The World Health Organisation (WHO) has explained that Ebola survivors may transmit the virus through sexual intercourse if it persists in their semen after recovery. In contrast, survivors who have met the criteria for discharge from treatment are not expected to transmit the virus through sweat or saliva.

Patrick Otim, programme area manager for emergency response at the WHO Regional Office for Africa, explained this in a video answering questions about the virus.

Mr Otim said male survivors should receive counselling on safer sex practices and access to condoms after discharge from treatment centres. He said they should undergo regular semen testing until they obtain two consecutive negative results.

“Ebola virus after recovery and for patients with what we call a viral persistence can be transmitted through sexual intercourse,” he said.

He explained that the virus could remain in certain parts of the body after clinical recovery, posing a risk of transmission through infected semen.

The WHO recommends that male survivors practise safer sex for 12 months in the absence of a semen-testing programme. Where testing is available, they should undergo regular testing until two consecutive negative results are obtained.

Sweat and saliva

Mr Otim said survivors who had recovered and been discharged from treatment centres could not transmit the virus through sweat or saliva because the virus would have been cleared from their blood.

He said patients were required to have two negative blood tests before discharge, adding that survivors who had met the discharge criteria could not transmit the virus through these fluids.

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However, he warned that people who were still actively ill could transmit Ebola through sweat and other bodily fluids.

Outbreak raises concerns

The explanation comes amid an ongoing Ebola outbreak involving the Democratic Republic of the Congo (DRC) and Kenya.

Nigeria confirmed an imported case on 20 October. The patient, a 42-year-old Ugandan-born woman living in Abuja, was evacuated to Switzerland with her husband on 26 October.

Although the WHO said Nigeria had no active confirmed cases after the evacuation, health authorities continued monitoring contacts and implementing containment measures.

In the DRC, the outbreak has recorded 10,060 confirmed cases and 4,887 deaths, according to figures released on Tuesday by the country’s Ministry of Public Health.

The World Health Organisation (WHO) has expressed hope that the Ebola outbreak in the Democratic Republic of the Congo (DRC) can be contained, despite confirmed cases of Bundibugyo virus disease surpassing 10,000.

The optimism comes as data released by the DRC’s Ministry of Public Health on Tuesday put confirmed cases at 10,060, with 4,887 deaths, according to a report by Al Jazeera.

The outbreak, declared on 15 May, is the largest and deadliest Ebola epidemic recorded in the DRC.

It is also the second-largest and second-deadliest Ebola outbreak globally, behind the 2014–2016 West African epidemic, which recorded about 28,600 cases and more than 11,000 deaths.

Reasons for hope

In a post on his official X account on Tuesday, Mohammed Janabi, the WHO Regional Director for Africa, said the rising figures reflected the toll the outbreak had taken on families and communities but noted that progress in recovery, research and response efforts offered reasons for hope.

Mr Janabi said more than 2,600 people had recovered, while new vaccine and treatment candidates were advancing through clinical trials.

He added that laboratory testing, treatment capacity, infection prevention and control, community engagement and surveillance were being strengthened to help contain the outbreak.

“Our teams are on the ground, working side by side with the government and partners to stop transmission and save lives,” he said, calling for sustained commitment, community trust and solidarity, as well as safe access to affected communities.

Spread beyond the DRC

The rising figures come amid growing concerns about the spread of the virus beyond the DRC, with Kenya and Nigeria reporting infections linked to the wider outbreak.

PREMIUM TIMES reported last week that Kenya had recorded nine confirmed cases, including two deaths, after the virus was introduced by a traveller who arrived from the DRC through Uganda.

Nigeria also confirmed its first Ebola case in more than a decade on 20 October, after a woman who had travelled from Uganda tested positive in the Federal Capital Territory (FCT).

In a subsequent report, PREMIUM TIMES reported that the Africa Centres for Disease Control and Prevention (Africa CDC) was investigating a possible link between the Nigerian case and the infection recorded in Kenya.

Both patients travelled through Entebbe International Airport in Uganda on 3 October, prompting investigations into whether they had shared equipment or had other contact. However, health officials have stressed that a direct connection between the infections has not been established.

Nigeria’s health minister, Muhammad Pate, later said genomic sequencing showed that the viruses detected in Nigeria and Kenya differed by only one mutation. He cautioned, however, that the finding did not establish where the Nigerian patient contracted the virus.

Contact tracing challenges

According to the Al Jazeera report, about 80 per cent of new cases in the DRC are occurring outside the known chains of transmission being monitored by health authorities.

This means many infections are being detected among people whose exposure to previously confirmed cases has not been established, complicating efforts to identify contacts and interrupt further transmission.

The Africa CDC has said at least 95 per cent of cases must be linked to known contacts of infected people for an outbreak to be considered under control.

Vaccine research underway

The absence of an approved vaccine against the Bundibugyo strain remains another major challenge in the response.

PREMIUM TIMES reported on Friday that the World Health Organisation (WHO) had announced the commencement of the Tumaini clinical trial in Bunia, eastern DRC, to assess potential vaccines against the strain.

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The trial began with the vaccination of its first participants on 23 October and is expected to evaluate several vaccine candidates, including Ervebo, which is licensed against a different Ebola virus species, as well as experimental candidates being developed by Moderna and the University of Oxford in collaboration with the Serum Institute of India.

The trial is intended to establish whether the candidates can safely generate an immune response and protect against the Bundibugyo virus. Their effectiveness against the strain has not yet been established.

The development follows an earlier WHO recommendation, reported by PREMIUM TIMES in August, that Ervebo be prioritised for a clinical trial after preliminary animal studies suggested it might offer some cross-protection against Bundibugyo virus disease.