An outbreak of ebola in the Democratic Republic of Congo (DRC) has been described as the largest spread of the infection in the country, with 329 confirmed cases.
Half of the reported cases are in Beni, a north-east city in the DRC.
The outbreak comes as the DRC remains in the grip of conflict with militant groups in North Kivu, which has further bolstered the spread of the disease and hindered immunisation efforts.
There is a further risk of the disease spreading to Uganda as the two nations share a porous border that many local farmers, merchants, traders, and refugees move across.
Tedros Adhanom Ghebreyesus, director-general of the World Health Organization told reporters that the violence is an impediment to progress.
“When there is an attack, the operation (vaccinations) actually freezes. And when the operation stops, the virus gets an advantage and it affects us in two ways […] One is catching up on the backload. And the other, the second problem, is that more cases are generated because we can't vaccinate them”.
Congo Health Minister Oly Ilunga said there had been reports that medical teams responding to the violence have “faced threats, physical assaults, repeated destruction of their equipment and kidnapping”. Two members of the Rapid Response Medical Units have been killed in an attack.
Despite this there has been a strong immunisation effort with the use of an experimental vaccine that has proven good results and more than more than 25,000 of the highest-risk people vaccinated, helping to counter the spread. However more cases are still being reported. Between October 31 and November 6, 29 new cases were reported in DRC, including three health workers.
Speaking on the risk of the disease spreading to Uganda, the country's health minister, Jane Ruth Aceng, told reporters, “the risk of cross-border transmission was assessed to be very high at a national level”.
In part this has inadvertently been aided by Chinese investment into infrastructure which has greatly improved transport.
Nahid Bhadelia, medical director of Boston Medical Center's Special Pathogens Unit, stated that; "It's a cruel irony that better roads and improved connectivity of people also make it easier for the disease to travel, particularly when the public health systems are still lagging behind”.
The current Ebola epidemic could be beyond control, Robert Redfield, director of the Centers for Disease Control and Prevention warned, adding that it may - for the first time since the deadly virus was first identified in 1976—become persistently entrenched in the population.