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A doctor has become the first probable Ebola case in one of the eastern Democratic Republic of Congo’s “high insecurity zones,” which are dogged by militia violence and hard to access, a scenario “we have all been dreading,” the WHO said on Friday.

Since the outbreak erupted on Aug. 1, 103 confirmed and probable cases of Ebola have been identified in North Kivu and Ituri provinces, including 63 deaths, the health ministry said in an overnight update.

The doctor living in Oicha town in North Kivu has been re-hospitalized with Ebola symptoms after his wife was confirmed as having the disease when she traveled to the nearby city of Beni, Dr. Peter Salama, the World Health Organization’s head of emergency operations, said.

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Oicha is almost entirely surrounded by ADF Ugandan Islamist militia, there are “extremely serious security concerns,” he said. Aid workers, priests and government officials are held hostage in the area, he said.

The doctor’s initial test for Ebola – which causes vomiting, fever and diarrhea – had been negative, but fresh results are awaited, Dr. Salama told Reuters.

So far, 97 of the doctor’s contacts who may have been exposed to the virus have been identified, and vaccination has begun in the town, he added.

“So for the first time, really, we have a confirmed case and contacts in an area of very high insecurity. It really was the problem we were anticipating and the problem at same time that we were dreading,” Dr. Salama told a news briefing.

WHO and health experts reached Oicha with armed escort by MONUSCO troops this week, he said, adding: “We know from that incident now in Oicha we are going to have to operate in some very complex environments due to security and access concerns.”

In a further worrying development, angry youth burned down a health center in another village, where vaccinations were under way, after learning of a death from Ebola, Mr. Salama said.

More than 2,900 people have been vaccinated against Ebola since the outbreak began, he said.

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“We are at quite a pivotal moment in this outbreak in terms of the evolution of the outbreak epidemiologically and in terms of the response,” he said.

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