(Reuters) – A cholera outbreak in central Mexico has risen to 159 confirmed cases and spread to four states as well as the capital, the country’s health minister said on Monday.

One death has been attributed to the outbreak, the ministry said as it launched a nationwide public health campaign aimed at preventing further infections.

The east-central state of Hidalgo has been the worst affected with 145 confirmed cases, including the death of a 75-year-old woman. Also affected were the states of Mexico with nine, Veracruz with two, San Luis Potosi with one, and another couple in Mexico City, said Health Minister Mercedes Juan.

Eight in 10 cases have been successfully treated, the minister said, while those infected with the disease in the past several weeks range in age from three to 86.

She added that another 3,075 “probable cases” have been detected.

The source of the outbreak is believed to be the Rio Tecoluco in Hidalgo, which has tested positive for cholera and provides fresh water for local residents, said David Korenfeld, head of Mexico’s national water commission.

Cholera is an infectious and sometimes fatal disease of the small intestine, often accompanied by severe nausea and diarrhea.

The outbreak is the first local transmission of cholera recorded since the country’s last cholera epidemic ended in 2001, according to a report last week by the Pan American Health Organization.

(Reporting by David Alire Garcia, Adriana Barrera, Veronica Gomez and Lizbeth Diaz)