Ebola treatment distrust is leading to a greater likelihood of spread

Data: DRC Ministry of Health; Chart: Andrew Witherspoon, Harry Stevens/Axios

The Ebola outbreak in the Democratic Republic of the Congo now has 7 hotspots and is considered to have an increased risk of spread within DRC and neighboring countries, the World Health Organization said in an update on Thursday.

What's new: WHO expects case numbers to continue rising due to the inability to reach all hotspot areas and the persistent pockets of community resistance that cause people to either not go to Ebola treatment centers or go after the infection is too advanced. 68% of deaths were of people not in an ETC, and the disease overall has had a 66% fatality rate, WHO said.

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Health care workers continue to face peril, as well. Not only are some getting infected — 102 people, or 6% of total cases, per WHO — but violence continues to target them as well.

• Violence targeting health care workers has grown globally, too — with 973 attacks and 167 deaths in 23 countries in 2018, according to a report out this week from the Safeguarding Health in Conflict Coalition.

What they're saying: DRC Ministry of Health spokesperson Jessica Ilunga tells Axios:

"The security situation has always been complex. However, over the last few months, it is getting worse and Ebola responders and operations are more often targeted by acts of violence mainly perpetrated by community-based militias. While these local militias have close links with the community, one should avoid using these acts of violence to gauge the level of community engagement in the region."

"Doing that creates a narrative that stigmatises the entire population of the city of Butembo, portraying them as inherently violent people who can only express themselves through these despicable acts. Such narrative also stigmatises and blames healthcare workers who are the first victims of that violence."

But, but, but: The news is slightly tempered by a welcomed but "unpredictable calm" in recent violent episodes in the DRC, accompanied by an increase in security around ETCs, WHO stated earlier this week.

Meanwhile, a WHO advisory group recommended last week that the DRC offer lower doses of vaccines to spread them out farther and to consider accepting other experimental vaccines to help boost the current one that's approved for use. Ilunga says

"National authorities received informal requests to consider three other vaccines but discussions are still in their preliminary stage. None of the manufacturers has already introduced a formal request to the national authorities."

Go deeper: Follow Axios' Ebola coverage here.