‘Game changer’ as Ebola outbreak hits urban centre in the Democratic Republic of the Congo.

The Ebola outbreak in the Democratic Republic of the Congo has entered a “new phase” after a case was confirmed in a city of 1.2 million people amid fears infections could rapidly spread.

A victim of the deadly virus was identified in the northwestern city of Mbandaka, 150km from the rural area where the outbreak was first detected earlier this month, DRC’s Health Minister Oly Ilunga said on Thursday.

The outbreak previously appeared to be confined to the Ikoko Impenge area, near the town of Bikoro, in the central African nation’s Equateur Province.

“We are entering a new phase of the Ebola outbreak that is now affecting three health zones, including an urban health zone,” Ilunga said in a statement.

The World Health Organization (WHO) estimates 23 deaths in DRC in recent weeks were linked to Ebola, which has no proven cure.

Only three cases, one of which was fatal, have been confirmed by laboratory tests since an outbreak of the virus was identified by the health ministry on May 8, however.

“We expect an increase in the number of cases confirmed in the coming days and weeks, so we are stepping up our intervention efforts because medical teams on the ground will need more support and capacity and increased access to medicines and equipment,” health ministry spokeswoman Jessica Ilunga told Al Jazeera.

Another 21 people have been, or continue to be, held in quarantine because they are suspected to have contracted the virus, Ilunga added, though medical tests have yet to confirm Ebola infection.

Results on the cases are expected within 24 hours, Ilunga said.

WHO response

The WHO, which has been coordinating with DRC’s health ministry in an attempt to combat the outbreak, said it would hold an emergency meeting on Friday to consider the possible international risks posed by Ebola.

Health officials said the newest case was worrying.

“This is a significant development because it’s harder to control an outbreak in an urban setting because there are many more prospects for contact than in a rural area,” WHO spokesman Tarik Jasarevic told Al Jazeera.

An infected person is estimated to have between 100-150 “contacts” with other people per day, a figure that may be higher in densely populated areas, Jasarevic added.

The WHO is sending 7,540 experimental vaccines to DRC, 4,300 of which have already arrived in the capital, Kinshasa, as part of a coordinated response to the outbreak.

Ebola, which can cause multiple organ failure, is passed from human to human by contact through the mouth, nose, or broken skin with blood or other bodily fluids of those infected.

The average fatality rate among those infected with the virus is about 50 percent, according to the WHO.

‘A game changer’

Earlier on Thursday, WHO Deputy Director Peter Salama said in a tweet that the latest confirmed case marked “a game changer” in the outbreak and would make beating back the virus “much tougher”.

https://twitter.com/PeteSalama/status/997028865934442497?ref_src=twsrc%5Etfw

Last week, Salama told reporters a “major urban outbreak” could occur if Ebola reached a city of Mbandaka’s size.

The latest cases in DRC come less than a year after its last confirmed Ebola scare in May 2017, during which eight people were infected, four of whom died.

Nine Ebola outbreaks have occurred in DRC since the virus was first identified in 1976.

An Ebola epidemic killed about 11,300 people in West Africa as it surged through Guinea, Sierra Leone, and Liberia between 2013 and 2016.

Humans contract the virus from infected animals, typically fruit bats, chimpanzees, gorillas and monkeys.

Early symptoms include fever, muscle pain and fatigue, followed by vomiting, diarrhoea, rashes and bleeding – both internal and external – apparent in the gums, eyes, nasal passages and faeces.

Ebola takes its name from the DRC’s Ebola River, a tributary of the River Congo.