Uganda's Ministry of Health has issued a fresh advisory to male survivors of Ebola, warning that while they may have recovered from the disease, the virus can remain in semen for at least six months, posing a risk of sexual transmission to partners.
The reminder comes as the country continues to register patients who have successfully recovered from the ongoing Ebola outbreak linked to the Bundibugyo virus, even as health authorities intensify efforts to interrupt all remaining chains of transmission.
"Uganda continues to register patients who have successfully recovered from Ebola. However, the virus remains in male survivors for at least six months," the Ministry of Health said in a public health advisory.
Health officials urged male survivors to strictly follow medical guidance during recovery.
"Men are encouraged to adhere to the advice of health workers and use condoms correctly and consistently to avoid passing the virus to their partners during this period," the ministry said.
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The warning highlights a lesser-known aspect of Ebola recovery. Although a patient may no longer have detectable virus in the bloodstream and may be declared clinically recovered, Ebola virus can persist in what scientists call immune-privileged sites parts of the body where the immune system has limited access. These include the testes, eyes and central nervous system.
Because of this persistence, infectious Ebola virus has been detected in semen months after recovery, making sexual transmission possible even after a survivor has left hospital.
The World Health Organization (WHO) recommends that male Ebola survivors practise safer sex, including the consistent use of condoms, until their semen tests negative twice for the virus or for at least 12 months if testing is unavailable. Survivors are also encouraged to access counselling and semen testing services where these are offered.
Sexual transmission of Ebola, though uncommon, has been documented in previous outbreaks and has, in some instances, been linked to flare-ups after outbreaks were believed to be under control. During the 2014–2016 West Africa epidemic, researchers traced several new Ebola infections to sexual contact with male survivors months after their recovery, prompting changes in global survivor care guidelines.
Scientists say Ebola belongs to a growing list of zoonotic diseases infections that originate in animals but can also spread between humans through sexual contact under certain circumstances.
While Ebola is primarily transmitted through direct contact with the blood or other bodily fluids of a person who is ill or has died from the disease, semen has emerged as an important route of transmission during the recovery phase.
Other zoonotic infections have also been shown to spread sexually. The Zika virus, first identified in monkeys before infecting humans, can be transmitted through semen and vaginal fluids and has been associated with birth defects during pregnancy.
Mpox, another zoonotic disease, can spread through close skin-to-skin and sexual contact, although it is not classified as a traditional sexually transmitted infection. Marburg virus disease, a close relative of Ebola, has similarly been detected in the semen of male survivors for months after recovery, prompting nearly identical public health recommendations.
Public health experts say these findings underscore the importance of survivor follow-up programmes, which extend beyond discharge from hospital to include counselling, laboratory monitoring and reproductive health services.