AP Explains: Why Ebola is now an international emergency

The World Health Organization says the deadly Ebola virus outbreak in northeastern Congo is now an international health emergency . More than 1,600 people have died since August in the second-worst outbreak of the disease in history. Wednesday’s declaration was sparked by the outbreak’s spread to a city of more than two million people , Goma, on the border with Rwanda.

Here’s a look at Ebola and the unprecedented challenges health workers face in trying to contain what the WHO chief has called one of the world’s most dangerous diseases in one of the world’s most dangerous regions.

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WHAT IS EBOLA?

The Ebola virus can spread quickly and be fatal in up to 90% of cases. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus is most often spread by close contact with bodily fluids of people exhibiting symptoms and with contaminated objects such as sheets. Health care workers are often at risk.

There is no licensed Ebola treatment but early care such as rehydration helps to improve chances of survival. Some patients in this outbreak have received experimental treatments but their effect has not been fully studied.

An experimental Ebola vaccine has been effective in its first widespread use, and more than 163,000 people have been vaccinated. The vaccine’s testing was sped up during the West African outbreak in 2014-16 that killed more than 11,300 people.

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WHY IS THIS OUTBREAK UNIQUE?

Health workers call this the first Ebola outbreak to occur in what is essentially a war zone. Dozens of rebel groups are active in Congo’s northeast, killing hundreds of people in recent years. Attacks have led to a traumatized population that can be wary of outsiders and some authorities.

Some residents question why so much attention and money is spent on Ebola, a disease not seen in this part of Congo until now, instead of other deadly diseases such as malaria.

Amid misunderstandings, responders have struggled to explain the importance of preventative measures. Some health workers have been attacked. An epidemiologist with WHO was shot dead earlier this year. The attacks have led to spikes in cases and hurt the painstaking work of tracing thousands of people who come into contact with those infected.

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WHAT’S THE SIGNIFICANCE OF DECLARING A GLOBAL EMERGENCY?

Declaring a global health emergency often brings an increase in international attention and aid. While WHO has said tens of millions of dollars are needed to help contain this outbreak, authorities in Congo lobbied against a declaration amid concerns that it could hurt the economy and lead jittery governments to close borders.

This was the fourth time the WHO expert committee met on this outbreak, which some experts have said met the criteria for a global emergency months ago. For such a declaration, an outbreak must constitute a risk to other countries and require a coordinated response.

The WHO expert committee met last month after the outbreak spread into nearby Uganda . But for months health experts have feared a spread into Goma, a major regional hub. “From here you can fly to everywhere in the world,” Dr. Harouna Djingarey, infectious disease program manager for WHO’s office in eastern Congo, said this week.

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