The Ebola outbreak in the Democratic Republic of Congo is spreading to new areas, with more than 70 per cent of new cases linked to people who were not previously identified as contacts of confirmed patients.

The development has raised concerns in North Kivu, which has now emerged as the new epic centre of the outbreak, with health workers reporting shortages of personnel, medical supplies and coordination in the response.

Africa CDC Director-General Dr Jean Kaseya says more than 60 per cent of deaths are occurring outside treatment centres, while only 23 per cent of people who were expected to be followed up after coming into contact with infected patients have so far been reached.

Kaseya says this suggests that there could be many patients who have not been tested, treated or recorded, making it increasingly difficult to contain the spread of Ebola.

North Kivu now accounts for about 40 per cent of newly confirmed cases in Congo, compared with 24 per cent at the end of August.

Médecins Sans Frontières (MSF) says the response in the province has been chaotic, citing a lack of coordination, health workers and sufficient organisations to support affected communities.

Some treatment centres are also struggling with increasing numbers of patients as well as shortages of health workers and medical supplies. As a result, some patients have been seeking care at regular health facilities.

The outbreak, which was declared in May, has already recorded more than 8,500 cases in Congo, making it the fastest-growing Ebola outbreak recorded in the country.

Health experts say population movements caused by conflict, mining activities, mistrust of authorities and misinformation about the disease continue to pose major challenges to efforts to contain the outbreak.

Health authorities are urging communities to cooperate with health workers by reporting suspected cases, helping trace people who may have been exposed and supporting safe burials to prevent further transmission.