KINSHASA, Congo — More than 1,000 people have died from Ebola in eastern Congo since August, the country’s health minister said on Friday, the second-worst outbreak of the disease in history behind the West African one in 2014-16 that killed more than 11,300.
The toll came as hostility toward health workers continued to hamper efforts to contain the virus.
Health Minister Oly Ilunga said that four deaths in the outbreak’s center, Katwa, had helped push the death toll to 1,008. Two more deaths were reported in the city of Butembo. The outbreak was declared almost nine months ago.
A volatile security situation and deep community mistrust have hampered efforts to control the spread of the disease in eastern Congo. Ebola treatment centers have been repeatedly attacked, leaving government health officials to run clinics in the hot spots like Butembo and Katwa.
International aid organizations stopped working in the two communities because of the violence. A Cameroonian epidemiologist working with the World Health Organization was killed last month during an assault on a hospital in Butembo.
Insecurity has become a “major impediment” to controlling the Ebola outbreak, Michael Ryan, the World Health Organization’s health emergencies chief, told reporters in Geneva on Friday.
He said 119 attacks had been recorded since January, 42 of them directed at health facilities, while 85 health workers had been wounded or killed. Dozens of rebel groups operate in the region, and political rivalries were one factor driving the community rejection of health personnel.
“Every time we have managed to regain control over the virus and contain its spread, we have suffered major, major security events,” Mr. Ryan said. His organization was “anticipating a scenario of continued intense transmission” of the disease, he added.
Ebola can spread quickly and kills in up to 90 percent of cases. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding, and can start to occur between two and 21 days from infection, according to the World Health Organization.
The organization has said that the most recent Ebola outbreak remained contained to eastern Congo even as the number of cases has risen in a dense, highly mobile population near the border with Uganda and Rwanda. Many people fear going to Ebola treatment centers, choosing instead to stay at home and risk transmitting the disease to caretakers and neighbors.
Residents of highly volatile Butembo believe Ebola was brought to the city on purpose. Amid rumors and misunderstandings, health workers have struggled to explain the importance of safe burials and other preventive measures. One out of four people interviewed in eastern Congo a month after the outbreak began wrongly believed Ebola was not real.
“I am deeply saddened to learn that the number of Ebola deaths has exceeded 1,000,” Vianney Musavuli, 24, said. “The problem is that people here in this area believe Ebola is a political thing, and that’s why residents are still attacking the teams in retaliation.”
Residents were blocked from taking part in a presidential election in January, with Congo’s government citing safety concerns. Some wondered why money was being poured into fighting Ebola when many more people were dying each year of malaria and other preventable diseases.
Insecurity also has prevented vaccination teams from getting to some areas, further limiting the health response. Still, more than 109,000 people have received an experimental but effective Ebola vaccine. Mr. Ryan said the authorities were looking at introducing another one.
He called for more help from Congo and elsewhere to close an “urgent, critical gap” of some $54 million in containment funding.
