The government disputed the numbers and said it had the situation under control.
"An epidemic is about to break out here. Over 2,000 cases have been reported so far that would meet the case definition of cholera," said Fred Hartman, an epidemiologist and technical director for a US Agency for International Development-backed program, the Rural Expansion of Afghanistan's Community-based Health Care.
Hartman, who has combatted cholera outbreaks around the world for 30 years and has been directly involved with efforts to contain the disease here, told The Associated Press that 8-9 people had died in the past two weeks, and warned the disease could spread quickly throughout the city's 4 million population.
"There are always deaths with cholera," he said.
Abdullah Fahim, an adviser to the health minister, said some 2,400 people have been diagnosed with acute diarrhea, but that only 30 had been confirmed to have cholera. He initially said nobody had died, but later said that two children and an adult who died with acute diarrhea were suspected of having cholera.
"We have had 30 cases confirmed. There is no need to declare that there is an epidemic. It would just create panic and we don't want to scare people," Fahim said.
Hartman agreed that the government was well-equipped to deal with the outbreak and had set up an emergency task force to ensure that hospitals have the necessary equipment and medicine to treat patients.
"For an undeveloped, war-torn country, Afghanistan's ministry of health has been able to respond very well," he said.
Cholera is a major killer in developing countries, where it is spread mainly through contaminated food or water. The bacterium attacks the intestine and causes severe diarrhea and dehydration.
Hartman, who works closely with the Health Ministry, refused to comment on the government's claim that nobody had died. He said the discrepancy in the official number of cholera cases and the figures he gave was common because of the way cholera outbreaks are treated.
Once cholera has been confirmed at a location, Hartman said, individuals who show symptoms of the disease receive immediate treatment but are rarely tested to confirm they have the illness.
While potentially fatal, cholera can be easily treated if patients are rehydrated quickly. "You are always going to get what's called the 'funny number syndrome' during outbreaks where there are varying numbers of cases," he said.
"After a while, you stop testing people and just treat them."
Hartman said the disease had been detected in wells around the city, the source of drinking water for most of Kabul residents, as well as irrigation ditches.
Fahim said authorities had launched a campaign urging people to boil drinking water, wash vegetables before eating them and regularly wash hands. Health Ministry workers have chlorinated wells throughout the city, he added.
A spokesman for UNICEF, the UN children's agency, Edward Carwardine, said the last cholera outbreak in Kabul was in 2003 when there were 7,000 suspected cases. But he said the government was fast to respond and the disease quickly disappeared after wells were chlorinated.
In 2001, 114 people died from a cholera outbreak in Afghanistan's north, according to the World Health Organization's Web site.
It had no information on the latest cases.
