The onset of seasonal rains in Zimbabwe has increased fears that the country's cholera epidemic could worsen with tens of thousands more people becoming ill and the disease spreading further into neighbouring countries.

"We've already got a very serious situation and rain will only make it much, much worse," said Matthew Cochrane, of the International Federation of Red Cross and Red Crescent Societies. The rainfall, which usually brings floods, has started in the northern provinces, he said. At least 18,000 people have fallen victim to cholera in Zimbabwe, according to the latest United Nations figures, with the recorded death toll topping 900. The true figure is feared to be far higher.

Cases could reach 60,000 and cholera, which has spread to South Africa and Botswana, could spill into other countries, Mr Cochrane said.

Botswana and South Africa are equipped to contain the outbreak, he added. But if it reached Zambia or Mozambique, it would be more difficult to stop. "If we start seeing huge numbers of people going into those countries bringing with them cholera or being exposed to cholera, then it could be like a wildfire in the bush," he said.

The Red Cross federation is negotiating with the Zimbabwe government over how to ramp up aid operations, Mr Cochrane said.

Oxfam has opened an appeal to raise £4 million in an attempt to provide clean water, sanitation and food to more than one million people. The charity has had to cut the food it gives out after a fall in donations.

Jane Cocking, humanitarian director of Oxfam, said: "The rapid deterioration of the situation makes this an extremely grave humanitarian crisis which could deteriorate even further in 2009.

"While the international community battles for a political solution, millions of Zimbabweans are going hungry. Oxfam is able to get clean water and food through to people who need it most. We need to respond now, there is no time to lose."

The charity is handing out water purification tablets and soap to 620,000 and providing food for 250,000.

Oxfam Zimbabwe country director Peter Mutoredzanwa said: "The average Zimbabwean woman can only expect to live 33 years and unless we respond now many more people will not live to see their 30s. Zimbabweans are no strangers to food shortages but we have now reached desperate levels. Some children eat only a meagre portion of food once every three days and people scavenge in rubbish dumps."

To make a donation call 0300 200 1999 or visit www.oxfam.org.uk or an Oxfam shop.

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