The UN Children's Fund in Zimbabwe says it is preparing to deal with a possible 60,000 cholera cases in coming weeks, four times current official estimates.
The Unicef chief in Harare, Roeland Monasch, said such a jump could bring the number of deaths to around 3,000.
Official figures say nearly 600 have already died from the disease but aid agencies fear the toll could be higher.
UK PM Gordon Brown says it is an international crisis and the world must tell Robert Mugabe "enough is enough".
Mr Monasch told the BBC that they were doing all they could to bring mortality rates down.
But he warned that if as many as 60,000 people became infected in the next few weeks, then the cholera epidemic could kill another 2,700.
He says the actual number of people who have already died is probably far higher than official figures as many clinics and hospitals are closed and people in rural areas frequently just bury their dead.
 |  Children in Zimbabwe are on the brink, and everyone's focus must now be on their survival  Roeland Monasch Unicef |
Unicef's Zimbabwe Communication Officer Tsitsi Singizi said local authorities did not have the capacity to provide safe water and rubbish collection. Cholera is often linked to contaminated supplies of drinking water.
Tsitsi Singizi said health services had also collapsed, making it impossible to treat the high number of infections.
"The outbreak is really outpacing our response. It's becoming endemic. Nine out of 10 provinces have reported a cholera case."
Unicef has launched an emergency response programme to focus on providing basic services - increasing health outreach services, providing nutritional supplements, boosting school attendance, and increasing access to safe water in the short term.
"Children in Zimbabwe are on the brink, and everyone's focus must now be on their survival," said Mr Monasch.
The disease has spread to neighbouring South Africa, Mozambique, Zambia and Botswana.
Condemnation
The situation has forced President Mugabe's government to declare a national emergency and appeal for international assistance.
But it has also drawn increasing international condemnation of Mr Mugabe, including calls from key African figures for military force to oust him.
Mr Mugabe and opposition leader Morgan Tsvangirai agreed to share power in September to tackle the country's economic meltdown but they have been unable to agree on the allocation of cabinet posts.
The deadlocked agreement followed disputed elections, which both men claimed to have won.
In the UK, the Archbishop of York Dr John Sentamu joined in criticism of Zimbabwe's government and called for Mr Mugabe and his allies to be overthrown so they can stand trial in The Hague.
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