Uganda begins countdown to end Ebola outbreak

Uganda has begun a 42-day countdown towards declaring its Ebola outbreak over after the final confirmed patient tested negative twice and was discharged from hospital on Thursday.

The patient, a national of the Democratic Republic of the Congo, had been receiving treatment at Mulago National Referral Hospital in Kampala. Health authorities said the country could be declared free of the outbreak if no additional infections are detected during the monitoring period.

Uganda has recorded 20 confirmed cases of Ebola disease caused by the Bundibugyo virus since the outbreak was identified in mid-May. Two patients died and 18 recovered. Fifteen infections involved people who had travelled from the Democratic Republic of the Congo, while five were linked to transmission within Uganda.

The last confirmed infection was reported on June 21. Surveillance continued while the remaining patient underwent treatment and contacts completed observation. More than 800 contacts have been listed during the response, with no individuals now under active follow-up.

The 42-day period represents twice the maximum 21-day incubation period for Ebola. During the countdown, health teams will continue testing suspected cases, investigating unexplained deaths and monitoring communities where infections or contacts were identified.

Government officials cautioned that the patient’s discharge did not mean the health emergency had ended. The country remains vulnerable because the much larger outbreak across the border in eastern Congo is still expanding, creating the possibility of further imported infections through formal crossings or unofficial routes.

Uganda’s outbreak was linked epidemiologically to transmission in Congo, where more than 2,000 confirmed infections and nearly 800 deaths have been recorded. The Bundibugyo strain has spread across several eastern provinces amid armed conflict, displacement, shortages of medical supplies and attacks on health workers.

A high proportion of new Congolese cases cannot be connected to known transmission chains, suggesting that many infections remain undetected. Patients have also died in communities without reaching treatment centres, complicating contact tracing and increasing the risk of exposure during home care and burials.

Uganda strengthened screening, laboratory capacity and isolation facilities after the first imported cases were identified in Kampala. Treatment units were activated in the capital and neighbouring Wakiso district, while trained health workers were deployed to manage patients and trace contacts.

Cross-border cooperation has included the deployment of laboratories and response personnel to affected Congolese areas. Authorities have also maintained health screening at entry points, although the movement of traders, displaced families and informal workers across the border remains difficult to track fully.

The government is pressing countries to remove travel restrictions imposed on Uganda after the outbreak began. At least 15 countries introduced measures affecting travellers, despite global health guidance discouraging broad restrictions that can disrupt trade, tourism and humanitarian operations.

Officials argue that Uganda contained transmission, maintained a fatality rate of 10 per cent and demonstrated that its surveillance system could identify imported infections. They have warned, however, that lifting controls must not weaken precautions for passengers arriving from areas where active transmission continues.

The United States has imposed tighter requirements on travellers from Uganda and Congo, including quarantine measures for some returning citizens. Humanitarian organisations have raised concerns that such policies could discourage doctors and other specialists from joining response missions in affected areas.

Unlike the Zaire Ebola strain, Bundibugyo virus disease has no approved vaccine or specifically licensed treatment. Patients receive supportive care, including fluids, oxygen, management of symptoms and treatment for secondary infections.

Clinical trials are evaluating experimental therapies, including combinations of monoclonal antibodies and antiviral medicines. Researchers are also developing a vaccine designed specifically for the Bundibugyo strain, with early-stage human testing planned in Britain using doses manufactured by the Serum Institute of India.

The outbreak has renewed concerns about gaps in preparedness for less common Ebola strains. Vaccines and antibody treatments developed during previous epidemics primarily target Zaire Ebola and may not provide adequate protection against Bundibugyo infections.