At least 21 people, mostly children have died and more than 60 others are hospitalized after a suspected cholera outbreak in the southern Philippines, officials with the Red Cross said.

The outbreak began more than a week ago among Manobo tribesmen in an isolated area on the island of Mindanao and has spread to several remote mountainous hamlets near Palimbang town in Sultan Kudarat province, about 600 miles south of Manila.

The Red Cross discovered the cases during an attempt to confirm reports that seven people had died from hunger in Palimbang. At least 15 people died in Milbuk and four other nearby villages also were affected.

A similar outbreak in the neighboring village of Ligaw three months ago killed eight people and sickened 60 others. Almost 150 cases of cholera were reported from July 27 to Aug. 6, affecting mostly tribal children.

The Health Department in Manila said it was still checking on reports of a cholera outbreak as laboratory tests have yet to confirm the cause.

Cholera is a severe gastrointestinal disease often caused by consuming water or food contaminated with fecal matter.