Hundreds of thousands of displaced people who fled Goma in the Democratic Republic of Congo after a volcanic eruption are at risk of infection by cholera, Doctors Without Borders (MSF) warned Sunday.

After the Nyiragongo volcano rumbled to life a week ago, fear of a second eruption spurred the government to issue an evacuation order Thursday that sent 400,000 residents fleeing.

As many as a quarter of them headed to Sake, about 30 kilometres (18 miles) to the northwest, while others made for Rutshuru in the north, and Minova in South-Kivu province.

"Obviously we fear a flare up of cholera. The risk is already elevated in this area where cholera is already endemic," Magali Roudaut, head of MSF's Goma-based mission in the DR Congo told AFP.

"With these populations on the move it would be catastrophic," she warned.

In Sake, where MSF has been fighting a cholera presence for years, Roudaut said between 100,000 and 180,000 people had taken refuge adding to the area's 70,000 population

"You can imagine the difficulty of absorbing that influx," she said.

"The biggest problem is access to water -- having enough drinkable water for these people is essential," she said.

Many of the displaced are staying churches, temples, mosques and community centres.

"Many people are still sleeping outside even if the people of Sake have been very welcoming," she added.

Roudaut said MSF deployed to address the water shortage, bringing in supplies and distributing water by tanker truck.

But she said more required and cited food, shelter and medicine as other major needs.

"This crisis demands assistance and an immediate intervention," she said.

International aid organisations are already heavily present in Goma, which is the capital of North-Kivu province, an area wracked by three decades of violence by scores of armed groups, many of them a legacy of two regional wars that ran from 1996 to 2003.

The UN humanitarian agency OCHA said after the eruption that more than 4,500 homes were destroyed by lava, affecting some 20,000 people.

The United Nations Stabilization mission in the DR Congo (MONUSCO) has started aerial monitoring of the volcano.

Adding to the trials of the displaced, hundreds of children were separated from their parents in the exodus -- a situation humanitarian organisations are hurrying to address.

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