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

Concerns are growing over possible further election-related violence in the Democratic Republic of the Congo — not only for its potential to hurt the country's chance for its first peaceful transfer of power, but for the likelihood it would escalate the deadly Ebola outbreak there, experts tell Axios.

What we're watching: Prior and frequent violent attacks by rebels in DRC already have set back progress made in efforts to stem the outbreak — any significant uptick could not only temporarily halt health measures but could cause longer-term damage by forcing the UN and others to pull back from the epicenter of the outbreak.

"If we have local violent reactions to the elections because they are seen as fraudulent... that will further aggravate an already insecure environment, and cause further setbacks to health care efforts on Ebola."
— J. Stephen Morrison, SVP, Center for Strategic and International Studies (CSIS)

Threat level: Violent episodes have increased recently, such as fires burning election voting machines, which prompted a delay of the election to Dec. 30. (The election had been scheduled for Sunday.)

"Unrest during the election period could delay some of our field operations so we are closely monitoring the situation," Jessica Ilunga, spokesperson for the DRC Ministry of Health, tells Axios.

  • Morrison warns that any serious escalation of violence, particularly toward health care workers, could cause the UN to raise its security level from 4 to 5 and force their personnel to leave and the U.S. embassy to evacuate, which would be "catastrophic."
  • Julie Fischer, co-director of Georgetown University's Center for Global Health Science and Security, says the elections are another layer of concern on top of an epidemic that's shown no signs of slowing down.

Yes, but: While there are also actively voiced community concerns that touch-screen voting machines could spread the virus, since it remains active outside the body for several hours, the risk is minimal considering the precautions they are taking at each polling station, DRC's Health Minister Oly Ilunga told AP

  • There will be health controls at polling stations with temperature control and hand-washing stations, Jessica Ilunga says.
  • Fischer says there's been little research showing if Ebola could spread widely through something like voting machines, but she believes the chances are low with the precautions being taken.

Estimates of the outbreak duration continue expanding, with the World Health Organization's top emergency response official tweeting last week that he expects Ebola response efforts to last for "at least 6 more months."

The good news:

  • The ring vaccination, which has been administered to at least 49,384 people in DRC, has been an effective deterrent when officials are able to locate contacts of the known infected, Morrison and Fischer say.
  • Community outreach has been touted as successful, as the Health Ministry tackles misinformation and distrust through a variety of methods.
  • A baby born to a woman infected with Ebola has been released after successful recovery at an Ebola Treatment Center, Ilunga says.
  • Georgia State University researchers report they found a new human protein, called RBBP6, that naturally inhibits replication of the Ebola virus that they hope will lead to a new drug.
"Clearly, RBBP6 does not stop the virus. We envision a drug that inhibits Ebola virus in a manner similar to RBBP6 but that works more potently to fully stop virus growth," study author Christopher Basler tells Axios

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