NAIROBI — Congo’s Health Ministry confirmed the first case of the Ebola virus in the city of Goma late Sunday night, in what could be a major escalation for the outbreak raging in the country.

Goma is home to more than a million people and lies directly on Congo’s border with Rwanda, where tens of thousands cross on foot daily.

The ongoing Ebola outbreak has spread through Congo’s North Kivu and Ituri provinces for almost a year. A small number of cases were confirmed but quickly contained in neighboring Uganda in June after a Congolese family sought treatment there. 

With the arrival of the case in Goma, the virus is present in two cities of more than a million people, Goma and Butembo.

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At a high-level meeting of global health officials in Geneva, the head of the World Health Organization said he would reconvene a panel of scientists to determine whether the outbreak ranks as a public health emergency of international concern, a designation that could unlock more resources to stop it but that has been declined three times before. 

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The new case in Goma involves a pastor who traveled there from Butembo by bus, according to the Health Ministry. The other 18 passengers on the bus are set to be given an experimental vaccination that has proved largely successful. Then health workers will follow up with all contacts made by the confirmed case as well as all the passengers.

On Tuesday the government said the pastor died.

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“Because of the speed with which the patient was identified and isolated, and the identification of all the other bus passengers coming from Butembo, the risk of it spreading in the rest of the city of Goma is small,” the ministry said in a statement.

Major checkpoints between Butembo and Goma were put in place to prevent the spread of the virus. But those are effective only if travelers sick with Ebola show symptoms.

“A person may or may not have a fever or symptoms at a certain time, and so may not raise concerns,” said Ibrahima Socé Fall, WHO assistant director-general for emergency response. “This is why so much energy is put into preparedness measures. The structures which were on standby are now in action.”

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The outbreak has killed 1,665 people as of Monday, while nearly 700 have survived the virus, which causes high fevers and internal bleeding. Days with dozens of new cases are common, despite a massive public health intervention across the affected area. 

Health workers worry that some cases — if not whole transmission chains — are in places that are inaccessible because of poor infrastructure or insecurity, making the extent of the outbreak hard to fully measure.

The area where the outbreak is taking place is also home to one of Congo’s most protracted and violent conflicts — a patchwork of ethnic militias, vigilantes and government-aligned forces. 

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Fighting has at times targeted the Ebola response, hampering it and leading to spurts of new cases. Near the outbreak’s epicenter in the city of Beni on Monday, two health workers were killed by unknown assailants. Tedros Ghebreyesus, the WHO director-general, said there have been almost 200 attacks on health workers, killing seven, since January.

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The current outbreak is the second-worst ever recorded, after an epidemic between 2013 and 2016 killed more than 11,300 people in West Africa.

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