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> Image copyright EPA Image caption Nearly 1,400 people have died in a recent outbreak in DR Congo

The head of a major medical research charity has called the latest outbreak of Ebola in central Africa "truly frightening".

Nearly 1,400 people have died in the Democratic Republic of Congo.

Dr Jeremy Farrar, the director of the Wellcome Trust, said the epidemic was the worst since that of 2013-16 and has showed "no sign of stopping".

Two people have also died in neighbouring Uganda, the first cases of Ebola reported in the country.

A five-year-old boy infected with the virus died on Tuesday and his 50-year-old grandmother died on Wednesday, the Ugandan health ministry said.

The Ugandan government has reported at least six other suspected cases of the virus.

In a statement, Dr Farrar said the spread was "tragic but unfortunately not surprising". He warned that more cases were expected, and a "full" national and international response would be needed to protect lives.

"The DRC should not have to face this alone," he said.

Media playback is unsupported on your device Media caption Treating Ebola in the DR Congo warzone

What's the situation so far?

Since the first case of Ebola in DR Congo last August, nearly 1,400 people have died - around 70% of all those infected.

The outbreak is the second-largest in the history of the disease, with a significant spike in new cases in recent weeks.

Only once before has an outbreak continued to grow more than eight months after it began - that was the epidemic in West Africa between 2013-16, which killed 11,310 people.

Efforts to contain the spread have been hindered by militia group violence and by suspicion towards foreign medical assistance.

Nearly 200 health facilities have been attacked in DR Congo this year, forcing health workers to suspend or delay vaccinations and treatments. In February, medical charity Médecins Sans Frontières (MSF) put its activities on hold in Butembo and Katwa - two eastern cities in the outbreak's epicentre.

In Uganda, a five-year-old boy died of the virus on Tuesday, according to the World Health Organisation (WHO).

Officials said his grandmother and younger brother also had the disease. The boy is said to have travelled across the border with his family from DR Congo on Sunday. He was then taken to a Ugandan hospital after exhibiting symptoms, including vomiting blood, officials said.

Seven other cases have been confirmed in the country, and Uganda's government said 50 people were suspected to have come into contact with those infected.

Image copyright Reuters Image caption The Ebola outbreak in the Democratic Republic of Congo is already the second deadliest in history

Emergency measures

Analysis by James Gallagher, Health and Science Correspondent, BBC News

Cases of Ebola appearing in another country are always a significant and worrying development. The key question now is how far has the virus spread in Uganda?

Has it been contained to just the family that crossed the border from DR Congo or has it spread more widely? This is a moment that Uganda has long prepared for and, hopefully, measures such as pre-emptively vaccinating healthcare workers will lower the risk of Ebola spreading.

This outbreak is already the second largest in human history and some have predicted it could take up to two more years to bring to an end. The WHO has twice ruled that this Ebola outbreak is not a yet global emergency. Its Emergency Committee will meet again on Friday.

What is being done to prevent the spread?

In Uganda, mass gatherings including market days and prayers have been cancelled. Market days in the town of Kasese attract an estimated 20,000 people at the border area.

Uganda's health ministry and the WHO said a rapid response team had been dispatched to identify others at risk.

The country has already vaccinated about 4,700 health workers against the disease, according to a joint statement by WHO and Ugandan health officials.

On Wednesday, WHO head Tedros Adhanom Ghebreyesus said that he would hold an IHR Emergency Committee meeting on 14 June. The group will decide if the outbreak should now be deemed a public health emergency.

What is Ebola? </s> The Ebola outbreak in the Democratic Republic of Congo made the long-feared jump across borders with three cases confirmed Wednesday in Uganda, including the death of a 5-year-old boy who had the virus.

The World Health Organization and Ugandan health authorities said Tuesday the Congolese boy had traveled from Congo on Sunday, entered Uganda with his family and sought medical care.

The other two confirmed cases are the boy’s 3-year-old brother and his grandmother, 50. They are being treated under isolation at the Bwera Hospital Ebola Treatment Unit, in the west of Uganda, the country’s Ministry of Health said.

In a tweet Wednesday, WHO said the boy died Tuesday night.

“The young patient – 5- year-old index case of #Ebola died last night. Two more samples were sent to UVRI and have tested positive. We, therefore, have three confirmed cases of #Ebola in #Uganda,” the tweet said, referring to the Uganda Virus Research Institute.

The ministry added that eight people who had been in contact with the family were being traced.

The Congo outbreak is both the second largest and second deadliest Ebola outbreak in history.

More than 1,300 people have died since it began in August. The epicenter is in North Kivu and Ituri provinces, among the most populous in the Congo and bordering Uganda, Rwanda and South Sudan.

Concern had been mounting that the infectious disease would cross the border, underscored by an increase in the number of cases in recent weeks.

Pressure on WHO to declare international emergency

Dr. Jeremy Farrar, director of Wellcome Trust, a UK medical research charity, said that while Uganda was well-prepared to cope with the disease, global health authorities should be ready for more cases in the Democratic Republic of Congo and other neighboring countries.

“This epidemic is in a truly frightening phase and shows no sign of stopping anytime soon,” he said in a statement.

“There are now more deaths than any other Ebola outbreak in history, bar the West Africa Epidemic of 2013-16, and there can be no doubt that the situation could escalate towards those terrible levels.”

Uganda’s Health Ministry said the boy and his grandmother had been vomiting blood, a severe symptom of Ebola, when they had presented themselves to doctors.

“Ebola is a horrific illness that ravages the human body,” said Brechtje van Lith, Save the Children’s country director in Uganda. “This first death, of a child, is a sickening reminder of the dangers of this disease.”

WHO is likely to come under pressure to declare the outbreak an international health emergency. In April, the health body said it did not constitute a “public health emergency of international concern.”

WHO defines a public health emergency of international concern as “an extraordinary event” that constitutes a “public health risk to other States through the international spread of disease” and “to potentially require a coordinated international response.”

Unlike the outbreak in West Africa that killed more than 11,000 people, there are now vaccines and experimental treatments to help stop the spread of the disease.

However, the Congo outbreak has proven difficult to bring under control because of community mistrust and violent attacks on health care workers.

“A step up in the national response with full international support is critical if we’re to contain the epidemic and ensure the very best protection for the communities at risk and for the health workers working to protect lives,” Farrar said. “This needs to be championed at the highest political levels, including at the UN and the upcoming G20.”

Uganda’s health ministry said it was vaccinating front-line health workers and people who had been in contact with the family. It said people should report any symptoms including unexplained bleeding from any body opening, vomiting of blood, bloody diarrhea and muscle pain.

It appealed to the public to “suspend social norms like shaking hands and hugging” and called on border districts to suspend mass gatherings such as weddings and markets and in places of worship. </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> An outbreak of Ebola, once confined to remote rural areas in the Democratic Republic of the Congo, now has spread to an area just outside of city of more than one million people, health officials said Thursday.

Dr. Peter Salama, the World Health Organization’s deputy director-general of emergency preparedness and response, called the new development “a major, major game-changer in the outbreak.”

The announcement came from the office of the Congo’s health minister late Wednesday night after it was learned that there was a single case of Ebola reported in Mbandaka, a densely populated city just under 100 miles from the site of the last reported case.

Since the outbreak began, there has been a total of 45 cases: 14 confirmed, 21 probable and 10 suspected. Only one of the 25 deaths actually has been confirmed by the health ministry as Ebola.

The fatal disease is spread by bodily fluids and can spread rapidly in densely populated regions.

“The scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, emergency coordinator in Mbandaka for Doctors Without Borders.

The aid organization said 514 people believed to have been in contact with infected people are being monitored. WHO said it is deploying about 30 more experts to the city.

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus initially is transmitted to people from wild animals, including bats and monkeys.

While there is no specific treatment for the deadly disease, which has a 90 percent fatality rate, WHO has shipped thousands of doses of an experimental vaccine to the region.

As the outbreak continues to grow, fears that it may spread abroad linger as many remember the West African Epidemic in 2014.

Eleven people were treated for Ebola in the United States in 2014, two of whom died, according to the Center for Disease Control and Prevention.

The Associated Press contributed to this report. </s> Image copyright Reuters Image caption Medical teams are vaccinating people to help stop the spread of the virus

The latest outbreak of the Ebola virus in the Democratic Republic of Congo is the worst in the country's history, the health ministry says.

Almost 200 people have died since August, officials say, with more than 300 confirmed or probable cases.

A vaccination programme has so far inoculated about 25,000 people.

DR Congo has suffered long years of instability and efforts to relieve the disease have been hampered by attacks on medical workers.

"At this point, 319 cases and 198 deaths have been registered," health minister Oly Ilunga said.

"In view of these figures, my thoughts and my prayers go to the hundreds of families grieving, to the hundreds of orphans and the families which have been wiped out."

About half the victims were from Beni, a city of 800,000 in the North Kivu region, the national health authority said.

The current outbreak is the tenth DR Congo has suffered and the worst since the country's first epidemic in 1976, so early in the disease's history it had yet to be named.

The outbreak in 1976 of what was then an unknown disease in a remote part of DR Congo sparked terror, but was brought under control by experts quickly identifying the virus' nature and using quarantines.

Ebola is spread via small amounts of bodily fluid and infection often proves fatal.

Early symptoms are flu-like, followed by vomiting, diarrhoea, a rash and internal and external bleeding. </s> The death toll from an Ebola outbreak in eastern Democratic Republic of Congo has risen to more than 200.

The health ministry said it had recorded 201 deaths from the virus and that 291 cases have been confirmed since the outbreak began in August.

About half of the cases were in Beni, a city of 800,000 people, in the North Kivu region.

The United Nation’s Department of Peacekeeping on Friday called on armed groups active in the region not to hinder efforts to fight the disease.

Teams responsible for responding to the outbreak “have faced threats, physical assaults, repeated destruction of their equipment and kidnapping,” Health Minister Oly Ilunga said.

“Two of our colleagues in the Rapid Response Medical Unit have even lost their lives in an attack,” he said.

The outbreak is the 10th in DR Congo since Ebola was first detected there in 1976.

Ebola is a serious infectious disease that can spread rapidly through small amounts of bodily fluid. It causes internal bleeding and can be fatal.

Since a vaccination programme began on August 8, more than 25,000 people have been innoculated, the health ministry said earlier this month. </s> The Democratic Republic of Congo's Ebola outbreak has spread to a provincial capital, prompting the World Health Organization (WHO) to call an emergency meeting.

The outbreak was announced last week in the remote rural area of Bikoro. So far 45 cases have been reported and 25 people are known to have died.

But cases have also been confirmed in Mbandaka, about 150km away, which is home to almost 1.2 million people.

The city lies on the Congo River, a busy transport corridor to the capital Kinshasa, where more than 10 million people live. </s> The Ebola epidemic in the Democratic Republic of the Congo is a public health emergency of international concern, the World Health Organization has declared, calling for more funds and support to close it down.

The second biggest Ebola outbreak ever, after the 2014-16 epidemic in west Africa, has reached a critical point with the diagnosis of a case in Goma, a city of 2 million people, which is a transport hub on the border with Rwanda. That follows the case last week of a women who crossed into Uganda to buy fish – and the arrival of a family harbouring the virus, three of whom died, in Uganda last month.

Dr Tedros Adhanom Ghebreyesus, the WHO director general, appealed on Wednesday for the international community to help with funds. WHO is working on a new plan to control the epidemic, he said, which would cost “hundred of millions” of dollars.

“It is time for the world to take notice and redouble our efforts. We need to work together in solidarity with the DRC to end this outbreak and build a better health system,” said Tedros.

Ebola virus reaches Congolese city of Goma Read more

“Extraordinary work has been done for almost a year under the most difficult circumstances. We all owe it to these responders – coming from not just WHO but also government, partners and communities – to shoulder more of the burden.”

He has made previous appeals for donors to provide the money they have promised. So far, only about half the pledges have come in. The WHO was not aware of any donor who has withheld funding because an emergency had not been declared, he said, “but if that was the excuse, it can no longer be used”.

Tedros appealed for countries not to seal their borders or close down travel to the DRC, arguing that it would only harm the attempts to end the epidemic.

One year on from the start of the epidemic in North Kivu, there have been 2,512 cases of the disease and 676 deaths, most of which have been confirmed.

This is the second biggest Ebola outbreak, after the west Africa epidemic, where 28,616 cases of disease and 11,310 deaths were reported in Guinea, Liberia and Sierra Leone between 2014 and 2016.

The WHO is not only alarmed about the arrival of the virus in Uganda and on the Rwandan border, but also by the flare-up again in Beni. “The geographical expansion is now 500km,” said Prof Robert Steffen, chair of the IHR emergency committee on Ebola in DRC, as he announced their advice to Tedros.

The WHO’s declaration was widely applauded by Ebola experts and the aid organisations struggling with the epidemic on the ground.

“This is perhaps the most complicated epidemic the world has ever had to face, yet still the response in the DRC remains overstretched and underfunded,” said Dr Josie Golding, epidemics lead at Wellcome. “A step-up in the response, led by the DRC and with full international support, is critical if we are to bring the epidemic to an end. This must include enhanced diplomatic, public health, security and logistic efforts as well as releasing much needed financial resources.”

Larry Gostin, the director of the O’Neill Institute in Washington DC and an expert on global health law, said the announcement gave the clearest possible signal that the WHO needs more financial and human resources. “Without a surge response, it will be impossible to bring the DRC Ebola epidemic under control.”

He called for bold action. “Standard strategies like case identification, vaccination and treatment can’t succeed in a complex humanitarian crisis like the situation in the DRC. Responders in the field are facing intense violence along with deep community mistrust. They often can’t get into the hot zone due to escalating violence and they can’t find cases to vaccinate and treat because families are hiding the sick. There has been no clear strategy to break the vicious cycle of disease, violence and distrust.”

The status quo is no longer tenable, Gostin said. “The complacency in the international community, including the United States, is crippling the response.”

The British Red Cross, Mercy Corps and World Vision, all of which are working on the ground, said they hoped the declaration would lead to a significant scale-up in the response. “A huge push and significant funding across the region are now required to contain this outbreak and bring it to an end. Otherwise, there is a real risk we will see a catastrophic spread of this deadly virus,” said Sarah Clayton-Fisher of the British Red Cross.

The possible arrival of the virus in Goma has long been feared by the agencies responding to the outbreak, because of its density and the movement of people through it to Rwanda.

Ebola in the DRC: everything you need to know Read more

“Ring” vaccination of the contacts of those who fall ill and their contacts has not succeeded in limiting the spread of the virus. There is mistrust of the vaccine. Some people falsely believe that the vaccine is what is making people sick, in part because it cannot protect anyone who is already infected when they have the shot. It is also very hard to track and trace the friends and relatives of the sick in areas where violent conflict is taking place.

“If we cannot contain Ebola at the epicentre, we will continue to see cases spread to metropolitan areas and across borders,” said Bob Kitchen, International Rescue Committee’s vice-president for emergencies.

“The inability to build community trust has proven a major barrier to stopping the spread of this disease. Local communities are perplexed and frustrated by continued increase in the number of people dying juxtaposed with a massive influx of international organisations into the region during the past year.”

There have been four declarations of public health emergencies since 2005, when the WHO’s new regulations were introduced: swine flu in 2009, polio in 2014, when there was a resurgence after near-eradication, Ebola in west Africa in 2014 and the Zika virus in Brazil in 2016.
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.