At least 10 people in one country's province have died from cholera as the United Nations warn a further one billion people are at risk.
In South Africa's most populous province of Gauteng, health authorities confirmed the deaths of 10 people and that nearly 100 have visited hospitals with symptoms in Hammanskraal, an area north of the capital, Pretoria.
It added that 37 people were admitted in critical condition and the victims included a three-year-old child and nine adults.
The United Nations dubbed the disease a "pandemic killing the poor" and sounded the alarm over its spread putting less well-off countries at risk.
"WHO estimates that a billion people across 43 countries are at risk of cholera," said Henry Gray, the UN health agency's incident manager for the global cholera response.
Cholera was a huge health issue in London in the Victorian era from 1830 to the 1860s with over 40,000 dying of the disease due to bacteria getting into the water supply when sewage was dumped into the Thames.
Jerome Pfaffmann Zambruni, the head of UNICEF's public health emergency unit, said the rise in cases was "a wake-up call".
"There is a pandemic killing the poor right in front of us and we know exactly how to stop it, but we need more support and less inertia from the global community because if we don't act now, it's going to get worse," he said.
So far this year, 24 countries have reported cholera outbreaks, compared to 15 by mid-May last year.
The most heavily affected countries so far this year are Malawi and Mozambique.
Nine other countries are deemed to be in "acute crisis": Burundi, Cameroon, the Democratic Republic of Congo, Ethiopia, Kenya, Somalia, Syria, Zambia and Zimbabwe.
The family of a woman who died due to the cholera outbreak in South Africa said that they could not afford to buy bottled water.
Mother of two, Nthabiseng Legwabe, died last Wednesday after complaining of stomach cramps and vomiting.
A WhatsApp voice note that Legwabe sent to her friend before suddenly collapsing in her home and passing away has been heard by Eyewitness News.
"Right now, my stomach is running, now it is just water coming out and I haven't eaten and I have vomited", she is reportedly heard saying.
Cholera is contracted from a bacterium that is generally transmitted through contaminated food or water.
It causes diarrhoea and vomiting and can be especially dangerous for young children.
Although cholera can kill within hours, it can be treated with simple oral rehydration and antibiotics, but sadly many people do not have access or cannot afford such medicines.
