Announcement comes amid warnings situation may worsen due to armed group attacks and community resistance.

The Democratic Republic of Congo (DRC) is facing its worst Ebola outbreak in the country’s recorded history, health officials have said.

The announcement late on Friday came amid increasing warnings that the situation could deteriorate because of attacks by armed groups and community resistance in the affected areas in eastern DRC.

Oly Ilunga Kalenga, the DRC’s health minister, said a total of 319 confirmed and probable cases have been reported in North Kivu and Ituri provinces since the outbreak was declared in August.

The figure exceeds the 318 cases documented in 1976, when the deadly Ebola virus was first identified in Yambuku, in the Equateur province.

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Kalenga said 198 deaths have been recorded so far in the current outbreak, the country’s 10th, including 165 confirmed cases, with 35 probable deaths. Of the 284 confirmed cases, 97 have survived.

“This epidemic remains dangerous and unpredictable, and we must not let our guard down,” Kalenga said in a statement.

“We must continue to pursue a very dynamic response that requires permanent readjustments and real ownership at the community level.”

‘World’s most complex epidemic’

But the medical response has been complicated by regular attacks by armed groups battling for control in the mineral-rich eastern parts of the country.

Health officials have also reported cases of community resistance.

“No other epidemic in the world has been as complex as the one we are currently experiencing,” said Kalenga.

According to the minister, the teams responding to the outbreak are attacked on average three or four times a week, in an unprecedented level of violence compared with the country’s nine previous outbreaks.

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“Since their arrival in the region, the response teams have faced threats, physical assaults, repeated destruction of their equipment and kidnapping,” said Kalenga.

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

Still, officials say they have been able to vaccinate more than 27,000 high-risk contacts, of which at least half could have developed Ebola, which is spread through bodily fluids such as sweat, saliva and blood.

Separately, Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO) said this week that the main challenges in the current epidemic are insecurity and community mistrust.

“When there is an attack, the operation (vaccinations) actually freezes. And when the operation stops, the virus gets an advantage and it affects us in two ways,” he told reporters in the DRC’s capital, Kinshasa, on Thursday

“One is catching up on the backload. And the other, the second problem, is that more cases are generated because we can’t vaccinate them,” he said.

The confirmation of new cases has accelerated in the last month and an emergency committee of WHO experts said in October that the outbreak was likely to worsen significantly unless the response was stepped up.