(CNN) One of the deadliest Ebola outbreaks in history continues to worsen in the Democratic Republic of Congo with as many as 319 people now dead.

The Ministry of Health said Tuesday that 542 Ebola cases had been recorded in the province of North Kivu -- 494 of which have been confirmed. Of the 319 believed to have died from the virus so far, 271 have been confirmed.

On average, Ebola -- which causes fever, severe headache and in some cases hemorrhaging -- kills about half of those infected, but fatality rates in individual outbreaks have varied.

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The World Health Organization (WHO) said efforts to contain the outbreak have been hampered due to "non-engagement" from local communities and armed conflict in the region.

North Kivu, which includes the cities of Beni, Kalunguta and Mabalako, remains the epicenter of the outbreak, though cases have been reported in neighboring Ituri province, according to the WHO. The two provinces are among the most populated in the nation and border Uganda, Rwanda and South Sudan.

Read More</s>Responding to the Ebola virus disease (EVD) outbreak in the Democratic Republic of the Congo continues to be a complex challenge. Pockets of community reluctance and the conflict setting continue to obstruct activities in some affected areas. Additional challenges may also be anticipated during the ongoing election period, which may lead to heightened political tension, a deterioration of the overall security situation and violent civil unrest; presenting an indirect threat to the Ebola response operations.

Despite these difficulties, meaningful progress has been made across the outbreak affected areas, most especially in Beni where there has been a general decrease in case incidence in recent weeks. The control of the outbreak there, and previously in the city of Mangina, demonstrates how the outbreak can be controlled when response activities can be scaled and implemented with the participation of local communities. While the Ministry of Health (MoH), WHO and partners work toward similar progress in Katwa, Butembo and other emerging clusters, we must acknowledge the unique challenges arising from each geographical area. The introduction, acceptance and resulting impact of interventions on the epidemiology of the outbreak will take time. Response teams continue to adapt and scale up the application of evidence-based public health measures and innovative tools.

Currently, the outbreak remains active across a geographically dispersed area covering fourteen health zones in North Kivu and Ituri provinces. Over the last 21 days (27 November – 18 December 2018), 114 new confirmed cases have been reported, from: Katwa (31), Beni (18), Komanda (17), Butembo (14), Mabalako (14), Kalunguta (5), Oicha (4), Vuhovi (3), Kyondo (3), Biena (1), Mandima (1), Masereka (1), Musienene (1), and Mutawanga (1). Only Tchomia Health Zone has not confirmed any new cases since the cluster was detected in mid-August. Amplification of the outbreak within these areas has been driven by a combination of social/community transmission and transmission within private and public health centres. In the past week, two new infections of health workers have been reported – 55 (53 confirmed and two probable) health workers have been infected to date, of whom 19 have died.

Cumulatively as of 18 December, 549 EVD cases (501 confirmed and 48 probable), including 326 deaths (case fatality ratio 59%), have been reported in 12 health zones in North Kivu Province and three health zones in Ituri Province (Figure 1). Overall trends in case incidence (Figure 2) reflect the continuation of the outbreak across these areas, with an average of 35 new cases reported each week since mid-October.

Small but meaningful victories continue to be won with the discharge of survivors from Ebola Treatment Centres (ETCs); aided by more timely admissions to ETC and use of Ebola therapeutics together with supportive care measures. In the past week, 18 additional patients were discharged from ETCs. Overall, 193 patients have recovered to date.

While all credible alerts outside of the abovementioned affected areas have tested negative for EVD to date, there remains a very high risk of further geographical spread within North Kivu and Ituri, to other provinces of the Democratic Republic of the Congo, and to neighbouring countries. Preparedness and operational readiness activities across these areas must continue to be scaled-up to mitigate this risk, and rapidly detect and respond to any potential cases.

The MoH continues to strengthen response measures, with support from WHO and partners. Priorities include coordination, surveillance, contact tracing, laboratory capacity, infection prevention and control (IPC), clinical management of patients, vaccination, risk communication and community engagement, psychosocial support, safe and dignified burials (SDB), cross-border surveillance, and preparedness activities in neighbouring provinces and countries. Infection prevention and control practices in health care facilities, especially antenatal clinics, need to be further strengthened.

For detailed information about the public health response actions by WHO and partners, please refer to the latest situation reports published by the WHO Regional Office for Africa:

This outbreak of EVD is affecting north-eastern provinces of the country bordering Uganda, Rwanda and South Sudan. Potential risk factors for transmission of EVD at the national and regional levels include: travel between the affected areas, the rest of the country, and neighbouring countries; the internal displacement of populations. The country is concurrently experiencing other epidemics (e.g. cholera, vaccine-derived poliomyelitis, malaria), and a long-term humanitarian crisis. Additionally, the security situation in North Kivu and Ituri at times limits the implementation of response activities. WHO’s risk assessment for the outbreak is currently very high at the national and regional levels; the global risk level remains low. WHO continues to advice against any restriction of travel to, and trade with, the Democratic Republic of the Congo based on currently available information.

As the risk of national and regional spread is very high, it is important for neighbouring provinces and countries to enhance surveillance and preparedness activities. The International Health Regulations (IHR 2005) Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread. WHO will continue to work with neighbouring countries and partners to ensure that health authorities are alerted and are operationally prepared to respond.

International traffic: WHO advises against any restriction of travel and trade to the Democratic Republic of the Congo based on the currently available information. There is currently no licensed vaccine to protect people from the Ebola virus. Therefore, any requirements for certificates of Ebola vaccination are not a reasonable basis for restricting movement across borders or the issuance of visas for passengers leaving the Democratic Republic of the Congo. WHO continues to closely monitor and, if necessary, verify travel and trade measures in relation to this event. Currently, no country has implemented travel measures that significantly interfere with international traffic to and from the Democratic Republic of the Congo. Travellers should seek medical advice before travel and should practice good hygiene.

For more information, see:
• South Sudan set to vaccinate targeted healthcare and frontline workers operating in high risk states against Ebola
• Summary report for the SAGE meeting of October 2018
• Statement on the October 2018 meeting of the IHR Emergency Committee on the Ebola virus disease outbreak in the Democratic Republic of the Congo
• WHO recommendations for international travellers related to the Ebola Virus Disease outbreak in the Democratic Republic of the Congo
• Ebola virus disease in the Democratic Republic of the Congo – Operational readiness and preparedness in neighbouring countries</s>By The Associated Press

JOHANNESBURG (AP) — Congo’s deadly Ebola outbreak is now the 2nd largest in history, World Health Organization says.

JOHANNESBURG (AP) — Congo’s deadly Ebola outbreak is now the 2nd largest in history, World Health Organization says.

Copyright © 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, written or redistributed.</s>One of the deadliest Ebola outbreaks in history continues to worsen in the Democratic Republic of Congo with as many as 319 people now dead.

The Ministry of Health said Tuesday that 542 Ebola cases had been recorded in the province of North Kivu — 494 of which have been confirmed. Of the 319 believed to have died from the virus so far, 271 have been confirmed.

On average, Ebola — which causes fever, severe headache and in some cases hemorrhaging — kills about half of those infected, but fatality rates in individual outbreaks have varied.

The World Health Organization (WHO) said efforts to contain the outbreak have been hampered due to “non-engagement” from local communities and armed conflict in the region.

North Kivu, which includes the cities of Beni, Kalunguta and Mabalako, remains the epicenter of the outbreak, though cases have been reported in neighboring Ituri province, according to the WHO. The two provinces are among the most populated in the nation and border Uganda, Rwanda and South Sudan.

The public health agency estimates that more than a million refugees and internally displaced people are traveling through and out of North Kivu and Ituri, which could hasten the spread of the virus further.

The Congo outbreak is the second-deadliest ever, behind only in West Africa in 2014, when the virus killed more than 11,000 people. It is Congo’s 10th epidemic since 1976, and second this year.</s>JOHANNESBURG (AP) — Congo’s deadly Ebola outbreak is now the second largest in history, behind the devastating West Africa outbreak that killed thousands a few years ago, the World Health Organization said Thursday. WHO’s emergencies…

JOHANNESBURG (AP) — Congo’s deadly Ebola outbreak is now the second largest in history, behind the devastating West Africa outbreak that killed thousands a few years ago, the World Health Organization said Thursday.

WHO’s emergencies chief, Dr. Peter Salama, called it a “sad toll” as Congo’s health ministry announced the number of cases has reached 426. That includes 379 confirmed cases and 47 probable ones. So far this outbreak, declared on Aug. 1, has 198 confirmed deaths, with another 47 probable ones, Congo’s health ministry said.

Attacks by rebel groups and open hostility by some wary locals have posed serious challenges to health workers that Ebola experts say they’ve never been seen before. Many venture out on critical virus containment missions only accompanied by U.N. peacekeepers in areas where gunfire echoes daily.

Salama this month predicted that the outbreak in northeastern Congo will last at least another six months before it can be contained. West Africa’s Ebola outbreak killed more than 11,000 people from 2014 to 2016.

Day by day, reports by health organizations note one new difficulty after another in this latest outbreak, even as their work sets milestones that have given new hope in the fight against one of the world’s most notorious diseases.

More than 37,000 people have received Ebola vaccinations, and Congo has begun the first-ever trial to test the effectiveness and safety of four experimental Ebola drugs. And yet the risk of Ebola spreading in so-called “red zones” — areas that are virtually inaccessible because of the threat of rebel groups — is a major concern in containing this outbreak.

“This tragic milestone clearly demonstrates the complexity and severity of the outbreak. While the numbers are far from those from West Africa in 2014, we’re witnessing how the dynamics of conflict pose a different kind of threat,” said Michelle Gayer, senior director of emergency health at the International Rescue Committee.

In a major concern for health workers, many new cases have been unconnected to known infections as the insecurity complicates efforts to track contacts of those with the disease.

The alarmingly high number of infected newborns in this outbreak is another concern, and so far a mystery. In a separate statement on Thursday, WHO said so far 36 Ebola cases have been reported among newborn babies and children under 2.

As the need for help in containing the outbreak grows, two of the world’s most prominent medical journals this week published statements by global health experts urging the Trump administration to do more.

In the Journal of the American Medical Association, one group noted that the U.S. government weeks ago ordered all Centers for Disease Control and Prevention personnel — “some of the world’s most experienced outbreak experts” — from Congo’s outbreak zone because of security concerns.

A separate statement published in the New England Journal of Medicine said: “Given the worsening of the outbreak, we believe it’s essential that these security concerns be addressed and that CDC staff return to the field.”

This is the first time this turbulent part of northeastern Congo has had an Ebola outbreak. Congo’s health ministry has carried vivid accounts of residents, spurred by rumors, who have been trying to stop safe burial practices that halt the spread of Ebola from victims to relatives and friends.

On Thursday, the ministry said a group of youths broke into a morgue, stole the body of an Ebola victim and returned it to their family.

Copyright © 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, written or redistributed.</s>The Ebola death toll in the Democratic Republic of Congo has reached 319, official figures have revealed.

Health chiefs fear 542 people in the African nation have been struck down in the second biggest outbreak of the virus in history.

The World Health Organization (WHO) said efforts to contain the outbreak, which began in August, have been challenging.

Aid workers have found it difficult to provide help in the worst affected regions of the DRC because of ongoing armed conflict.

It comes as neighbouring countries remain on high alert amid fears the killer virus – responsible for a brutal epidemic in 2014 - could spread.

The confirmed figures show 491 people have been struck down with Ebola – with a further 51 currently undergoing testing.

The WHO data also revealed the confirmed death toll is 271, as the remaining 48 deaths continue to be thoroughly investigated.

Experts warn the infection is being spread because people are moving in and out of the region, while some communities are not engaging.

Provinces North Kivu, which includes the heavily populated cities of Beni, Kalunguta and Mabalako, and Ituri remain the centre of the outbreak.

Some areas, which had previously recovered, have seen a reintroduction of cases, such as Musienene - where the last reported case was 32 days ago.

Health experts have said this Ebola outbreak, the tenth to strike Congo since the virus was discovered there in 1976, is like no other.

Aid workers face the threat of attack from armed groups and resistance from a wary population in a region that had never faced an Ebola outbreak before.

Armed rebels have attacked, kidnapped and killed medical staff trying to combat the outbreak and equipment has been destroyed, making it difficult to help victims.

Tracking suspected contacts of Ebola victims remains a challenge in areas controlled by rebels.

Ebola can be transmitted between humans through blood, secretions and other bodily fluids of people - and surfaces - that have been infected.

The treatment of Ebola itself has taken an experimental turn in DRC, where scientists are now conducting a real-time study of how well pioneering drugs work.

More than 160 people there have already been treated with the drugs, and the way people are treated won't change, but scientists will now be able to compare them.

Four experimental drugs are being used to try and combat the disease – mAb 114, ZMapp, Remdesivir and Regeneron.

Patients will get one of the four, but researchers won't know which they were given until after the study.

The outbreak has been plagued by security problems, with health workers attacked by rebels in districts where the virus has been spreading.

Last week, officials announced more Ebola cases are being diagnosed in the city of Butembo, 35 miles (56km) away from Beni, where most of the outbreak is happening.

Experts warn the quick spread makes tackling the virus more complicated because containing it has been challenging enough in the one city.

They fear experimental vaccines which have been doled out to thousands of people, and have reportedly prevented the death toll rising into the thousands, will run out.

It comes after news broke last week that hundreds of health workers in South Sudan will be given Ebola vaccinations amid fears the virus will spread.

No cases have been confirmed in neighbouring South Sudan yet, but the country is on 'high alert', according to the World Health Organization (WHO).

More than 2,000 healthcare and frontline workers in the country will be offered a vaccine to try and stop the spread.

Teams of vaccinators are ready to conduct the vaccinations, starting in the capital, Juba, on December 19.

The UN Refugee Agency warned there is an influx of Congolese refugees seeking shelter in South Sudan because of conflict in the DRC.</s>Global health experts are urging the Trump administration to allow U.S. government disease specialists — "some of the world's most experienced" — to return to northeastern Congo to help fight the second-largest Ebola outbreak in history.

JOHANNESBURG (AP) — Global health experts are urging the Trump administration to allow U.S. government disease specialists — “some of the world’s most experienced” — to return to northeastern Congo to help fight the second-largest Ebola outbreak in history.

The U.S. experts have been sidelined for weeks, ordered away from the region because of State Department security concerns. Two top medical journals this week have published commentaries calling on the U.S. to change its mind and send them back where they are sorely needed.

This Ebola outbreak is like no other, with some health workers comparing the region to a war zone. Dozens of armed rebel groups are active, and their deadly attacks have forced responders to pause crucial Ebola containment work for days. Many new cases have been unrelated to known infections, alarming evidence that gaps in tracking the disease remain.

Late Thursday, the World Health Organization declared this outbreak second only to the devastating West Africa one that killed more than 11,000 people from 2014 to 2016. Congo’s health ministry said the number of confirmed and probable Ebola cases has reached 426, edging past the Uganda outbreak in 2000. So far this outbreak has 198 confirmed deaths and 47 probable ones.

“It is in U.S. national interests to control outbreaks before they escalate into a crisis,” one group of global health experts wrote in a commentary in the Journal of the American Medical Association. A separate one in the New England Journal of Medicine said : “Given the worsening of the outbreak, we believe it’s essential that these security concerns be addressed and that CDC staff return to the field.”

It is not clear how many Centers for Disease Control and Prevention workers are now trying to tackle the outbreak from Congo’s capital, Kinshasa, which is nearly 1,000 miles (1,600 kilometers) away.

A State Department official said that CDC experts — and those with the U.S. Agency for International Development, who are also affected by the order — are still working closely with international partners to stop the outbreak.

“We remain hopeful that the security situation improves so we can return to the affected communities,” Kathy Harben, a CDC spokeswoman, said in a statement. The CDC supports the expertise of the State Department and Department of Defense “in determining locations where it is safe to position our staff.”

Security concerns are real, Ebola responders say. Teams with the WHO and Congo’s health ministry venture out on virus containment missions accompanied by U.N. peacekeepers or other armed security in areas where gunfire echoes daily.

Given the complications, this Ebola outbreak will last at least another six months before it can be contained, WHO emergencies chief Dr. Peter Salama has predicted.

Earlier this month, CDC director Dr. Robert Redfield suggested that one option is to “move into the idea that this becomes more of an endemic Ebola outbreak in this region.” That’s not a welcome thought to neighboring Uganda and Rwanda.

Despite the challenges, Ebola health workers have made breakthroughs that have given new hope in the fight against one of the world’s most notorious diseases. More than 37,000 people have received Ebola vaccinations and Congo has begun the first-ever trial to test the effectiveness and safety of four experimental Ebola drugs.

Speaking to The Associated Press on Friday from the outbreak zone, the Ebola response program director for the International Rescue Committee, Dr. Stacey Mearns, said the absence of the CDC’s experts can be felt acutely. Her colleague, Dr. Mesfin Teklu Tessema, the IRC’s senior health director, was among the more than two dozen people who signed the statement published in JAMA on Thursday.

“If the (U.S.) ban were not in place, the CDC would have a big and growing presence here,” said Mearns, who worked closely with the CDC in West Africa’s Ebola outbreak. The U.S. sent thousands of responders to West Africa from the CDC and other government agencies, including the military.

The CDC’s experts have rich experience in surveillance, treatment and lab testing, Mearns said, adding that some of that work is now being done from afar.

“We haven’t seen the height of this outbreak,” she warned as Ebola moves into new areas in Congo that are worrying close to the heavily traveled border with Uganda. “If want to see the end of this, we do need all critical actors on the ground.”

Associated Press writers Maria Cheng in London and Mike Stobbe in New York contributed to this report.

Copyright © 2018 The Associated Press. All rights reserved. This material may not be published, broadcast, written or redistributed.</s>BENI, Congo — The second-deadliest Ebola outbreak in history is “certainly” expected to continue for another three or four months, Congo’s health minister said Thursday.

In an interview with The Associated Press, Health Minister Oly Ilunga also sought to calm concerns days ahead of a presidential election in which millions of people will use touch-screen voting machines. The deadly Ebola virus is spread via infected bodily fluids, so some worry they may pick it up from the screens.

The minister said precautions have been taken. Several tons of hand sanitizer have been deployed for use in polling stations throughout the outbreak zone in eastern Congo, and voters are being encouraged to sanitize their hands before and after using the machines.

So far there have been 549 Ebola cases in the outbreak that was declared on Aug. 1, including 501 confirmed cases. There have been 278 confirmed deaths.

This Ebola outbreak is the most complex in history amid attacks by rebel groups, the health minister said. But in an upbeat development, he sees “clear, clear, clear improvement” in community response to Ebola containment efforts.

The response in wary places like Beni, where more than 1,000 people have been killed in rebel attacks in recent years, has at times been harsh, with some health workers attacked. This is the first time that eastern Congo has faced an Ebola outbreak, and responders have raced to combat rumours and misunderstandings.

There are still risks of confrontation every time the virus spreads into a new area, the health minister said. But “we can notice today that there is an acceptance, in general, an engagement in the community.”

Ebola’s possible spread into so-called “red zones,” where the threat of rebel attack makes response work almost impossible, remains a concern.

The minister said his biggest worries continue to be Ebola’s possible spread to other major cities in eastern Congo, such as Goma near the Rwanda border, and across the heavily travelled border into Uganda, which already has begun giving frontline health workers an experimental Ebola vaccine.

Uganda is the focus of “intense collaboration” with health officials there, the minister said.

He said that every time a new case of Ebola is declared, health officials must allow about 60 days from that date, with no new occurrences, before the outbreak can be considered over.</s>FILE PHOTO: Healthcare workers carry the coffin of a baby believed to have died of Ebola, in Beni, North Kivu Province of Democratic Republic of Congo, December 15, 2018. REUTERS/Goran Tomasevic/File Photo

LONDON, Dec 20 (Reuters) - Doubts are growing about whether the world’s emergency stockpile of 300,000 Ebola vaccine doses is enough to control future epidemics as the deadly disease moves out of rural forest areas and into urban mega-cities.

Outbreak response experts at the World Health Organization (WHO) and at the vaccines alliance GAVI are already talking to the leading Ebola vaccine manufacturer, Merck, to reassess just how much larger global stocks need to be.

"We're actively engaged with the World Health Organization and with groups like GAVI, the U.S. government and others to try to understand what will be an appropriate sized stockpile in the future," Merck's head of vaccines clinical research, Beth-Ann Coller, said in a telephone interview.

Supply of the Merck shot, which is currently being used to fight a large and spreading outbreak of Ebola in eastern Democratic Republic of Congo, is not a problem right now, according to the WHO's deputy director-general of emergency preparedness and response, Peter Salama.

But the nature of Ebola outbreaks is changing, he told Reuters. As the virus finds its way out of rural villages into populous urban settings, plans for how to contain it in future must change too.

"What I'm concerned about is the medium- to long-term stockpile. The figure of 300,000 was very much based on previous Ebola outbreaks where you never really had huge numbers of cases because they were in isolated, rural, populations. But now, we increasingly see Ebola in mega-cities and towns."

"We need to view it now as an urban disease as well as a rural one - and therefore one requiring a different order of magnitude of preparations, including vaccines," he said.

Merck's experimental Ebola vaccine, known as rVSV-ZEBOV, is the furthest ahead in development. Another potential vaccine being developed by Johnson & Johnson could also eventually become part of the stockpile, global health officials say.

Congo's two Ebola outbreaks this year illustrate the shifting nature of the threat.

The first was relatively contained, infecting up to 54 people and killing 33 of them in an area of DRC's Equateur Province that is remote and sparsely populated.

Several of the eight outbreaks before this one in Congo - including one in 2014 and another in 2017 both also in Equateur - were also quickly contained and limited in size.

But this year's second outbreak in Congo - and the country's tenth since the virus was first identified there in 1976 - is concentrated not in rural villages but in urban areas of the North Kivu and Ituri provinces.

It has already infected more than 450 people, killed more than 270, and last month spread to Butembo, a densely populated city of about one million.

This kind of prospect means global health emergency responders must "review our assumptions around Ebola", Salama said. "If it were to take off in Butembo, or Goma, or, even worse, Kinshasa, we'd be talking about a totally different issue in terms of ... vaccine supplies required."

Seth Berkley, chief executive of the GAVI vaccines alliance which has an agreement with Merck to ensure a current stockpile of 300,000 rVSV-ZEBOV doses, told Reuters that around 40,000 doses had been used so far in the Congo outbreak.

The emergency response is based on "ring vaccination" which aims to control an outbreak by identifying and offering the vaccine to contacts of anyone likely to be infected. This method uses relatively small numbers of vaccine doses and forms a human buffer of immunity to try to prevent spread of the disease.

For now in Congo, Berkley said, there is no immediate need to boost the stockpile. But looking towards future inevitable outbreaks, the numbers would likely need to change.

"The challenge we would have - and this has been under discussion - is if we started to do community-based vaccination in urban and semi-urban areas. That's when the numbers would start to get quite big quite quickly," he told Reuters.

Merck's shot has proven safe and effective in trials in West Africa but has yet to be approved for a license by U.S. and European regulators, so is being used in the Congo outbreak under special emergency rules for experimental products.

When it gets approval, which Coller hopes would be in 2019, it will be made at a newly built manufacturing plant in Germany.

Coller said Merck is not yet clear how many doses a year, or a month, the German facility could churn out once it is in production, but she stressed the company would "work collaboratively with the public health agencies to do our best to support their needs".</s>AS MANY as 319 people have been killed by the Ebola virus sweeping Congo as one of the deadliest outbreaks in history threatens to spread across borders.

Of the 542 people thought to have contracted the lethal disease in the province of North Kivu, 494 has been confirmed, according to the latest figures from Congo’s Ministry of Health. 



Of the 319 believed to have died from the virus to date, 271 have been confirmed, the figures show. 



The World Health Organisation (WHO) is becoming increasingly concerned about Congo’s current outbreak of Ebola, which has ravaged the country’s rural communities this year. 



North Kivu, which includes the cities of Beni, Kalunguta and Mabalako, remains the epicentre of the outbreak. 



The province is one of the most populated in the country and borders Uganda, Rwanda and South Sudan.

Meanwhile, Congolese refugees fleeing across the border to neighbouring Sudan are not being screened for the disease, Sudanese health authorities have confirmed. 



"People from neighbouring DR Congo are entering South Sudan without being screened for Ebola due to lack of testing kits," Tambura State health minister, Mr David Simbi, said on Tuesday. 



He said the influx risked spreading the deadly virus across the border.



The new cases will alarm health officials after an unprecedented outbreak of the disease between 2014 and 2016 killed more than 11,000 people across western Africa.

“People from DR Congo are entering South Sudan without being screened” Cases of the disease, a type of viral hemorrhagic fever, were confirmed in Britain, Italy, Spain and the United States, where one person died.



The epidemic of 2014 to 2016 was the most widespread outbreak of Ebola in history, plaguing countries such as Guinea, Liberia, and Sierra Leone with death and economic woe.



In June 2016, the outbreak was officially declared over, but the virus is still present in several African countries. 



People who remain most at risk are those who care for infected people or handle their blood or fluid, such as hospital workers, laboratory workers and family members, according to NHS guidance.

Ebola is believed to be spread over long distances by bats, which can host the virus without dying, as it infects other animals it shares trees with such as monkeys.



It often spreads to humans via infected bushmeat.



Congo's vast, remote geography gives it an advantage, as outbreaks are often localised and relatively easy to isolate.



Initial symptoms associated with Ebola include a fever, sore throat and muscular pain before more serious effects such as Diarrhoea, vomiting, a rash and stomach pain starts to develop.

Many victims bleed internally and externally before death if the symptoms aren't treated immediately.



"The Ebola virus causes an acute, serious illness which is often fatal if untreated," according to the World Health Organisation's website. 



"Ebola first appeared in 1976 in two simultaneous outbreaks, one in what is now, Nzara, South Sudan, and the other in Yambuku, Democratic Republic of Congo.



"The latter occurred in a village near the Ebola River, from which the disease takes its name."
Over 300 people have died of Ebola in the Democratic Republic of Congo and the World Health Organization is concerned the outbreak is not being contained.