The cholera epidemic that hit Zimbabwe late last year is now officially over. But humanitarian groups warn the onset of the rains later this year could trigger another outbreak. Efforts are underway to avert more deaths from the disease.

The World Health Organization says more than 4,250 people died from cholera and more than 98,000 people were infected during Zimbabwe's last rainy season. The International Federation of Red Cross and Red Crescent Societies have described the recent outbreak as the worst in Africa in 15 years.

Tsitsi Singizi, spokesperson for the United Nations Children's Fund, UNICEF, told VOA that while the scale and numbers may be unprecedented the outbreak was nothing new.

"Over the last six years Zimbabwe has been experiencing a cholera outbreak every year,"  he said. "The historic pattern of cholera warrants almost a preparedness plan every year to respond to cholera."

Singizi says one of the reasons for the poor response to the outbreak last year was the near collapse of the public health system. She says this has largely been remedied with the support of donor and humanitarian organizations who are paying allowances to medical personnel. Zimbabwe's minister of health, Doctor Henry Madzorera, says this has ensured that most health workers have returned to work.

"In spite of the poor salaries and working conditions we find that most of our health workers are back at work now," he said. "The health care delivery system is now many, many times better than it was in August last year when the outbreak started."

Globally, cholera outbreaks usually occur in rural areas. But the epicenter of last year's epidemic was the capital city Harare. Other urban centers were also hit hard. Infrastructure in these centers was so degraded that the authorities failed to provide safe drinking water and streams of raw sewage flowed in some residential areas.

Tsitsi Singizi said UNICEF is concerned that the sanitation and water problems have not yet been resolved. Since the epidemic, the U.N. agency has sunk more than 200 boreholes in areas in Harare and elsewhere that have not had running water for a long time.

Dr. Madzorera said local authorities are working frantically to ensure that the sewage and water infrastructures are rehabilitated before the rains. The health minister said the Ministry of Finance has given Harare $17 million government to fix Harare's water and sanitation infrastructure.

Dr. Madzorera said even though the epidemic is over, Zimbabwe is in what he described as a state of alert. He said the cholera command and control center still meets every week. He said Zimbabweans are being educated on how to prevent cholera and encouraged to use a range of water purification methods.

The international community is also helping.  In addition to the boreholes, UNICEF is providing some urban authorities with water purification chemicals, providing hygiene kits to schools and replenishing stocks of rehydration kits. The World Health Organization has also started training community cholera surveillance teams to help in the early detection of, and response to, a fresh outbreak, if that happens.