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Authorities in the Congolese border city of Goma have confirmed a second case of Ebola, raising fears that the outbreak, now the second-deadliest ever, could cross the border into Rwanda.

The second case, in a 46-year-old father of 10 from Ituri province, is thought to be unrelated to the first Goma case, according to local health officials. The man traveled hundreds of miles to Goma from a mining area in northeastern Congo on July 13 but didn’t start showing symptoms until July 22. He is now isolated at an Ebola treatment center.

Authorities say they have significantly boosted measures to prevent the spread of the disease beyond the borders of the Democratic Republic of Congo (DRC).

This includes the vaccination of health workers in Rwanda, Uganda and South Sudan, 24-hour monitoring at Goma’s international airport, and the widespread use of an experimental but effective Ebola vaccine.

But the World Health Organization says the risk of regional spread remains “very high.”

Goma, which is home to two million people, is a major transit hub in northeastern Congo and sits on the Rwandan border.

The outbreak has already crossed one border, with three confirmed cases reported in one family in Uganda, resulting in the death of a five-year-old boy in June. However, thanks to coordinated efforts to prevent the spread of the disease, Uganda was declared Ebola-free again last week.

The Ebola outbreak in the DRC began a year ago, but the rate of infection has risen dramatically in recent months. This case marks the second case reported in Goma in the space of two weeks.

This has become the second-deadliest Ebola outbreak ever. As of July 28, there have been 2577 confirmed cases including 1790 deaths.

Two weeks ago the World Health Organization declared the outbreak a “public health emergency of international concern.” It’s the agency’s highest alarm, and this is only the fifth time in its history the designation has been used.

“The risk of national Ebola spread is high,” Tedros Adhanom Ghebreyesus, WHO director-general said in a tweet Wednesday. “The population in Goma is highly mobile, so this is an event we have anticipated. This is why we have been doing intensive preparedness work in Goma so that any new case is identified and responded to immediately.”

While the WHO’s declaration saw millions of dollars of additional funding flood in from donors around the world, experts on the ground believe money alone will not help solve the problem that has persisted for 12 months.

Part of the problem is that the crisis is taking place in a region that has never experienced an Ebola outbreak before, and many in the community simply don’t believe Ebola is real.

This has led to a distrust of health workers, leading to almost 200 attacks against healthcare workers or Ebola treatment facilities. The mistrust of outsiders has also seen many Congolese refuse the Ebola vaccine, preferring to use alternative treatments, including witch doctors.

“It is critical that the resources are used not only on a medical solution but also on the community engagement and that should be central in the overall response to ensure that the response is adapted and will produce lasting results to stop the epidemic,” Benoit Munsch, DRC Country Director for humanitarian agency CARE International currently based in Goma, told VICE News.