Uganda has begun pressing foreign governments to remove Ebola-related travel curbs, after the country’s last confirmed patient was discharged from hospital.
The patient, a Congolese national, left the isolation centre at Mulago national referral hospital in Kampala on Thursday. His discharge starts the World Health Organization’s required 42-day monitoring period, after which Uganda can be formally declared Ebola-free if no further cases are recorded.
The outbreak infected 20 people in Uganda and resulted in two deaths.
Despite what officials describe as a relatively strong containment effort, 15 countries still have partial or full travel restrictions in place against Uganda. The government says those measures have badly affected tourism, trade and wider business activity.
The United States has issued a level four “do not travel” advisory for Uganda because of the Ebola outbreak, placing it in the same warning category as countries including North Korea, Somalia, Afghanistan and Russia.
“As we make progress in managing this disease, we are engaging and asking those countries with a view to opening up so that the economy does not get injured,” Uganda’s health minister, Dr Chris Baryomunsi, said after the ceremony marking the patient’s release.
Baryomunsi cautioned that Uganda has not yet reached Ebola-free status. Under WHO rules, a country must pass two consecutive 21-day incubation cycles without any new infections before an outbreak can officially be declared over.
“This is an imported outbreak. We remain on high alert because what we are celebrating here is different from what is happening in the Democratic Republic of the Congo,” he said.
The DRC reported on Thursday that the number of confirmed cases in the country had risen to 2,073, including 796 deaths, as of 14 July. The outbreak, caused by the Bundibugyo strain of the virus, was first declared by the WHO on 17 May.
Uganda’s outbreak has been markedly different from previous Ebola emergencies in the region, with only two deaths and 20 confirmed infections including 15 Congolese nationals, four health workers and one driver.
WHO’s representative in Uganda, Dr Kasonde Mwinga, said the country’s response demonstrated the value of sustained investment in epidemic preparedness.
“The case fatality rate of less than 10% is among the lowest recorded in Ebola outbreaks because the lowest has always been 30%. That is not by luck. It is because people invested in preparedness,” she said.
Mwinga said Uganda had established treatment facilities, trained emergency medical teams and pre-positioned medical supplies before the outbreak, allowing authorities to respond rapidly when cases were detected.
The outbreak also accelerated scientific efforts to develop vaccines against the Bundibugyo strain of Ebola, for which no licensed vaccine exists.
Dr Ronnie Bahatungire, the clinical services commissioner at Uganda’s health ministry, said the country had already participated in trials involving experimental therapies during the outbreak and plans to join vaccine studies. “We will participate at whatever point in time when an opportunity arises,” Bahatungire said.
This week, Oxford University’s Oxford Vaccine Group launched the world’s first Phase I clinical trial of BD-Ebov, a vaccine candidate targeting the Bundibugyo strain, in response to the outbreak, with the first patient already enrolled.
Despite Uganda’s progress, authorities said the threat remains across the border. Baryomunsi said presidents Yoweri Museveni of Uganda and Félix Tshisekedi of DRC had agreed on closer cross-border cooperation and signed a bilateral memorandum of understanding, where Uganda has already sent health experts to DRC to contain the outbreak and stop Congolese travelling to Uganda to seek medical attention.
“We have so far sent 50 health workers with four laboratories and these have been set up in four different locations. We agreed that if they require additional human resources, we shall send more depending on how the situation progresses,” Baryomunsi said.
