Cholera is killing hundreds of Indians and settlers in isolated villages in Peru's lowland jungle, and health officials say the epidemic is more widespread than they thought.

Cholera may kill thousands more people in the Amazon basin, where many people live days from the nearest clinic, doctors and health officials say. The disease causes vomiting and diarrhea so severe it can kill a person in as little as four hours."The situation in the jungle is becoming really terrible," said Dr. Manuel Quimper, a Health Ministry epidemiologist. "The heat and the isolation of the villages may make cholera much more devastating than on the coast or in most of the mountains."

At least 1,526 Peruvians have died of cholera since the epidemic broke out in late January in northern port towns, the Health Ministry says. It says 250 of the deaths occurred in the jungle.

The World Health Organization estimates cholera will kill as many as 42,000 South Americans over the next few years and infect up to 6 million people.

More than 200,000 cases have been reported, mainly in Peru and Ecuador. The number of Peruvians infected already has surpassed early predictions by the World Health Organization.

Cholera also has killed more than 200 people in Ecuador, about 20 in Colombia and one person in Chile.