Updated

A cholera outbreak in a sprawling refugee camp has spread to eastern Congo's provincial capital of Goma, increasing fears of an epidemic amid a tense standoff between troops and rebels, officials said.

Cholera cases rose slightly Monday in the towns of Goma and Kibati, with at least 90 known cases and six new admissions overnight. Officials with Doctors Without Borders said the cases they were treating were well-contained. Only four new ones were reported at the group's clinic in Kibati camp.

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But dozens of people have died of cholera in recent weeks elsewhere in eastern Congo. Doctors also fear an epidemic behind rebel lines, where access has been limited by fighting and rebels have driven tens of thousands of people from camps where outbreaks had been contained.

Also, refugee conditions in many places continue to worsen.

In an unofficial refugee camp set up in Goma for park rangers and their families, some 900 people crowded into plastic tents — some smaller than a sports-utility vehicle — and hungrily eyed six heavy sacks of beans donated by an international Catholic charity.

Camp director Christian Shamavu was responsible for safeguarding gorillas and elephants as a ranger at Virunga National Park until a month ago.

"It's easier to protect gorillas and elephants than people," Shamavu said Monday. "Because the animals don't have sickness and have to go the hospital."

Families live less than three feet (one meter) apart from each other, sharing five makeshift showers and scrabbling in the damp dirt to find space to cook, wash clothes and entertain the children. In the last month, 33 people in the camp have contracted cholera. Sixty have contracted malaria. But families keep trickling in to take shelter from the rebels that now hold the park.

"We usually get a lot of new cases of cholera one, two days after the big rains," Shamavu said, as heavy drops began pelting from the dark skies.

The humanitarian crisis has exploded since rebel leader Laurent Nkunda launched an offensive Aug. 28, stopping his forces at the gates of Goma before declaring a cease-fire. Retreating Congolese troops and rebels sent the population fleeing for their lives, and sporadic clashes have broken out since then.

Thousands of refugees are packed into camps or sleeping out in the open, scrambling for washing and cooking water. Some 50,000 refugees have crowded around Kibati, some taken into log cabins by villagers, others living in tents or hastily built huts.

Weekend clashes between rebels and soldiers ignited concern that patients could scatter and launch an epidemic. But it appears unlikely that a European Union force will come to help stem the fighting. France failed to secure support Monday from other European Union nations for sending a 1,500-strong EU battlegroup to eastern Congo to bolster U.N. peacekeepers.

The fighting in eastern Congo is fueled by ethnic hatred left over from the 1994 slaughter of at least 500,000 Tutsis in neighboring Rwanda. Nkunda says he is fighting to protect minority Tutsis from Rwandan Hutu militants who participated in the genocide before fleeing to Congo.

A summit of southern African leaders said Sunday that members could, if necessary, send peacekeepers to bolster the U.N. force.

A rebel spokesman said insurgents will fight any soldiers.

`I don't know if they will come and engage us," Nkunda's spokesman Babu Amani said Monday. "We won't keep silent while they kill us. We will defend ourselves."