Congo’s Ebola outbreak has spread to a crossroads city of more than 1 million people, authorities said Thursday in a troubling turn that marks the first time the vast, impoverished country has had to fight the lethal virus in an urban area.

Medical teams rushed to track down anyone thought to have had contact with infected people, while the World Health Organization continued shipping thousands of doses of an experimental vaccine.

One confirmed case and one suspected case of hemorrhagic fever were discovered in an area that includes Mbandaka, a densely populated provincial capital on the Congo River, said Congo’s Health Minister Oly Ilunga.

The city is about 150 kilometers (93 miles) from Bikoro, the rural area where the outbreak was announced last week.

“The scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area,” said Henry Gray, emergency coordinator in Mbandaka for Doctors Without Borders.

A total of 44 cases of Ebola have been reported in Congo since last week: three confirmed, 20 probable and 21 suspected, according to WHO. Twenty-three people among those cases have died.

Up to now, the outbreak was confined to remote rural areas, where Ebola is easier to contain. The virus, which is spread by bodily fluids, can travel far more easily in heavily populated areas.

“We are entering a new phase of the Ebola outbreak,” Ilunga said.

Mbandaka, a city of almost 1.2 million, is a busy travel corridor in Congo’s northwest Equateur province and is upstream from the capital, Kinshasa, a city of about 10 million. It is an hour’s plane ride from Kinshasa or a four- to seven-day trip by river barge.

Doctors Without Borders said 514 people believed to have been in contact with infected people are being monitored. WHO said it is deploying about 30 more experts to the city.

Those exposed will for the first time in Congo receive Ebola vaccinations, the health minister said. WHO has sent 4,000 doses to Congo and said it will dispatch thousands more in the coming days as needed.

“This is a concerning development, but we now have better tools than ever before to combat Ebola,” Tedros Adhanom Ghebreyesus, WHO director-general, said of the new urban case.

The vaccine has been shown to be highly effective against Ebola. It was tested in Guinea during the outbreak that killed more than 11,300 people in West Africa from 2014 to 2016.

WHO has said it will use the “ring vaccination” method. It involves vaccinating contacts of those feared infected, contacts of those contacts, and health care and other front-line workers.

This is the ninth Ebola outbreak in Congo since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.

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