BUNIA, Congo (AP) — More than 100 people have died from Ebola less than a month after authorities declared an outbreak of the disease in eastern Congo, a grim toll as officials intensify efforts to slow the disease discovered weeks late.

Attacks on health workers from angry residents, skepticism among some locals and armed conflict in hot spots continue to challenge efforts to stop the Ebola outbreak declared on May 15, caused by a severe form of the disease.

Out of the 550 cases confirmed as of Sunday, there have been 101 deaths and 19 recoveries, the latest situation report said late Monday. The outbreak is concentrated in Congo’s eastern province of Ituri, which accounts for more than 90% of the cases. Cases have also been recorded in the North Kivu and South Kivu provinces, and has spread across the border to Uganda.

However, the number of cases in Congo is believed to be higher because the outbreak was confirmed weeks late and the contact tracing coverage rate, which has improved in recent days, is still at 64%.

The latest Ebola outbreak is caused by the rare Bundibugyo virus, which does not have an approved vaccine or treatment unlike the “Zaire virus,” another name for the Ebola virus, responsible for most of Congo’s past 16 outbreaks of the disease.

The rapid increase in the number of cases is partly due to the scale up of diagnostic capacities, enabling testing of the backlog of previously collected samples, authorities said.

The outbreak disrupts a provincial capital

Health measures put in place to limit the spread of Ebola have disrupted daily life in Bunia, the bustling capital of Ituri province.

Justin Abekani, who ferries customers on his motorcycle, said they are "now only allowed to carry one customer per motorbike.”

There is still widespread skepticism and disregard for health protocols in some parts of the province. Survivors of Congo's 2018 Ebola outbreak, the second-biggest in history, have warned that a repeat of past mistakes could lead to a high number of preventable deaths.

Front-line health workers, who labor with little pay or rest, have been attacked multiple times by angry residents, and have been unable to reach some communities cut off by conflict involving armed rebels.

Eastern Congo has for years seen attacks by dozens of separate rebel and militant groups, some of them with links to foreign countries or the extremist Islamic State group.

Conflict and movement complicate disease tracing

The fighting is "disrupting surveillance and response activities, and increasing the risk of undetected transmission,” the World Health Organization said Monday. “Such incidents underline the challenges of the context and the importance of working closely with local leaders and communities.”

Nearly a million people have been displaced by conflict in Ituri, according to the U.N. humanitarian office, making contact tracing difficult as people flee attacks or move frequently in the vast province with dense forests, poor roads and remote villages that can take days to reach.

Tracing also is difficult among the thousands of artisanal miners who regularly move between remote sites in the mineral-rich region.

WHO currently assesses the risk of spread for the rest of Africa and at the global level as low.

“(Ebola) patients can recover if they get the medical support they need,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said Monday during a visit to Uganda.

Protests in Kenya over US plans for Ebola quarantine

On Tuesday, Kenyan police fired tear gas to disperse protesters in the town of Nanyuki, near a military air base where the United States plans to build an Ebola quarantine center, a project that has since drawn protests but was later halted by the courts.

A heavy deployment of riot and regular police prevented the protesters from marching toward the base.

Last month, U.S. officials said Washington intends to send Americans exposed to Ebola while abroad to a new facility in Kenya rather than flying them back home. They said the center would be located at Laikipia Air Base with a capacity of 50 quarantine beds.

A Kenyan court later suspended construction of the facility and barred the arrival of any foreign patients, pending the outcome of a case filed by the Law Society of Kenya and a constitutional watchdog group. The petitioners cited concerns about Kenya’s fragile health system and the lack of transparency surrounding the bilateral agreement.

Kenya has not recorded any Ebola cases but neighboring Uganda has reported 19 confirmed cases.

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Asadu reported from Abuja, Nigeria. Associated Press writer Evelyne Musambi in Nairobi, Kenya, contributed to this report.

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