we had not budgeted for this [cholera]", said Phuti Seloba, the provincial health spokesman.

A provincial report noted that "with the massive influx of Zimbabwean nationals, most of who are infected with the cholera bacteria, we are headed for a ... [much bigger] challenge than we initially anticipated."

"We have the situation under control here in South Africa, but we don't know what the situation is like in Zimbabwe," said Seloba. "Our case fatality rate is around one percent [an acceptable level for a preventable disease]".

The case fatality rate in Zimbabwe has shot up to 4.8 percent, "which is a matter of great concern to us," said Tsitsi Singizi, spokeswoman for the UN children's fund, UNICEF, in Zimbabwe. "In a preventable disease like cholera we should be able to save four out of every five cases."

Custodia Mandhlate, the WHO Representative in Zimbabwe, said in a statement: "This outbreak can be contained, but it will depend on many factors, in particular, a coordinated approach between all health providers to make sure we are providing the right interventions where they are needed most."

These interventions include prevention, quick case detection and control, and improved treatment. According to the WHO, shortages of medicines, equipment and staff at health facilities throughout Zimbabwe are compounding the health challenges.

The main causes of the cholera outbreak are inadequate supply of clean drinking water and poor levels of hygiene.

However, Zimbabwe's President Robert Mugabe was reported as saying in a nationally broadcast speech on 11 December that cholera was under control. "I am happy to say our doctors have been assisted by others and WHO ... so now that there is no cholera," he told viewers.

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