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Data: Ministry of Health DRC; Chart: Andrew Witherspoon/Axios

Recent violence in the areas where the deadly Ebola virus is centered in the Democratic Republic of the Congo has triggered stronger moves by the U.S. and international organizations to prevent the virus from spreading to other countries.

Why it matters: Violence has pushed public health measures against Ebola into sporadic stoppages — effectively allowing the infectious disease to take foothold again. Fighting against Ebola requires constant tracking of every person who's been in contact with an infected person, as well as a vaccination and treatment regime and education on hygiene.

What we're hearing:

"To say it's fragile would be an understatement. We've never had such an explosive combination of rebel activity and spread of the virus, particularly in some populations that don't believe in traditional public health measures."
— Michael Osterholm, director, University of Minnesota's Center for Infectious Disease Research and Policy

What's happening now: There's been a recent uptick in violence in DRC's North Kivu area, which borders Uganda and Rwanda, where there's been been a civil war raging. Another problem is that there have been pockets of resistance to traditional public health measures, Osterholm says.

  • On Wednesday, villagers attacked an ambulance, injuring 3 Red Cross workers and halting their assistance in burials. This could increase the risk that the virus will spread, since the virus remains infectious in the body after death.
  • On Sept. 22, 21 people were killed in a raid in a city in North Kivu called Beni, allegedly from Ugandan Muslim militants. This halted public health efforts for several days.
  • "I'm really worried we'll see more health care workers injured or killed ... making the situation even more difficult and complex," Osterholm says.
  • In addition, DRC Ministry of Health spokesperson Jessica Ilunga tells Axios they continue fighting elements of ignorance and suspicion that cause possibly infected people to resist quarantine and treatment protocols, sometimes heading to the border.

The U.S. Agency for International Development announced Monday it deployed an elite disaster assistance response team. A USAID spokesperson tells Axios:

"This outbreak is occurring in a highly insecure environment, which complicates public health response activities."  
"While the DRC has faced nine previous Ebola outbreaks, this is the first outbreak in an area with such high population density or scale of chronic insecurity and humanitarian crisis ... There remains a risk of further spread of Ebola within the DRC and to neighboring countries."

The World Health Organization raised its warning of the virus spread to the region to a "very high" risk earlier this week. WHO director Tedros Adhanom Ghebreyesus on Wednesday requested help from the UN Security Council to help secure health operations there. He tweeted:

"Security is a big challenge for the #Ebola response in #DRC. We’re at a critical point. Following the recent attack in Beni, our operations were in lockdown — but when we are in lockdown, Ebola is not. The virus gets an advantage. We appeal the #UNSC to ensure full access for ops."

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