"I am fearful of cholera but there is no potable water and I have no option. I don't have money," she told Reuters on Friday in Blantyre's Ndirande township.

Malawi seemed to be getting its deadliest cholera outbreak yet under control, with World Health Organization figures showing a decline in cases and deaths, but locals and health experts worry that trend could quickly reverse in Freddy's wake.

One of the strongest and deadliest storms ever in Africa, the storm has killed over 320 people in Malawi alone, with heavy rains, floods and mudslides making access to clean drinking water impossible for many.

Cholera spreads through contaminated water and food. Many people have mild symptoms, but it can kill within hours if untreated.

"Unfortunately ... there is a real concern now that we could in the next few weeks see a reversal in the gains that were so hard-won over the past month or so," said Arielle Nylander, senior health policy analyst at WaterAid.

Eunice Mselemu, a nurse who works at a cholera camp in a health facility near Blantyre, said she had observed cases already increasing and is concerned overwhelmed health workers will be unable to cope.

Robert Hanjahanja, chief executive of the city's water board, which is battling to fix broken water pipes, said there was a crisis.

Malawi has conducted two oral cholera vaccination campaigns, but a global surge in cholera outbreaks has meant vaccines are in short supply.

WHO officials say the best that countries like Malawi can do is to stretch their meagre resources and try to contain outbreaks as they emerge.

Another Ndirande resident, Francis Moyani, said he was determined to get the cholera vaccine as he was scared of contracting the disease.

"As things are, cholera will rise and I want to be fully protected," he said.

(Reporting by Eldson Chagara and Frank Phiri in Blantyre, and Carien du Plessis in Johannesburg; Writing by Bhargav Acharya; Editing by Alexander Winning and Richard Chang)

By Eldson Chagara