Over 3,000 people in Sudan have been exposed to cholera since July, the World Health Organization reported on Tuesday, warning that the outbreak had now spread to a region where conflict is hampering efforts to tackle the deadly disease.

“Unity State is where we’re focusing our efforts now. There’s an active conflict so it’s not easy to control but we’re doing our best,” said Usman Abdulmumini, WHO South Sudan country representative.

An intestinal infection often linked to contaminated drinking water, cholera causes diarrhea and vomiting, leaving small children especially vulnerable to death from dehydration.

The outbreak has caused 44 deaths and spread to nine of South Sudan’s 28 states, WHO said. But Abdulmumini said the disease was no longer spreading in the capital Juba which has accounted for about two thirds of cases.

“The outbreak continues but the good news is that we have controlled it in most of the states,” he told the Thomson Reuters Foundation by phone.
“We’re not afraid that it’s getting out of hand.”

Unity State has experienced some of the worst violence since fighting erupted in South Sudan at the end of 2013 between soldiers loyal to President Salva Kiir and those backing his former deputy Riek Machar.

The pair signed a shaky peace deal last year but violence continues. The conflict has killed thousands, uprooted nearly 2.5 million people and fueled a major hunger crisis.

More than 6.1 million are in need of aid, according to the International Organization for Migration. The U.N. children’s agency UNICEF warned in July that the cholera outbreak could lead to a devastating loss of life if it spread to conflict-hit states where many health facilities have been closed or destroyed.