How Ugandans can stay safe as Ebola resurfaces across border in DR Congo

_______________

OPINION

By Winfred Nakaweesi

On September 5, 2025, the Democratic Republic of Congo (DRC) declared a new outbreak of Ebola virus disease in Kasai province. So far, 28 suspected cases and 15 deaths have been reported. The virus has been confirmed as the Ebola Zaire strain; the deadliest form of Ebola. Four of the infected are healthcare workers, underscoring how contagious it can be. The outbreak is in remote Bulape and Mweka health zones, making it hard for response teams to reach patients quickly.

Moreover, the DRC has now experienced 15 Ebola outbreaks since 1976, reflecting how common these flare-ups are. By comparison, Uganda has faced Ebola far less often. Stepping up preparedness is critical.

Ebola virus disease is a rare but severe haemorrhagic fever in humans. It spreads through direct contact with the blood or body fluids of an infected person, or with objects contaminated by those fluids. Early symptoms include high fever, extreme fatigue and severe headaches. These can be followed by vomiting, diarrhea, and sometimes unexplained bleeding. On average, one out of every two cases die from this disease. There is no cure currently available for Ebola in Uganda. The only licensed vaccine works after a case is found and can be given to close contacts in an emergency.

Uganda shares a long, busy border with the DRC. In the western districts of Kasese and Bundibugyo, people cross daily for trade, school, work, and family events. For example, thousands enter Uganda each week at Mpondwe (Kasese) to shop in the Kasindi market. We have seen that strict border vigilance can save lives: in August 2018 a 9-year-old Ebola patient was identified at the Mpondwe crossing. Border screeners noted her high fever and bleeding as she arrived, and she was immediately sent to the Kasese Ebola treatment unit. That quick action likely prevented further spread.

Immediate action is required. Ebola’s incubation period (up to 21 days) means someone can enter Uganda before showing symptoms. Once illness starts, that person becomes highly contagious. If even one patient slips past our checks and becomes sick here, the virus can spread rapidly. In Uganda’s last Ebola outbreak earlier this year, our teams traced over 500 contacts within hours, we will need to do the same again, or even faster, to stop chains of transmission. Every hour counts and everyone must act.

Cross-border surveillance is our first line of defence. Ugandan and Congolese health teams have worked together on this before. In 2018, district officials agreed that every crossing point must be mapped and monitored. Now we must implement that plan fully. At official entry points like Mpondwe, Busunga (Bundibugyo), and Bunagana, trained health workers should be on duty 24/7 with thermometers and checklists to identify any suspected cases.

Border and immigration officials should keep all health screening posts staffed 24/7, use digital thermometers at gates and have forms ready to record travellers’ information, refuse entry of anyone who is visibly ill unless they are escorted to a clinic, record names and contacts of all arrivals from DRC, cooperate with local health inspectors, brief customs officers on Ebola symptoms so they know when to alert. Border teams should also coordinate closely with immigration and police. Giving people soap and sanitizer as they enter, and seeing that they comply, can also help.

Communities and families should practice frequent handwashing with soap (especially after market visits or handling animals), avoid direct contact with anyone who has bleeding or severe diarrhea and if caring for someone with sudden high fever, vomiting or bleeding, protect their hands with gloves and not let blood or vomit touch their skin, don’t share utensils or bedding with anyone who is ill, be aware of the signs of Ebola and listen to Ministry of Health updates and verified news.

In villages, do not hide a sick person: encourage them to get medical help immediately. Do not touch the body of someone who died of an unknown illness; wait for trained burial teams to do it safely. Avoid eating bushmeat (bats, monkeys, antelopes) and discourage others from it, and if anyone dies unexpectedly after a brief illness, report it to the nearest clinic or health office at once. Community health workers (VHTs) and local clinics should actively monitor their villages for unusual fevers or illnesses.

Local government and leaders should map out every border crossing and footpath in their district, coordinate with police to patrol against informal crossings, use local radio to share health advisories and ensure religious and cultural leaders spread fact-based messages about Ebola, not rumours.

Ministry of Health should continue running the national Ebola response centres on high alert mode, preposition ambulances, PPE (gloves, gowns, masks), intravenous fluids, and antibiotic stocks in all high-risk districts and keep laboratory testing available. They should train and remind all health staff in triage that any patient with fever and bleeding must be treated as a possible Ebola case until proven otherwise, and coordinate with DRC’s health ministry to share information in real time.

Africa CDC, WHO and partners should maintain close technical support, provide updated situation reports and early warning data to Uganda and supply additional supplies as required. If needed, help Uganda deploy the Ebola Zaire vaccine and strengthen our electronic surveillance and contact tracing tools, as well as keep funding readiness activities so border districts have no gaps in their response.

Uganda has a strong foundation for outbreak response. We have trained disease detectives in every district, active laboratory networks, and a culture of community solidarity. With these measures; strict screening at the border, continuous surveillance of illness and deaths, and high public awareness, we will keep this Ebola outbreak out of Uganda. The risk is serious, but it is not inevitable. Every one of us has a role to play: be it a community that stays alert, a health worker who reports a suspected case, or a border official who insists on screening.

The writer is a Field Epidemiology Fellow with the Uganda Public Health Fellowship Program, Ministry of Health