Four new cases of Ebola have been confirmed in the Democratic Republic of Congo, just a week after the country announced the end of its ninth Ebola outbreak.Congo’s Ministry of Health was notified Saturday of 26 cases of fever “with hemorrhagic signs” that included 20 deaths in Beni, a city in the northeast province of North Kivu. Of the six samples analyzed for Ebola, four came back positive.

Ebola is considered endemic to Congo because of its equatorial forest ecosystem. Authorities do not believe the new outbreak is connected to the Bikoro outbreak, which infected 54 people and killed 33 and which was just declared over. The two outbreaks are separated by more than 2,500 kilometers (1,553 miles).

The Ministry of Health noted that therapeutic treatments are still in country from the last outbreak, but the species of this Ebola virus has yet to be determined.The Bikoro outbreak was contained using an experimental vaccine, provided by Merck, to target the Ebola Zaire strain. The World Health Organization raised $36 million from a variety of countries and nongovernmental organizations to fight that outbreak, and more than 3,300 people were vaccinated.

North Kivu province borders Rwanda and Uganda. Beni has been the site of intense fighting in recent decades, and between 2014 and 2016, more than 800 people were killed in the area, many of them by machete.Allied Democratic Forces, a Ugandan Islamist group, was blamed alongside Congolese army officers for the killings.

The earlier outbreak was tackled with 3300 doses of an experimental new vaccine. While it is too early to say if the vaccine made an impact, none of those treated died.Researchers have not yet identified the particular strain of ebola causing the new outbreak. But WHO’s emergency response chief Peter Salama said it could be the Zaire, Sudan or Bundibugyo strain.If it is the Zaire strain, the Merck vaccine used in the last ebola outbreak may be an option.

If not, the situation will be much more complex “and we may not have any vaccine options”, Salama told Reuters at WHO’s headquarters in Geneva.The majority of the cases occurred in the second half of July … When the provincial medical teams have looked back … they have noted cases that could be consistent with ebola that began even in May but it’s far too early to say,” Salama said “It would appear that the risk, as we can surmise for DRC, is high. For the region it’s high given the proximity to borders, particularly Uganda.We’re talking about a few health areas mostly in one health zone. So we are talking about tens of kilometres but I stress that this is very preliminary information at this stage.”

Traditional monitoring and containment methods were supplemented by the use of a new Ebola vaccine during the intervention to end the Mbandaka outbreak.The role played the vaccine in ending the outbreak is unknown, although none of the 3,300 people who received it after being exposed to the virus died.However, it is unclear if the vaccine can be used in the latest outbreak because it is not yet known which of the four strains of Ebola have struck Mangina. The rVSV-ZEBOV vaccine used in Mbandaka is only effective against the Zaire species of the virus.

Ebola is endemic in Congo, where the disease was first reported in 1976. This is the tenth outbreak to affect the country, although there may have been more that have gone undetected. Congo’s health minister, Oly Ilunga Kalenga, said improved surveillance methods have ensured that outbreaks are now identified more rapidly, enabling a more effective response.

“Although we did not expect to face a tenth epidemic so early, the detection of the virus is an indication of the proper functioning of the surveillance system,” he said in a statement. Despite the challenges, the World Health Organisation pledged to contain the latest outbreak.
“Ebola is a constant threat in DRC,” the body’s head, Tedros Adhanom, said. “We will fight this one as we did the last. We have started moving staff and supplies to the affected area.”