Infection of cholera, a highly contagious fatal disease, has been confirmed in two more patients—from Sanepa of Lalitpur and Kapan of Kathmandu—on Tuesday.

According to the Epidemiology and Disease Control division, the National Public Health Laboratory has confirmed infection of the disease in a 35-year-old man from Sanepa and a 34-year-old man from Kapan.

“A team has been mobilised for surveillance of the affected areas, where the infected patients reside,” Dr Chuman Lal Das, director at the Epidemiology and Disease Control Division, told the Post. “We have alerted all agencies concerned about the possible risks.”

With the confirmation of two new cases, the number of cholera infections in Kathmandu Valley has reached four in the last two days.

The disease was confirmed in two sisters aged 18 and 23 years from Kathmandu Metropolitan City-28, Bagbazar on Sunday.

Vibrio cholera 01 Ogawa serotype has been confirmed in stool samples of all infected patients, according to officials at the division.

Cholera is a highly infectious disease that causes severe diarrhoea and vomiting, which causes dehydration and can lead to death within a few hours if left untreated. The World Health Organisation says cholera is a global threat to public health and an indicator of inequality and a lack of social development.

All the infected patients have been admitted to Sukraraj Tropical and Infectious Disease Hospital for treatment.

The hospital administration said all infected patients are receiving treatment in the intensive care unit.

According to officials at the infectious disease hospital, sporadic cases of suspected cholera have been reported in the Valley of late. Doctors warn of cholera outbreaks caused by contaminated water with the increase in rainfall and disruption in garbage collection in Kathmandu Valley.

In October last year, Vibrio cholera outbreak in several local units of Kapilvastu district killed at least four people including three minors—boys aged seven and two, and a five-year-old girl. Another deceased was a 45-year-old man.

Following the outbreak, the Health Ministry had launched a mass vaccination drive against the disease after all its attempts failed to curb the infection.

The UN health agency says that a multifaceted approach is key to controlling cholera and reducing deaths.

Doctors say launching awareness drives against water-borne diseases and ensuring safe drinking water are the only ways to save people from dying of water-borne diseases, including cholera.

A combination of surveillance, water, sanitation and hygiene, social mobilisation, and treatment is required to contain the spread of the infection, according to doctors.