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The Ebola outbreak in the Democratic Republic of the Congo (DRC) has now reached 1,009 cases, with 629 confirmed deaths, the health ministry announced Monday.

Compared to the West Africa outbreak of 2014-2016, the numbers are low — that devastating outbreak saw 28,616 cases of Ebola and 11,310 deaths across in Guinea, Liberia, and Sierra Leone.

But experts warn that the threat remains high.

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The most significant difference between the West African outbreak and the current outbreak in the DRC is the intense conflict surrounding the North Kivu province. Just last month, five Ebola centers were attacked, including one run by humanitarian organization Médecins Sans Frontières.

“That makes the ability to do what is essential to stop Ebola outbreaks extremely difficult,” Dr. Daniel Lucey, adjunct professor in the department of microbiology and immunology at Georgetown University Medical Center, told Global Citizen.

Contract tracing, which involves tracking down anyone who has been in contact with an infected person — and now offering them the experiental vaccine — is much harder in this kind of scenario.

Lucey worked in Sierra Leone and Liberia in 2014 during the Ebola outbreak, providing care to patients and training health care workers on personal protective gear.

“It was the worst situation I’ve ever seen,” he said, struggling to find the words to describe it, almost five years later. “Nothing could compare to it.”

He confirms that the major difference in today’s outbreak is the severity and scale of the insecurity in the DRC.

While West Africa experienced civil wars prior to the Ebola outbreak in 2014, which influenced the level of trust communities had in government officials and foreigners, the countries impacted by Ebola were nowhere near as insecure as the North Kivu province in the DRC.

“The level of insecurity and distrust is much, much greater and still ongoing in the DRC now where the outbreak is, unlike other places in DRC where outbreaks have occurred and been stopped pretty quickly,” Lucey said.

He’s referring to the outbreak that broke out in Bikoro in Equateur Province and was officially declared on May 8. It was quickly contained and declared defeated by July 24, 2018.

Despite the added obstacle of violence, the health community is armed with the experimental Ebola vaccine and investigational treatments.

And while there is distrust, Lucey said that the large number of people willing to be vaccinated with a vaccine that has not yet been approved shows great trust, too.

More than 96,000 people have been vaccinated in the DRC, along with health workers in Uganda and South Sudan, as of March 23, according to the World Health Organization (WHO).

Ebola has also been contained in the two provinces, which Lucey calls “interim success” — if the disease were to spread to neighboring Uganda or South Sudan, it could be catastrophic.

This is another key difference between the West Africa outbreak and the one in the DRC.

“By the time it was laboratory-confirmed in West Africa around March 22 of 2014 … already the virus had spread into the other two countries,” Lucey explained.

But the concern around the armed conflict cannot be understated. The WHO is now calling on the international community to join an urgent push to end the outbreak.

“The communities affected by this outbreak are already traumatized by conflict,” said WHO Director-General Dr. Tedros Ghebreyesus in a statement. “Their fear of violence is now compounded by fear of Ebola. Community engagement takes time. There are no quick fixes. But we are learning and adapting to the evolving context every day.”

Lucey emphasizes that community trust is key in truly putting an end to this. He’s not fluent in French, so he isn’t able to go help in the Congo, but he said that he wished he were there now.

“It’s extremely, extremely challenging and unprecedented with regard to the prior, say 25, Ebola outbreaks since the virus was discovered,” he said. “There’s no guarantees. I am very concerned, but I am also very hopeful — not optimistic, but very hopeful that this epidemic won’t expand.”

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