A woman has contracted Ebola and died in the Democratic Republic of Congo (DRC), marking the first case since the Central African country ended its last outbreak last year, the health ministry said on Sunday.

The woman was found with symptoms of the virus in the town of Biena, near the city of Butembo, on February 1, and died in hospital on February 3. She was married to a man who had contracted the virus in a previous outbreak.

“The provincial response team is already hard at work. It will be supported by the national response team which will visit Butembo shortly,” the ministry said in a statement.

Health workers at an Ebola treatment center at Beni, the Democratic Republic of Congo, in July 2019.

Health workers at an Ebola treatment center at Beni, the Democratic Republic of Congo, in July 2019.

The World Health Organization (WHO), which is helping response efforts, says it has tracked more than 70 contacts of the woman. The places she visited are also being disinfected.

It is not yet clear if this case marks the start of a new outbreak or if it’s a manageable flare-up from the last one. Samples from the woman have been sent to the capital Kinshasa to confirm the link to the previous outbreak.

“It is not unusual for sporadic cases to occur following a major outbreak,” the WHO said in a statement. It added that WHO epidemiologists are on the ground investigating, but that emergency response efforts had been hampered by ongoing insecurity in the region.

Democratic Republic of the Congo declares the end to its 11th Ebola outbreak

Democratic Republic of the Congo declares the end to its 11th Ebola outbreak

The emergence of more cases could complicate efforts to eradicate Covid-19, which has infected 23,600 people and killed 681 in the DRC. A coronavirus vaccination campaign is expected to start in the first half of this year.

However, an Ebola vaccine and a well-drilled health system means the country is better-placed than ever to deal with outbreaks, even in urban settings. Ebola has a much higher death rate than Covid-19, but unlike coronavirus it is not transmitted by asymptomatic carriers. And lessons learned from the fight with those multiple outbreaks have helped efforts to stop the spread of coronavirus, experts say.

A recurring problem

The DRC declared the end of its 10th Ebola outbreak last June, and of its 11th outbreak in a different region last November.

The Ebola virus disease can cause fever, headache, muscle pain, vomiting, and diarrhea, among other symptoms. It’s transmitted through contact either with infected animals or with the bodily fluids of infected people.

DRC's health system is 'on life support' as it fights several killer diseases, including coronavirus

DRC’s health system is ‘on life support’ as it fights several killer diseases, including coronavirus

The DRC’s equatorial forests have been a breeding ground for Ebola. The disease killed nearly 2,300 people between 2018 and 2020, in the world’s second-largest Ebola outbreak on record.

The country has experienced 11 outbreaks since the virus was first discovered near the Ebola River in the DRC in 1976 — more than double any other country.

Furthermore, ongoing militia violence in the northeast, including attacks against health centers, have claimed the lives of residents and health workers. Nearly a million people were forced to flee their homes in 2019 alone, the UN agency said, making access to medical care and prevention even more difficult