The World Health Organization is expected on Friday to declare that an outbreak of the deadly Ebola virus rampaging through two countries in Central Africa represents an international health emergency, a move that would be intended spur international donors to race resources to the impacted region in hopes of curbing its spread.
The decision would come days after the virus spread across international boundaries for the first time. For ten months, the Ebola virus had been contained within two provinces of the Democratic Republic of the Congo. But this week, at least two cases have emerged in neighboring Uganda.
The declaration would be only the fifth time the WHO has labeled a viral outbreak a Public Health Emergency of International Concern. Previously, the WHO has used the declaration to highlight the spread of swine flu in 2009, polio and the Ebola virus in 2014 and the Zika virus in 2016.
The outbreak has infected 2,108 people in Congo so far, the health ministry said Thursday. An estimated 1,411 people have died, though that number is likely lower than the actual number of victims, experts have said.
There had been some cause for hope in recent days as the number of Ebola cases discovered on a daily basis declined. But on Thursday, Congo's health ministry said it had identified 24 new cases, one of the worst days of the entire epidemic. Six people died, including three who had not sought treatment a worrying sign that impacted communities are still not seeking treatment for those who begin to show symptoms.
The virus spread to Uganda when six members of a family fled a treatment facility near the border and crossed through remote tracks to evade border control. The family sought treatment at a hospital in Uganda, where they were isolated. A five-year old boy became Uganda's first victim. His 50-year old grandmother also died.
The remaining members of the family and a nanny were taken back to a health facility in Congo, where treatment facilities are better equipped to care for patients, the health ministry said. By Friday, there were no more identified cases in Uganda.
But the WHO's emergency declaration is meant to get the world's attention at a time when the international sense of urgency has faded.
Donor countries and nonprofit groups have already contributed or pledged tens of millions of dollars to the response. WHO alone has more than 700 responders in North Kivu and Ituri provinces, the two areas that have experienced the brunt of the outbreak. Groups like UNICEF and the Red Cross/Red Crescent have hundreds more people in the field.
But rampant violence against health responders has caused problems and delays that have allowed the virus to spread. Doctors Without Borders pulled its personnel out of the most impacted areas after several attacks on medical facilities. A World Health Organization epidemiologist was killed in one attack on a facility in the city of Butembo in April.
The security situation has delayed American involvement. Responders from the Centers for Disease Control and Prevention and USAID have been limited to preparing neighboring countries and organizing the response from Goma and Kinshasa after the State Department decided the region presented too great a security risk.
Neighboring countries have been preparing for the possibility that the virus might jump borders in a region where the population is highly mobile and where more than a million people are displaced from their homes because of decades of ethnic conflict.
Thousands of medical personnel in Uganda, Rwanda and South Sudan have already received a vaccine to protect themselves, and border guards have screened more than 65 million people crossing through 80 ports of entry and operational health checkpoints.
CORRECTION: An earlier version of this story misstated that the outbreak had already been declared an international emergency due to an editing error.