Robert Redfield, the director of the Centers for Disease Control and Prevention said that people need to be prepared for the worst.  Redfield said the Democratic Republic of Congo’s newest Ebola outbreak may not be containable.

Tom Inglesby, the director of the Johns Hopkins Center for Health Security in Baltimore, said that if the Ebola outbreak becomes endemic in the Congo’s North Kivu province, it shows “we’ve lost the ability to trace contacts, stop transmission chains and contain the outbreak.” In this situation, Ebola could spread, which could negatively impact both trade and travel, according to a report by Becker’s Hospital Review.

“I do think this is one of the challenges we’ll have to see, whether we’re able to contain, control and end the current outbreak with the current security situation, or do we move into the idea that this becomes more of an endemic Ebola outbreak in this region, which we’ve never really confronted,” Dr. Redfield told The Washington Post.

According to The Washington Post, if international Ebola containment efforts fail in the Congo, it would mark the first time the virus was not stopped since 1976 when Ebola was first identified. The current Ebola outbreak is going on its fourth month, totaling 300 cases and 186 deaths as of November 4th.

The problems with containment of this particular Ebola outbreak stem from the fact that the disease is spreading in an active war zone with several armed groups attacking health officials, government aids and civilians. Some civilians with Ebola have refused treatment, and health care workers are still being infected. About 60 to 80 percent of new cases do not show an epidemiological link to prior cases.

The daily rate of new Ebola cases had more than doubled in early October. In addition, there is community resistance and a deep mistrust of the government as the raging outbreak continues to spread through an active war zone.  The World Health Organization (WHO), CDC and other international health organizations say they are worried about the current Ebola outbreak spreading to port cities like Butembo, which will only exacerbate infection transmission rates.