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The Accra Metro Health Directorate has recorded 826 cases of Cholera within the last four months and out of the number, 18 people have been reported dead. Dr. Simpson Anim Boateng, Public Health Director of the Accra Metropolitan Assembly said on Adom FM�s Dwaso Nsem on Monday that the persons who died from the outbreak reported late to health facilities. Dr. Anim Boateng noted that cholera outbreak is a result of people defecating anyhow and disposing of rubbish at unauthorized places. He called for the cleaning of the environment especially food joints and market places. Dr. Anim Boateng said the 18 deaths compared to that of last year is much lower because over 4,000 cases were reported then with 25 deaths. A former Health Minister under the Kufuor administration, Dr. Kwaku Afriyie found it difficult to believe that in this age, people die of Cholera. He said that "Accra is very dirty and that is why some of us don�t like staying in Accra and the kind of system adopted to fight the outbreak is not the best." He called for enforcement of sanitation laws and stiffer punishment for people who litter indiscriminately. Dr. Afriyie admitted that this year�s figure is far lower than what was recorded last year, but said the fatality cases ratio is unacceptable. He called for rapid response to reported cases and tidying up public places. He called on AMA Health Directorate to devise mechanisms to test food temperature and destroy such foods if the temperature was found to be below 70 degrees. Meanwhile, Public Relations Officer for AMA, Nuumo Blafo III has called for a change in attitude towards the environment because �the city itself is not dirty but inhabitants in it have made Accra dirty.� The Kumasi Metropolitan Assembly is yet to report any cholera case.