Cholera has reportedly reached Port-au-Prince, capital of the devastated country of Haiti.

After the earthquake earlier this year and the recent heavy rains accompanying Hurricane Tomas, the disease has been spreading throughout Haiti.

Now Kara Gibson, a doctor working in Port-au-Prince, says she has seen suspected cases in Cite Soleil, one of the capital’s slums. “Now that it is in Cite Soleil, you can expect to see it just explode,” she told the BBC. “And the hospital in that area is already at capacity.”

It is not known for sure whether cholera was present in Haiti before the earthquake earlier this year, and the source of this current outbreak is unknown, although it is a South Asian strain of the disease (AFP). However, with many people in Port-au-Prince still living in makeshift shelters with little or no proper infrastructure the problem may be about to get much worse.

“This certainly right now is an epidemic,” Jordan Tappero, leader of the US Centers for Disease Control and Prevention’s Haiti team, told Time. “We have to keep a mind-set that cholera is likely to spread across the county due to poor sanitation and lack of potable water.”