(Adds World Health Organisation comment in paras 8-9)

By Stephanie Nebehay

GENEVA, Sept 5 (Reuters) - Cholera has broken out among some of up to 300,000 people in northwestern Pakistan who have fled fighting between government forces and militants, the International Committee of the Red Cross (ICRC) said on Friday. The situation in the Bajaur region, a haven for al Qaeda and Taliban fighters along the Afghan border, remains "very volatile" despite a government-declared ceasefire for Ramadan, a senior ICRC official said.

The neutral humanitarian agency's top priority is providing clean water and sanitation to tens of thousands who fled Bajaur for nearby Lower Dir district since the conflict intensified four weeks ago.

"Cholera has started in certain areas...It is a major concern," Pascal Cuttat, head of ICRC's delegation in Pakistan, told a news briefing.

"The most immediate need remains access to clean water and sanitation. No food, health care or shelter is going to be of any good if people get water-borne diseases," he said.

Cholera, transmitted mainly through contaminated water and food, was already endemic in the area, he said. It begins with acute watery diarrhoea that in severe cases can cause death by dehydration and kidney failure within hours.

The ICRC had no figures for the number of cases of cholera, which Cuttat said had been confirmed in local laboratories by Pakistani doctors.

The World Health Organisation said there were cases of acute watery diarrhoea among the displaced, including two children who died, but it had no confirmed reports of cholera.

"We understand these cases of acute watery diarrhoea are being contained. A lot of treatment and sanitation efforts have been undertaken," WHO spokesman Paul Garwood said in Geneva.

Women and children account for about 80 percent of an estimated 50,000 displaced people in hot and overcrowded makeshift camps or schools in Lower Dir, Cuttat said. Most men stayed in their villages to guard property and harvest crops.

Another 20,000 people have fled more recent fighting which erupted in Swat Valley in North West Frontier Province, he said.

The ICRC deploys 400 local aid workers and 50 expatriates throughout Pakistan, a major U.S. ally in Washington's fight against Islamist militancy since the Sept 11, 2001 attacks.

Washington says al Qaeda and Taliban militants hide out in sanctuaries in northwest Pakistan's ethnic Pashtun tribal areas on the Afghan border, where they orchestrate attacks in Afghanistan and Pakistan and plot violence in the West. (Editing by Keith Weir)

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