In Dominican Republic at least 23 people have died of cholera, and 1,288 have been infected following an outbreak in neighboring Haiti last year, say officials.
The health ministry released the new toll on Thursday, saying that in the last three weeks alone the number of dead has nearly doubled from 13 and the number of infections has risen by more than 400.
The government said it had installed two new laboratories for detecting the disease, but Health Minister Bautista Rojas said he expects a rise in cases in the coming three to four weeks.
The head of the Dominican Medical College, Senen Caba, has meanwhile disputed the toll, saying the epidemic has killed 30 and infected 5,000.
Cholera is an intestinal infection caused by ingestion of contaminated food or water. It can strike swiftly, causing intense diarrhea, vomiting and nausea that leads to severe dehydration and sometimes death.
The Dominican outbreak, first detected in November 2010, is believed to have come from Haiti, where at least 4,850 people have died from the disease and some 300,000 have been infected.
A UN investigation concluded earlier this month that the disease in Haiti bore striking similarities to a South Asian strain but did not confirm the widespread belief among Haitians that it came from Nepalese peacekeepers.