Ukrainian and international officials are warning of a possible cholera outbreak in the Russian occupied besieged city of Mariupol.

Britain’s Defense Intelligence agency, from its Twitter account Friday, said Russia is having trouble supplying basic services to the territories it is occupying, including sanitation, safe drinking water and medical supplies. They said there have been isolated cases of cholera already reported in the city.

Those reports reinforce comments made earlier in the week by an aide to Mariupol’s mayor made on Ukrainian television. Petro Andryushchenko said the humanitarian situation in Mariupol is getting worse every day. He said drinking water had been contaminated by decomposing garbage and corpses, increasing the risk of a cholera outbreak.

His specific claims could not be independently verified, but the World Health Organization’s (WHO) Europe regional director, Hans Kluge, speaking at a news briefing last month in Kyiv, issued a warning about the potential for a cholera outbreak in occupied areas, where water and sanitation infrastructure is damaged or destroyed.

At that same briefing, WHO’s emergencies coordinator for Europe described Mariupol’s hygienic situation as a “a huge hazard” and said they received “information that there are swamps actually in the streets, and the sewage water and drinking water are getting mixed.”

The WHO says cholera is an extremely serious disease caused by eating or drinking food or water that is contaminated with the Vibrio cholerae bacterium. It can cause severe acute watery diarrhea with severe dehydration. It affects both children and adults and can kill within hours if untreated.

Russian forces bombarded Mariupol for weeks, and Ukrainian officials estimate 90% of the city was destroyed.

Some information for this report was provided by Reuters.

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