Uganda Confirms Five Ebola Cases as Bundibugyo Virus Spreads Across Border
Uganda confirmed three new Ebola infections on Saturday, May 23, raising the country’s total to five cases since the outbreak was first detected there on May 15. The new patients include a Ugandan driver, a Ugandan health worker, and a Congolese woman who travelled through several Ugandan cities before testing positive, according to Uganda’s Ministry of Health.
The health ministry identified the three patients in a statement published on X, naming them as a Ugandan driver, a Ugandan health worker, and a woman from the neighbouring Democratic Republic of Congo, which is the epicentre of a deadly regional outbreak. RTÉ
The driver had transported Uganda’s first confirmed patient, while the health worker had been exposed while caring for that same patient. Both are receiving treatment and were identified among known contacts, the ministry said. WHBL
The third case is more complex — and illustrates the cross-border mobility that is making containment difficult. The Congolese woman entered Uganda with mild abdominal symptoms, later travelling from Arua, near the border, to Entebbe before seeking care at a private hospital in the capital Kampala. She initially improved and returned to Congo, but subsequently tested positive after a follow-up prompted by a tip-off from a pilot involved in transporting her. U.S. News & World Report
“The ministry continues to strengthen surveillance, case management, contact tracing and public awareness efforts to contain the outbreak and protect the health and safety of all Ugandans,” the health ministry said in its statement. RTÉ
Charles Olaro, Uganda’s Director General of Health Services, confirmed the new cases in a statement posted on social media on Saturday. Bloomberg
All identified contacts linked to the confirmed cases are being closely monitored, the ministry said, urging the public to remain vigilant and report suspected symptoms. WHBL
On Thursday, May 22, Uganda had already taken a significant step to reduce transmission. Ugandan authorities suspended all public transport to the DRC after confirming its first two cases — one infection and one death — involving Congolese nationals who had crossed the border. Channels Television
The wider regional picture is significantly more alarming. The World Health Organization has declared the outbreak of the rare Bundibugyo strain a public health emergency of international concern and said the risk of a national epidemic in the Democratic Republic of Congo is “very high.” Nearly 750 suspected cases and 177 suspected deaths have been recorded in Uganda’s neighbour, which remains the centre of the outbreak. WHBL
WHO Director-General Dr. Tedros Adhanom Ghebreyesus said on Friday, May 22, that the situation in the DRC was particularly difficult to manage. He said health workers were scrambling — in highly insecure, remote areas — to catch up with the spread of the virus and track down contacts of everyone thought to be infected. Channels Television
The WHO has cited late detection, the absence of a vaccine or virus-specific therapeutics, widespread armed violence, and high population mobility as factors making Congo especially vulnerable. Those same factors — in particular, the lack of any approved treatment — separate this outbreak from past Ebola crises where experimental drugs were available. WHBL
The Bundibugyo strain, which drives the current outbreak, is one of the rarer variants of the Ebola virus. Experts suspect the outbreak had been circulating undetected for some time before laboratory testing in Kinshasa confirmed the Bundibugyo virus on May 15. The outbreak originated in Ituri Province in northeastern DRC, in areas affected by insecurity, population displacement, mining-related population movement, and frequent cross-border travel — all of which may increase the risk of further transmission. Channels TelevisionCDC
The WHO’s May 17 PHEIC determination noted that the high positivity rate among initial samples — eight positives among 13 collected across various areas — pointed toward a potentially much larger outbreak than was being detected and reported, with significant local and regional risk of spread. At least four healthcare worker deaths in a clinical context consistent with haemorrhagic fever had been reported, raising concerns about transmission within health facilities. WHO
For Uganda, the cross-border nature of all five confirmed cases presents particular challenges for the national response. Three of the five patients are directly or indirectly linked to a Congolese national who entered the country — and the case of the Congolese woman who travelled from Arua to Entebbe to Kampala and then returned to DRC before testing positive demonstrates the difficulty of catching cases before they move.
The CDC noted that the outbreak is occurring in areas affected by insecurity, population displacement, and frequent cross-border travel, all of which may increase the risk of further transmission, and classified the risk of spread to the United States as low at this time. CDC
For DRC’s neighbours — Rwanda, Burundi, South Sudan, Tanzania, Republic of Congo, Central African Republic, Zambia, Angola, and Uganda — the WHO’s PHEIC designation places a formal obligation to prepare. The WHO stated that neighbouring countries sharing land borders with the DRC are considered at high risk for further spread due to population mobility, trade and travel linkages, and ongoing epidemiological uncertainty. WHO
The Bundibugyo strain last caused a significant outbreak in Uganda in 2007, when 149 cases and 37 deaths were recorded in Bundibugyo District. The current outbreak is the DRC’s 17th declared Ebola event. Uganda has faced multiple Ebola outbreaks, including a Sudan strain outbreak in 2022 that infected 142 people and killed 55 before being declared over in January 2023.
Uganda’s health ministry has confirmed that contact tracing operations are ongoing for all five cases. The WHO, having declared the outbreak a PHEIC on May 17, indicated it would convene an Emergency Committee to issue formal temporary recommendations to states, which are expected to include measures around exit screening at airports, seaports, and major land crossings, as well as restrictions on travel for confirmed cases and their contacts for 21 days after exposure. Clinical trials for candidate therapeutics and vaccines against the Bundibugyo strain are also expected to be initiated with international partner support, according to WHO guidance issued alongside the PHEIC declaration. WHO
