United Nations and international aid agencies warn that cholera is spreading in drought-stricken Somalia as hunger grips that nation and the threat of famine inches closer.

The World Health Organization reports more than 21,000 cases of cholera, including 533 deaths, in Somalia since the beginning of the year. 

The International Federation of Red Cross and Red Crescent Societies also reports that an outbreak of the deadly disease in the self-declared autonomous region of Somaliland has killed 28 people in just the last week-and-a-half, and hospitalized nearly 170 others. 

Jens Laerke, spokesman for the U.N.’s Office for the Coordination of Humanitarian Affairs, says the case fatality rate of cholera in Somalia is about 2.3 percent, with an emergency threshold of 1 percent. He says two regions, Middle Juba and Bakool, exceed those rates.

“We have accumulative case fatality rates of Middle Juba, 14.1 percent and in Bakool, 5.1 percent. So, at least in one area, Middle Juba, 14 times the emergency threshold,” he said. 

WATCH: Video footage from Internally Displaced People’s camp

The United Nations reports 6.2 million people, more than half of Somalia’s population, urgently need humanitarian assistance. Of these, 2.9 million are suffering from extreme hunger. 

Laerke tells VOA that many of those desperately needy people have been reached with aid, but many have not.

“Clearly, if we do not reach them for whichever reason, given that we are providing life-saving assistance, I think there should be no doubt that people will die; particularly, children are extremely vulnerable. Things such as cholera/acute watery diarrhea are killers of kids,” he said. 

Cholera causes acute watery diarrhea.

Separately, Laerke says, measles is once again threatening young children. He says more than 3,800 suspected cases have been reported across the country this year, and the disease appears to be on an upward trend.

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