More than 10,000 people have been infected with Ebola and nearly half of them have died, according to figures released Saturday by the World Health Organization, as the outbreak continues to spread.

The Ebola epidemic in West Africa is the largest ever outbreak of the disease with a rapidly rising death toll in Guinea, Liberia and Sierra Leone. There have also been cases in three other West African countries, Spain and the United States.

The U.N. health agency said Saturday that the number of confirmed, probable and suspected cases has risen to 10,141. Of those cases, 4,922 people have died. Its figures show about 200 new cases since the last report, four days ago.

Even those grisly tolls are likely an underestimate, WHO has warned, as many people in the hardest hit countries have been unable or too frightened to seek medical care. A shortage of labs capable of handling potentially infected blood samples has also made it difficult to track the outbreak. For example, the latest numbers show no change in Liberia’s case toll, suggesting the numbers may be lagging behind reality.

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