The Ebola virus has now infected more than 600 people in the Democratic Republic of the Congo, making it the second-worst outbreak in history as the epicenter spreads south to a hard-hit city near the border with Uganda.

The Congolese health ministry said in a statement Tuesday that six new cases had been identified in the city of Katwa, where a rash of cases have been identified in recent weeks. There have now been at least 114 cases of the Ebola virus identified in Katwa, about one-sixth of those identified in the region as a whole.

ADVERTISEMENT

The outbreak that began in August has infected at least 609 people in the provinces of North Kivu and Ituri, along Congo’s eastern border with several smaller countries. Another 49 cases are listed as probable, meaning health officials were unable to test for the Ebola virus before the victim died.

At least 402 people have died of the virus in recent months, a mortality rate of 61 percent. The current outbreak is now second only to the 2013–2015 outbreak in West Africa that killed more than 11,300 people.

Congo, the main epicenter of the latest outbreak, appears to have corralled the virus’s spread. The city of Beni, which has reported 225 cases of the virus, has not registered a new case since Jan. 1.

But that does not mean Beni is in the clear: The virus can incubate for as long as three weeks in a human body before a victim shows symptoms. Public health officials must wait for two full incubation periods — 42 days — before declaring a region free of the virus.

Public health officials are nervously watching the city of Butembo, a large trading hub about seven miles east of Katwa, for signs that the virus continues to spread. A new case was identified in Butembo on Tuesday.

ADVERTISEMENT

Those officials said the response has been stymied by continued resistance from communities that may be at risk.

Over the weekend, angry residents in the city of Marabo attacked health care workers building a new Ebola treatment facility in their midst, according to a report from a United Nations news agency in the region.

“The population is intoxicated. They are told that [Ebola] is a false disease, it is a political fact,” Ituri interim Gov. Pacific Keta told the United Nations news agency Radio Okapi . “But it is a real disease.”

Several other health teams have been attacked in recent months in North Kivu, a province of 8 million residents and home to more than 1 million internally displaced people driven from their homes by ethnic violence.

A bombing in Beni in September, claimed by one of the more than 20 armed insurgent groups operating in the region, killed about two dozen people. Seven United Nations peacekeeping soldiers were killed in separate attacks in mid-November. A more recent attack forced the World Health Organization to evacuate a badly wounded health care responder.

“The situation is changing. It’s been complicated even further,” WHO Director-General Tedros Adhanom Ghebreyesus told The Hill in an interview last week. “It’s a high population density area, high mobility, high displacement, the chances are there for spread.”

Those attacks, and unrest around Congo’s contested presidential election, have slowed some of the response activities, Tedros said. The United States pulled back several of its personnel from the Centers for Disease Control and Prevention (CDC) after an August attack on a Congolese military base.

Some CDC officials are on the ground in nearby countries like Uganda, Rwanda and South Sudan, administering vaccines to health care workers in case the virus jumps over international borders.

Public health workers have vaccinated more than 60,000 people across the region, mostly front-line health care workers and those who have come into contact with an Ebola patient. Health officials have screened thousands of passengers traveling through the international airport in Goma, the largest city in North Kivu, with direct flights to Kinshasa, Congo’s capital.

There are some hopeful signs amid the chaos of the outbreak. Last week, a recovered Ebola patient gave birth inside an Ebola treatment center in Beni, the first known instance of a fetus surviving the virus. The Congolese health ministry said the infant, Sylvana, tested negative for the Ebola virus.

And an American who had been evacuated to the United States after coming into contact with an Ebola patient was released by the Nebraska Medical Center after three weeks. The center, which did not identify the patient under observation, said the patient had not shown any symptoms of the Ebola virus.