An outbreak of the deadly Ebola virus in two eastern provinces of Congo has spread to a major international trading hub with almost a million residents, Congolese health officials said Wednesday. 
Health officials in Butembo, a city with close links to neighboring Uganda, said they had confirmed that a man who died at Butembo University Hospital had tested positive for the virus. 
The Congolese health ministry said the man had contact with an Ebola patient in Beni, a city about 25 miles north of Butembo where almost two dozen Ebola victims have been identified, before fleeing south.
The health ministry said it had prepared the hospital staff to deal with potential Ebola cases. Ndjoloko Tambwe Bathe, who is heading the response for the Congo health ministry, traveled to the city on Wednesday to set up a full response team. The ministry is setting up an Ebola treatment unit, the fifth established in the region since the outbreak began.


The most recent outbreak of the Ebola virus began in July in North Kivu Province, home to about 8 million residents and about a million internally displaced refugees. So far, health officials have identified 129 probable and confirmed cases. Eighty-nine people have died.
Most of those cases have been in the Mabalako health district, where the first cases were reported in late July after a funeral for a woman in the town of Mangina. Several relatives who attended the funeral, who probably washed and dressed the woman’s body to prepare her for the afterlife, later came down with symptoms.
Several probable and confirmed cases have been identified in neighboring Ituri Province, north of North Kivu.
Public health officials had already been worried about the spread of the virus once it reached Beni, a city of about a quarter million residents that also has close trade ties to Uganda. Now that it has reached Butembo, those officials said, their fears have grown.
“Good news is case detected quickly, response already in place & expanding,” Peter Salama, the World Health Organization’s deputy director-general for Emergency Preparedness and Response, wrote on Twitter. “Bad new[s] is increases risk of further spread, and having Ebola in an urban centre makes ending the outbreak much harder.”


In the weeks after the outbreak began, global public health officials and nongovernmental organizations have raced hundreds of epidemiologists and technicians and millions of dollars in relief aid to the region. Those officials had identified at least 4,300 people who had come into contact with someone infected with the Ebola virus, and more than half of those people remain under watch in case they develop symptoms. 
Public health officials also worried that the security situation in North Kivu Province would hinder their ability to track down those who had come into contact with Ebola patients. Ethnic violence and attacks from Islamist guerrillas based in Uganda made some of that critical contact-tracing far more difficult.

In an interview last week from Beni, WHO spokesman Tarik Jasarevic said contact tracers were largely confident that they had identified virtually all of those who could potentially become infected.
“The feeling is that we have, in Mangina, the resources. It seems the cases that are coming are coming from the contacts, which is a good sign,” Jasarevic said. He said the WHO teams had been able to access all the villages where Ebola cases might be present.

The Congolese Health Ministry said a vaccination campaign that has been underway for weeks had already reached 6,343 people, including more than 3,000 in Mabalako, almost 2,000 in Beni and more than a thousand in Mandima. Front-line health care workers and those who might come into contact with an Ebola victim get the highest priority for the new vaccine.
This is the second Ebola outbreak this year in which the new vaccine has been deployed. The vaccine, developed during the waning days of an Ebola outbreak in the West African nations of Liberia, Sierra Leone and Guinea, was earlier deployed to Equateur Province, a region about 750 miles west of North Kivu.

None of those who received the vaccine in Equateur subsequently fell ill.
Since the Ebola virus was first discovered in 1976, there have been 14 confirmed outbreaks, mostly in Congo — or, as it was then known, Zaire. The outbreak in West Africa killed more than 11,300 people, by far the deadliest of any epidemic. The latest outbreak is already the ninth-deadliest of its kind.