Democratic Republic of Congo’s Ebola outbreak is unlikely to be contained unless violence stops, said the World Health Organisation, after attacks halted work for almost five days.

The world’s second biggest Ebola outbreak has killed more than 1,000 people in a part of eastern Congo plagued by militia violence. Distrust by local residents has further hampered the response, with health workers and centers repeatedly attacked.

In the past week a burial team was attacked in the town of Katwa and 50 militiamen stormed the city of Butembo, the epicenter of the outbreak, in addition to a number of other “serious security incidents” in Ebola hot spots, said WHO.

“Without commitment from all groups to cease these attacks, it is unlikely that this EVD (Ebola virus disease) outbreak can remain successfully contained in North Kivu and Ituri provinces,” the agency said in a statement.

High transmission rates in recent weeks raise the risk of a spread to other provinces and countries, a WHO spokesman added.

Each time the response is suspended due to violence there is a spike in the number of cases, aid agencies said.

“This disruption in programming is the longest yet and our teams are concerned that this will lead to a surge in the number of cases,” said David Miliband, president of the International Rescue Committee (IRC), on Friday.

The increasingly volatile situation “is making progress against the disease impossible,” he said in a statement.

The outbreak has killed 1,074 people out of a total of 1,604 confirmed or probable cases, according to the health ministry.

The world’s worst epidemic of Ebola, a hemorrhagic fever, killed more than 11,300 people in West Africa from 2013 to 2016.

Better information sharing and security analysis would help, since agencies do not always know who is responsible for attacks or what areas are safe, said Whitney Elmer, Congo country director for international charity Mercy Corps.

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“What’s not happening right now is a systematic way that the information is coming together. This would help us make decisions more quickly,” she told the Thomson Reuters Foundation.

WHO Director General Tedros Adhanom Ghebreyesus tweeted on Friday that he was “profoundly worried”.

“The tragedy is that we have the technical means to stop Ebola, but until all parties halt attacks on the response, it will be very difficult to end this outbreak,” he said.

REUTERS