For the first time since it was identified in 1976, Ebola, a fatal viral disease, may not be able to be contained in the North Kivu province of the Congo.

Robert Redfield, the director of the the Centers for Disease Control and Prevention (CDC), said in a briefing on Capitol Hill hosted by the the Johns Hopkins Center for Health Security that the Ebola outbreak has become so grave that public health leaders and specialists should work on possible solutions to contain the disease internationally, according to the Washington Post.

Redfield stated, “I do think this is one of the challenges we’ll have to see, whether we’re able to contain, control and end the current outbreak with the current security situation, or do we move into the idea that this becomes more of an endemic Ebola outbreak in this region, which we’ve never really confronted.”

The Congo’s Ebola outbreak has been documented in 300 cases. It has also occurred in an active war zone, which complicate the work of health response teams. For example, the United States removed CDC Ebola experts due to security risks.

Tom Inglesby, director of the Johns Hopkins Center for Health Security, stated, “This will mean that we’ve lost the ability to trace contacts, stop transmission chains and contain the outbreak.”

North Kivu is also home to Butembo, a significant regional trading port. Since North Kivu has a population of 6 million, the outbreak will have far-reaching implications for international travel.

As the virus spreads, public health experts advise vaccinating more of the population instead of only those who have contacted infected people.