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.