BUNIA, Congo (AP) — Anxious healthcare workers in eastern Congo said Wednesday they are underprotected and undertrained in the face of a rapidly spreading outbreak of a rare type of the Ebola virus in one of the world's most remote and vulnerable places.

“It’s truly sad and painful because we’ve already been through a security crisis, and now Ebola is here too,” said Justin Ndasi, a resident of Bunia, the site of the first known death that was announced last week after what experts have called a worrying delay in detecting the virus.

The Ebola response is unfolding in a region long threatened by armed groups that have kept a large part of the population on the run, further complicating health workers' catch-up efforts to trace the outbreak's spread. The World Health Organization, which on Wednesday said the outbreak posed a low risk globally, has said “patient zero” still has not been found.

In Bunia, where tons of health supplies have been airlifted this week, residents said masks have become harder to find and some disinfectants that previously sold for 2,500 Congolese francs (about $1) now cost up to 10,000 francs (over $4).

‘The scale of the epidemic is much larger’

WHO has declared the Ebola outbreak a public health emergency of international concern, requiring a coordinated response, and expressed concern over its “scale and speed."

The agency's head in Congo has said the outbreak would last at least two months.

The rare type of Ebola, known as the Bundibugyo virus, spread undetected for weeks following the first known death while authorities tested for another, more common Ebola virus, which came up negative, health experts and aid workers have said. Health experts say the delayed detection and volatile population movements complicate the response.

So far, 51 cases have been confirmed in Congo’s northern provinces of Ituri and North Kivu, as well as two cases in Uganda, WHO Director-General Tedros Adhanom Ghebreyesus said Wednesday. Beyond that, there are 139 suspected deaths and almost 600 suspected cases.

But "the scale of the epidemic is much larger,” he said. “We expect those numbers to keep increasing.”

And the arrival of even a potentially effective vaccine is months away. Dr. Vasee Moorthy, a special adviser in the office of the WHO chief scientist, said a vaccine to address Bundibugyo would not be available for at least six to nine months. He cited two candidates: A version of the Ervebo vaccine that would be specifically designed for Bundibugyo, and another based on a vaccine developed by Oxford University for two Ebola strains.

Eastern Congo was already facing “immense pressure from conflict, displacement and a collapsing health system, and this Ebola outbreak is stretching already limited resources even further,” said Dr. Lievin Bangali, senior health coordinator for the International Rescue Committee in Congo. “Years of underfunding, compounded by recent cuts to frontline health and outbreak preparedness programming, have weakened the ability to detect and respond to outbreaks quickly.”

‘We have no protection’

Schools and churches remained open in Bunia on Wednesday, and some residents were wearing masks. At health centers, anxiety grew.

A Doctors Without Borders team identified suspected cases over the weekend at the city's Salama hospital, which has no isolation ward, Trish Newport, emergency program manager at aid group Doctors Without Borders, said on social media.

“The team called around to other health facilities to see if they had isolations,” she said. “Every health facility they called said, ‘We’re full of suspect cases. We don’t have any space.’ This gives you a vision of how crazy it is right now.”

But in Mongbwalu, at the outbreak's epicenter after the body of the first known death was taken there, the nearby border with Uganda remains open and gold mining continues, Chérubin Kuku Ndilawa, a local civil society leader, told The Associated Press.

“There’s no panic. People continue with their normal lives, but they’re also starting to spread the word,” said Ndilawa, adding that controlling the outbreak has been hindered by a lack of public handwashing stations.

It was very different at Mongbwalu General Hospital. Dr. Didier Pay said it was treating around 30 Ebola patients, and a student from the local medical technology institute died on Wednesday morning.

"The patients are scattered here and there in rather unusual conditions,” Dr. Richard Lokudu, the hospital's medical director, told the AP. “We hope for the proper triage and isolation facilities to be installed today, and if that doesn’t happen, we will be completely overwhelmed.”

He added: “The challenge is that the staff are not trained to handle suspected cases. We are also understaffed." If confirmed cases surge, "we have no protection.”

An American with Ebola is in isolation in Germany

Congo was expecting shipments from the United States and Britain of an experimental vaccine for different types of Ebola, developed by researchers at Oxford, Jean-Jacques Muyembe, a virus expert at the National Institute of Biomedical Research, told reporters on Tuesday.

Meanwhile, a U.S. national who tested positive for the virus in Congo arrived in Berlin on Wednesday for treatment in a special isolation ward.

A “comprehensive examination” was taking place to determine treatment, German Health Ministry spokesperson Martin Elsässer said. He said he wouldn’t comment on the patient’s condition, whom German authorities and the U.S. CDC have not identified.

Separately, Christian aid organization Serge said one of its doctors — identified as American medical missionary Dr. Peter Stafford — had been evacuated from Congo “and is receiving specialized medical treatment” after he developed symptoms.

The US says it will ‘lean into’ its response

Congo said the first person died from the virus on April 24 in Bunia, but the confirmation did not come for weeks. The body was sent home to Mongbwalu, which Congo's health minister says caused the outbreak to escalate.

There is a long road ahead, according to Dr. Anne Ancia, the head of the WHO team in Congo. She said cuts in funding had “a marked detrimental effect on humanitarian actors.”

The outbreak highlights the effects of the Trump administration's deep cuts in foreign aid.

On Tuesday, U.S. Secretary of State Marco Rubio told reporters the administration would “lean into” Ebola response efforts with a priority on funding 50 emergency clinics in affected areas. The U.S. pledged to contribute $23 million to the effort.

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Associated Press writers Jamey Keaten in Geneva, Wilson McMakin in Dakar, Senegal, and Geir Moulson in Berlin contributed to this report.

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