WILLIAM BRANGHAM: The Ebola outbreak in the Democratic Republic of Congo continues to worsen, with the number of confirmed cases climbing to over 4,500.

Over 2,100 people have already been killed by the virus, a death toll that was reached almost three times faster than the outbreak over a decade ago.

As Ebola speeds through the Democratic Republic of Congo, even those who are still healthy are struggling.

CLAUDE STEVEN KATO, Motorcycle Taxi Manager (through translator): We used to carry two passengers on a motorcycle.

But, with the Ebola outbreak, the authorities are only allowing us to carry one passenger per motorcycle, which is having a huge impact on our finances.

We're barely making any money.

WILLIAM BRANGHAM: Sellers at this market in Bunia are trying to make a living, but the outbreak is impossible to ignore.

This is considered the fastest growing Ebola outbreak yet, reminding experts of the one more than a decade ago that killed over 11,000 people.

Director General of the World Health Organization Dr.

Tedros Adhanom Ghebreyesus continues to sound the alarm.

TEDROS ADHANOM GHEBREYESUS, Director General, World Health Organization: It's already the second biggest Ebola epidemic on record.

And it's moving faster than any previous Ebola outbreak.

At its current pace, it's on track to eclipse the West African Ebola outbreak of 2014 to 2016.

WILLIAM BRANGHAM: The rare Bundibugyo strain is what's driving this current outbreak.

There are currently no approved vaccines or therapeutics.

And this strain kills anywhere from a quarter to half of those who are infected.

Complicating all of this is a fragmented medical system, short of people and protective gear, but with ample amounts of fear and misinformation.

BIENVENU KAMBALE VAYILANDA, Director, Tokobika Medical and Surgical Center (through translator): We must continue to focus our awareness efforts on the outskirts of Bunia and on those within the city who are unable to accept the existence of Ebola and who are dying in the community until they come to accept that the disease is already here.

We must step up these awareness efforts so that everyone can receive care as soon as possible.

WILLIAM BRANGHAM: Some frontline health workers say they haven't been paid in three months, and they're walking off the job in protest.

CHADRACK RILEGO, Nurse, Elikya Ebola Treatment Center (through translator): Without the effort of nurses, doctors, and hygienists, there is nothing.

You can't defeat Ebola.

They are fighting this with someone you don't even acknowledge.

We put our lives in danger, even our families as well, because, if I am hit by the epidemic, I go home.

My wife, my children, my parents would also be infected.

WILLIAM BRANGHAM: The United Nations says, on top of it all, ongoing violence over Congo's lucrative minerals between Rwandan-backed groups and the Congolese military prevents those who need medical care from getting to it.

FARHAN HAQ, United Nations Deputy Spokesman: The World Health Organization reports that between 60 and 70 percent of Ebola-related deaths occur in communities, with many patients reaching health facilities too late or unable to access care in time.

We, along with our partners, continue to support the response, but our work is hindered by insecurity.

We reiterate our call on all parties to the conflict to protect civilians and facilitate safe and sustained humanitarian access to communities impacted by both violence and the outbreak.

WILLIAM BRANGHAM: Yesterday, the head of the African CDC said the outbreak had now spread to a new province.

For more on this crisis, we turn to epidemiologist Anne Rimoin.

Among her other work, she's led decades of work on Ebola in the Democratic Republic of Congo.

She's the director of the Center for Global Health Security at the University of California, Los Angeles.

Anne, thank you so much for being here.

It seems like we have got exponential growth of cases in the DRC right now.

What is your reading, your best sense of how things are going on the ground right now?

DR.

ANNE RIMOIN, UCLA Epidemiologist: Well you have an outbreak that's occurring on top of already a series of emergencies in a place like the DRC.

You have conflict, you have poor health care infrastructure, you have poor infrastructure in general, and so it's not surprising to see that this outbreak is continuing to spiral out of control, given all of the things that are happening at the same time.

WILLIAM BRANGHAM: I mentioned a few of the challenges in that tape piece, but, from your perspective, what are the biggest challenges to getting our arms around this outbreak?

DR.

ANNE RIMOIN: Well, I could give you an entire list of challenges, but I will focus on a few of them.

The first one, I would say, is that just like the nurse in your reel just said, the health care workers are the cornerstone of this outbreak response.

And if they are not being supported, if they don't have the equipment that they need to protect themselves, it's going to be a major problem.

You cannot expect people to be putting themselves constantly in danger without the support they need.

Another problem that you have is diagnostics.

This is a different species of Ebola.

And, as a result, the tests have not been as readily available.

You know, we have been prepared for another Ebola Zaire outbreak, the strain that has been responsible for the vast majority of Ebola outbreaks, but this is Bundibugyo.

It's different, and the tests have not worked.

So being able to roll out new tests has very been very important.

You have to identify people who are actually sick with Ebola, and then you have to be able to isolate them, treat them, and find the contacts.

That brings me to the next thing.

Contact tracing means you have to have good surveillance infrastructure, and you also have to have trust of the community.

And all of these things are very complicated.

And all of these things together just bring what I have been saying from the beginning.

It's an emergency on top of emergency in a very complex situation.

WILLIAM BRANGHAM: I want to loop back to one of the things that you mentioned here, which is the work force, the medical work force.

I was reading the WHO's dispatch most recently about this, and noting how many health workers themselves are getting sick.

Is that -- in your sense, is that because how contagious this strain is?

Is that a function of training?

Is that a function of access to protective equipment?

What is that?

DR.

ANNE RIMOIN: I think it's a number of things.

First and foremost, health care workers are the ones that are right there on the front line.

They're doing all of the things that put people at greatest risk of exposure of Ebola, which is primarily spread through close contact with bodily fluids, like vomit and urine and all of the bodily fluids that exist.

So that's number one.

They are right in the line of fire.

Second of all, protective equipment is not as readily available as it should be.

And, third, people come in with a wide variety of symptoms.

And so if you don't know that somebody has Ebola, it's very hard to know exactly how you're supposed to protect yourself.

And so because there's such a wide range of symptoms that can be from mild to very acute, at this point, everybody has to be treated like a suspected Ebola case.

WILLIAM BRANGHAM: The WHO also reported that the outbreak seemed to have started back in February, not, as it was officially declared an outbreak, in May.

Do you have a sense as to why that gap occurred?

And does that gap also mean this is partly why we have had such a hard time controlling it?

DR.

ANNE RIMOIN: Ebola is something that can mimic other things.

And so you need good surveillance, but you also need really good diagnostic tests.

And the tests that were available were, again, these tests that were targeting Ebola Zaire, not Ebola Bundibugyo.

And, in fact, there had been several people tested for Ebola in the local laboratories using the Ebola Zaire test.

And it wasn't until it was -- those samples were actually brought to another laboratory in Kinshasa, where they actually had the assay that could detect Ebola Bundibugyo, that we -- they where they were able to determine what it was.

So there was this huge lag in time in terms of being able to detect what it was.

And, with Ebola, you have got to get in front of it.

And the longer that this virus has to spread, the more transmission chains you are going to have to be tracking down.

So Ebola spreads exponentially, and if you're not in front of it right away, you're going to be exactly where we can expect to be right now, chasing behind so many different chains.

WILLIAM BRANGHAM: Anne Rimoin, always great to hear from you.

Thank you so much for being here.

DR.

ANNE RIMOIN: It's my pleasure.

Thanks for having me.