Ebola death toll rises to 214 in Democratic Republic of the Congo as health workers are forced to stop fighting the deadly virus when their hotel is hit by a shell in armed rebel attack

16 health workers were taken out of the city to be given psychological help

Nobody was injured in the attack, which was carried out 'metres' from the hotel

The Ebola outbreak has now killed 214 people and infected 366 in the country

Published: 13:44 EST, 18 November 2018 | Updated: 07:49 EST, 19 November 2018

Health workers in the Democratic Republic of the Congo had to be evacuated from their hotel after it was hit by a shell in a nearby armed rebel attack on Friday.

Some 16 World Health Organization staff were taken out of the city of Beni, where they are trying to fight an Ebola outbreak which has so far killed 214 people.

Efforts to control the epidemic had to be toned down on Saturday because of the attack, with vaccinations and peacekeeping suspended, but work resumed on Sunday.

The organisation's director general said he heard 'heavy gunfire' over the phone, and a shell hit the workers' hotel but didn't explode.

Violence is common in the central African country and has made it difficult to stop the Ebola outbreak – earlier in the week eight United Nations peacekeepers and 12 local soldiers died in an ambush.

At least 366 people have caught Ebola since the outbreak began at the beginning of August, and experts last week warned it may not be over for another six months.

At least 214 people have died in the DRC's current Ebola outbreak and 366 people have caught the virus, which is highly contagious and incurable

Hundreds of health workers are stationed around the city of Beni in Democratic Republic of the Congo to try and contain a deadly Ebola outbreak (pictured, health workers at the Doctors Without Borders treatment centre in Butembo)

People thought to have Ebola are quarantined in medical treatment centres like the one, pictured, run by Doctors Without Borders in the city of Bunia, 200km from Beni

WHO staff showed 'distress' after the attack on Friday night in Beni – where the outbreak started – so they were evacuated to the nearby city of Goma.

Efforts to contain the disease were toned down on Saturday and no vaccinations were given, but work resumed as normal yesterday.

Rebels from the Allied Democratic Forces militia had attacked a camp used by the UN, just 'a few metres' from a hotel where Ebola workers are staying, but nobody was injured.

Around 200 staff are based in the area, 16 of whom were evacuated to be given counselling and rest after the ordeal.

The WHO's director general, Dr Tedros Adhanom Ghebreyesus, was informed by a phone call while the attack was still happening, Stat News reported.

'They called me immediately and the gunfire was very close to them,' he said.

And Dr Ghebreyesus added the medical workers have asked for more protection from the UN: 'They’re putting more troops and maximizing the protection.

'So we will use all the means we have … to protect all humanitarian workers there,' he added.

The violence in the region has made the Ebola outbreak – the 10th in the DRC since the disease was discovered there in the 1970s – particularly difficult to control.

Armed groups have kidnapped and killed people trying to treat the sick, and ongoing conflict has made locals suspicious of official health workers.

Dr Ghebreyesus added: 'We honour the memory of those who have died battling this outbreak, and deplore the continuing threats on the security of those still working to end it.'

Another factor making it harder to combat the outbreak is the widespread use of pop-up unofficial medical centres.

People are seeking help in makeshift clinics, some of which are just rooms in people's houses which don't have running water and reuse needles.

'Those facilities, we believe, are one of the major drivers of transmission,' said Peter Salama, the WHO's emergency response chief.

Ebola causes a fever and severe weakness – pictured, health workers carry a patient through an Ebola treatment centre in Butembo, Democratic Republic of the Congo, on November 3

Health workers must be covered from head to toe at all times because Ebola spreads through contact with infected people – pictured, medics carry a bible to a patient in Butembo

'Probably more than 50 per cent of cases in Beni have been driven from these tradi-modern health care facilities, and the fact that hygiene and injection practices in these areas are relatively unsafe.'

Experts realised the way the disease was spreading had changed in October, when unprecedented numbers of children started becoming infected.

Health workers found these were children being treated for malaria in the unofficial health centres – they believe people are confusing the two diseases because early symptoms, including fever, weakness and vomiting, are the same.

HAS THE DRC HAD AN EBOLA OUTBREAK BEFORE?

DRC escaped the brutal Ebola pandemic that began in 2014, which was finally declared over in January 2016 - but it was struck by a smaller outbreak last year.

Four DRC residents died from the virus in 2017. The outbreak lasted just 42 days and international aid teams were praised for their prompt responses.

The new outbreak is the DRC’s tenth since the discovery of Ebola in the country in 1976, named after the river. The outbreak earlier this summer was its ninth.

Health experts credit an awareness of the disease among the population and local medical staff's experience treating for past successes containing its spread.

DRC’s vast, remote geography also gives it an advantage, as outbreaks are often localised and relatively easy to isolate.

Officials in the country last week said they have never seen such a devastating outbreak.

'No other epidemic in the world has been as complex as the one we are currently experiencing,' said Dr Oly Ilunga Kalenga, the DRC's health minister.

Having started on August 1, it is the 10th outbreak in the country since the disease, which causes extreme fever, bleeding and diarrhoea, was first discovered 42 years ago.

'This epidemic remains dangerous and unpredictable, and we must not let our guard down,' said Dr Kalenga.

'We must continue to pursue a very dynamic response that requires permanent readjustments and real ownership at the community level.'

He added: 'Since their arrival in the region, the response teams have faced threats, physical assaults, repeated destruction of their equipment, and kidnapping.

'Two of our colleagues in the Rapid Response Medical Unit even lost their lives in an attack.'

Dr Kalenga said teams responding to the outbreak are violently attacked, on average, three to four times a week.

In October, militants killed 11 civilians and a soldier in Beni, a city with a population of around 230,000 people where the outbreak is thought to have started.

Despite facing resistance from people who don't want health workers treating them, the government has managed to vaccinate more than 27,000 people.

Those who are known to have come into contact with others who had the disease have been targeted by the vaccination programme.

Of the 366 people thought to have been infected with Ebola during the DRC's outbreak, 319 of those have been confirmed – pictured, medical workers at the Doctors Without Borders treatment centre in Butembo help a patient whose illness has not been confirmed

An unusually high number of children have been infected in this outbreak, officials say – pictured, a worker carries a swaddled four-day-old baby thought to have caught the virus

Unusually, children are being badly affected because they're catching the virus while in medical clinics for other reasons, experts say.

Jessica Illunga, a spokesperson for the health ministry in DRC said in October: 'There is an abnormally high number of children who have contracted and died of Ebola in Beni.

'Normally, in every Ebola epidemic, children are not as affected.'

Dr Peter Salama, emergency response chief at the World Health Organization (WHO), last month warned the current Ebola outbreak would only get worse.

The combination of rebel violence and pre-election unrest is creating a 'perfect storm' for an even worse epidemic, he said.

WHAT IS EBOLA AND HOW DEADLY IS IT?

Ebola, a haemorrhagic fever, killed at least 11,000 across the world after it decimated West Africa and spread rapidly over the space of two years.

That pandemic was officially declared over back in January 2016, when Liberia was announced to be Ebola-free by the WHO.

The country, rocked by back-to-back civil wars that ended in 2003, was hit the hardest by the fever, with 40 per cent of the deaths having occurred there.

Sierra Leone reported the highest number of Ebola cases, with nearly of all those infected having been residents of the nation.

WHERE DID IT BEGIN?

An analysis, published in the New England Journal of Medicine, found the outbreak began in Guinea - which neighbours Liberia and Sierra Leone.

A team of international researchers were able to trace the pandemic back to a two-year-old boy in Meliandou - about 400 miles (650km) from the capital, Conakry.

Emile Ouamouno, known more commonly as Patient Zero, may have contracted the deadly virus by playing with bats in a hollow tree, a study suggested.

HOW MANY PEOPLE WERE STRUCK DOWN?

WHICH COUNTRIES WERE STRUCK DOWN BY EBOLA DURING THE 2014-16 PANDEMIC? (CDC figures)
COUNTRY	CASES	DEATHS	DEATH RATE (%)
GUINEA	3,814	2,544	66.7%
SIERRA LEONE	14,124	3,956	28.0%
LIBERIA	10,678	4,810	45.0%
NIGERIA	20	8	40.0%
SENEGAL	1	0	N/A
SPAIN	1	0	N/A
US	4	1	25.0%
MALI	8	6	75.0%
UK	1	0	N/A
ITALY	1	0	N/A

Figures show nearly 29,000 people were infected from Ebola - meaning the virus killed around 40 per cent of those it struck.

Cases and deaths were also reported in Nigeria, Mali and the US - but on a much smaller scale, with 15 fatalities between the three nations.

Health officials in Guinea reported a mysterious bug in the south-eastern regions of the country before the WHO confirmed it was Ebola.

Ebola was first identified by scientists in 1976, but the most recent outbreak dwarfed all other ones recorded in history, figures show.

HOW DID HUMANS CONTRACT THE VIRUS?

Scientists believe Ebola is most often passed to humans by fruit bats, but antelope, porcupines, gorillas and chimpanzees could also be to blame.

It can be transmitted between humans through blood, secretions and other bodily fluids of people - and surfaces - that have been infected.

IS THERE A TREATMENT?

The WHO warns that there is 'no proven treatment' for Ebola - but dozens of drugs and jabs are being tested in case of a similarly devastating outbreak.

Hope exists though, after an experimental vaccine, called rVSV-ZEBOV, protected nearly 6,000 people. The results were published in The Lancet journal.