The more than 600 people confirmed to have contracted Ebola in the Democratic Republic of Congo (DRC) could “double,” in what is already the largest outbreak in that country’s history and the second deadliest ever recorded, the director of a non-governmental organization (NGO) reportedly predicted over the weekend.

Health officials in the DRC recorded six cases daily from October to December across all affected areas and the number is increasing, Jean-Philippe Marcoux, the director of the NGO Mercy Corps in the DRC, reportedly revealed.

“Now it’s doubling – it’s very possible that it can double again,” he explained, the Guardian reported Friday. “If we don’t significantly increase the resources, it will keep increasing. It will spread progressively to other health areas, and it will be there for a long time.”

Security concerns have hampered international efforts to combat and contain the disease, ultimately fueling the spread of the virus, according to several experts and health officials.

In an interview late last week with the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, Dr. Peter Salama, the deputy director-general for emergency preparedness and response at the World Health Organization (WHO), indicated that it would take at least six months to contain the current Ebola outbreak.

“This is the most complicated setting we’ve ever experienced in order to stop an Ebola outbreak,” Salama told CIDRAP, the center reported Thursday. ”At a minimum, it will take six further months to stop.”

That day, the WHO stressed that there is a very high risk of the disease spreading across the DRC and spilling over into neighboring countries, namely Uganda, Rwanda, and South Sudan “due to extensive travel between the affected areas,” the Guardian noted.

On Monday, several news outlets warned that the lethal virus is spreading towards the city of Goma, home to an estimated one million people.

“Cases have begun appearing in a district between the two major cities involved in the epidemic, suggesting the virus is spreading south,” the Daily Mail reported. “If Ebola does make it to the major city of Goma then ‘all bets are off’ for the bid to control the outbreak, one health official said.”

According to the latest data from the WHO, the disease had grown to 663 cases (613 confirmed; 49 probable) and 407 deaths (358 confirmed; 49 probable) as of January 15.

The ongoing civil war between militant groups and government forces plaguing the DRC has restricted prevention work, ultimately hampering efforts to contain the disease. Violence has worsened since the December elections in the country.

“About 30 health facilities were targeted by protesters in Beni, while efforts to trace anyone who has had contact with the virus were partially suspended due to security concerns,” the Guardian acknowledged.

The Kaiser Family Foundation (KFF) also stressed on Friday:

The security situation that has driven the spread of this outbreak shows no sign of abating and those leading the response estimate it will take at least 6 more months to contain it. Despite an increased global capacity to address Ebola generally, the outbreak in DRC remains extremely concerning and has potential to get worse.

Experts told CIDRAP that the outbreak began in August in North Kivu and Ituri provinces.

The Center also attributed the spread of the disease to “community resistance, population movement, violence against health workers, and political instability.”

Despite the human resources challenges, the WHO deputy-director told CIDRAP there is a good supply of doses of Merck’s unlicensed VSV-EBOV vaccine and in-field Ebola testing kits.

“Merck has 300,000 doses in the global supply, and we’ve used about 60,000 so far, so we have some buffer,” he said. However, he cautioned, “Were the outbreak to become a multi-country outbreak, then we would quickly face critical vaccine shortages.”

By November 2018, the WHO had already deemed the current Ebola outbreak the deadliest outbreak of the disease in the history of the DRC and second most lethal across the world.

The worst Ebola outbreak in history took place in 2014 when the disease killed over 11,000 people in West Africa.

KFF noted that price tag of the international community’s response had reached an estimated $120 million so far, “with more expected to be needed as the epidemic grinds on.”

The health foundation explained:

Unlike in 2014, the WHO International Health Regulations (IHR) Emergency Committee (EC) has so far decided against declaring the DRC outbreak a ‘public health emergency of international concern’, though if the virus spreads across borders or a large increase in cases occurs, the WHO may revisit this decision.

The security conditions, heightened by the contentious elections in December, have reportedly curtailed direct engagement by American personnel, with U.S. officials withdrawing Centers for Disease Control and Prevention (CDC) staff back from the front lines of the response over safety concerns, KFF noted.

Some experts have reportedly urged the United States government (USG) to increase its engagement, but “there is little indication that the USG will deviate from its current policy of keeping U.S. personnel out of those regions, especially in light of the increased risk of violence in the post-election period,” KFF concluded.

Health officials first discovered Ebola, a virus that causes hemorrhagic fever, in the DRC back in 1976 when the country was known as Zaire. The virus is named after a river in the DRC.