With only 4 previous global health emergencies declared in history, the World Health Organization announced Wednesday that the deadly Ebola outbreak in Congo is now an international health emergency after a case was confirmed in a city of 2 million people.

Even though other experts say it has long met the required conditions, the World Health Organization declined on three previous occasions to advise the United Nations health agency to make the declaration for this outbreak. Since August, more than 1,600 individuals have died in the second-deadliest epidemic of Ebola in history that is taking place in a region defined as a war zone.

The declaration comes days after a single case has been verified with an international airport in Goma, a significant regional crossroads on the Rwandan frontier in northwestern Congo. Also, a sick Congolese fish trader traveled to Uganda and back while symptomatic — and later died of Ebola.