The cases represent a setback to costly efforts to contain the virus, including the use of an experimental vaccine, and show efforts to stem its spread can be hampered by age-old customs or scepticism about the threat it poses.
Three patients left of their own accord from the isolation zone of the Wangata hospital in Mbandaka city between Sunday and Tuesday, said Henry Gray, emergency coordinator for Medecins Sans Frontieres, or Doctors Without Borders. The other was sent back to hospital on 22 May and died that evening, according to MSF.
"We talk to them about what Ebola is, how it is transmitted, what the symptoms are", said Balthazar Moyongo, 50, a community worker in Mbandaka.
So far, no other NSC staff or the CDC director have made public statements, the report said, noting that in comparison, senior Obama administration officials had highly visible roles.
"This is a hospital".
"It is critical to remember that the Ebola outbreak in northwest DRC is not the only challenge this country is facing", Salama said.
But lack of trust between patients and doctors is often the reason those sick with Ebola would attempt to evade treatment, which can be intimidating when it involves isolating them from their families and only interacting with medical professionals dressed in hazmat suits.
Prototype vaccine will first be given to frontline health workers and then to people who have been in contact with Ebola cases.
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"It is unfortunate but not unexpected". "It is normal for people to want the loved ones to be at home during what could be the last moments of life".
USA health authorities said on Wednesday they were preparing to send an experimental Ebola treatment to the Democratic Republic of Congo for use in a clinical trial aimed at stemming an outbreak in the country that has spread to Mbandaka, a city of about 1.5 million people.
"We are on the epidemiological knife-edge", Peter Salama, head of emergency responses at the World Health Organization, said at a special meeting to discuss the crisis in Geneva.
The UN health agency has been scrambling in this outbreak to prove it has learned its lesson after bungling the initial response to the 2013-2015 Ebola epidemic in West Africa.
Health officials are particularly concerned by the disease's presence in Mbandaka, a crowded trading hub upstream from Congo's capital, Kinshasa, a city of some 10 million people.
It will be important to watch if the epidemic jumps worldwide borders, spreads throughout the urban centre of Mbandaka, or spreads along the Congo River to other populations, he said. This aggressive tracing is done in an effort to contain the spread of the deadly disease, thus it is especially unsafe when infected individuals move beyond their containment.
The outbreak began in rural northwestern DRC in a remote location called Bikoro.
Ebola first appeared in 1976 in Sudan and Congo, and the virus takes its name from a river in the latter. It is spread through direct contact with body fluids from an infected person, who suffers severe bouts of vomiting and diarrhoea.
The vaccine, provided by U.S. company Merck, is still in the test stages but it was effective toward the end of the Ebola epidemic that killed more than 11,300 people in Guinea, Sierra Leone and Liberia from 2014 to 2016.