Evidence map›Paper›PMID 38783244›Full record

ArticleBMC infectious diseases2024

Sudan virus disease super-spreading, Uganda, 2022.

Allan Komakech, Shannon Whitmer, Jonathan Izudi, Charles Kizito, Mackline Ninsiima, Sherry R Ahirirwe, Zainah Kabami, Alex R Ario, Daniel Kadobera, Benon Kwesiga and 73 more

Abstract read
In one paragraph

Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. CD4Nature immunology · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

83 authors.

Allan KomakechUganda National Institute of Public Health, Kampala, Uganda. akomackech@musph.ac.ug.
Shannon WhitmerUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jonathan IzudiDepartment of Community Health, Faculty of Medicine, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
Charles KizitoKikandwa Health Center III, Kassanda, Uganda.
Mackline NinsiimaUganda National Institute of Public Health, Kampala, Uganda.
Sherry R AhirirweUganda National Institute of Public Health, Kampala, Uganda.
Zainah KabamiUganda National Institute of Public Health, Kampala, Uganda.
Alex R ArioUganda National Institute of Public Health, Kampala, Uganda.
Daniel KadoberaUganda National Institute of Public Health, Kampala, Uganda.
Benon KwesigaUganda National Institute of Public Health, Kampala, Uganda.
Samuel GiduduUganda National Institute of Public Health, Kampala, Uganda.
Richard MigishaUganda National Institute of Public Health, Kampala, Uganda.
Issa MakumbiNational Public Health Emergency Operations Center, Kampala, Uganda.
Daniel EurienBAYLOR Uganda, Kampala, Uganda.
Joshua KayiwaNational Public Health Emergency Operations Center, Kampala, Uganda.
Lilian BulageUganda National Institute of Public Health, Kampala, Uganda.
Doreen N GonahasaUganda National Institute of Public Health, Kampala, Uganda.
Irene KyamwineUganda National Institute of Public Health, Kampala, Uganda.
Paul E OkelloUganda National Institute of Public Health, Kampala, Uganda.
Hildah T NansikombiUganda National Institute of Public Health, Kampala, Uganda.
Immaculate AtuhaireUganda National Institute of Public Health, Kampala, Uganda.
Alice AsioUganda National Institute of Public Health, Kampala, Uganda.
Sarah ElayeeteUganda National Institute of Public Health, Kampala, Uganda.
Edirisa J NsubugaUganda National Institute of Public Health, Kampala, Uganda.
Veronica MasanjaUganda National Institute of Public Health, Kampala, Uganda.
Stella M MigambaUganda National Institute of Public Health, Kampala, Uganda.
Patience MwineUganda National Institute of Public Health, Kampala, Uganda.
Petranilla NakamyaUganda National Institute of Public Health, Kampala, Uganda.
Rose NampeeraUganda National Institute of Public Health, Kampala, Uganda.
Andrew KwiringiraUganda National Institute of Public Health, Kampala, Uganda.
Rebecca AkunzirweUganda National Institute of Public Health, Kampala, Uganda.
Helen Nelly NaigaUganda National Institute of Public Health, Kampala, Uganda.
Saudah K NamubiruUganda National Institute of Public Health, Kampala, Uganda.
Brian AgabaUganda National Institute of Public Health, Kampala, Uganda.
Jane Frances ZalwangoUganda National Institute of Public Health, Kampala, Uganda.
Marie Gorreti ZalwangoUganda National Institute of Public Health, Kampala, Uganda.
Patrick KingUganda National Institute of Public Health, Kampala, Uganda.
Brenda Nakafeero SimbwaUganda National Institute of Public Health, Kampala, Uganda.
Robert ZavugaUganda National Institute of Public Health, Kampala, Uganda.
Mercy Wendy WanyanaUganda National Institute of Public Health, Kampala, Uganda.
Thomas KiggunduUganda National Institute of Public Health, Kampala, Uganda.
Lawrence OonyuUganda National Institute of Public Health, Kampala, Uganda.
Alex NdyabakiraKampala Capital City Authority, Kampala, Uganda.
Mariam KomugishaUganda National Institute of Public Health, Kampala, Uganda.
Brian KibwikaUganda National Institute of Public Health, Kampala, Uganda.
Innocent SsemandaUganda National Institute of Public Health, Kampala, Uganda.
Yasin NuwamanyaUganda National Institute of Public Health, Kampala, Uganda.
Adams KamukamaUganda National Institute of Public Health, Kampala, Uganda.
Dorothy AanyuUganda National Institute of Public Health, Kampala, Uganda.
Dominic KizzaUganda National Institute of Public Health, Kampala, Uganda.
Daniel Okello AyenKampala Capital City Authority, Kampala, Uganda.
Sophia MuleiUganda Virus Research Institute, Entebbe, Uganda.
Stephen BalinandiUganda Virus Research Institute, Entebbe, Uganda.
Luke NyakarahukaUganda Virus Research Institute, Entebbe, Uganda.
Jimmy BalukuUganda Virus Research Institute, Entebbe, Uganda.
Jackson KyondoUganda Virus Research Institute, Entebbe, Uganda.
Alex TumusiimeUganda Virus Research Institute, Entebbe, Uganda.
Dativa AliddekiAfrica Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
Ben Masiira, African Field Epidemiology Network, Kampala, Uganda.
Esther MuwanguziWorld Health Organization, Geneva, Switzerland.
Ivan KimuliWorld Health Organization, Geneva, Switzerland.
Daniel Bulwadda, Infectious Diseases Institute, Kampala, Uganda.
Herbert Isabirye, Infectious Diseases Institute, Kampala, Uganda.
Deborah AujoMinistry of Health, Kampala, Uganda.
Arthur KasambulaMinistry of Health, Kampala, Uganda.
Solome OkwareWorld Health Organization, Geneva, Switzerland.
Emmanuel OchienWorld Health Organization, Geneva, Switzerland.
Innocent KomakechWorld Health Organization, Geneva, Switzerland.
Charles OkotWorld Health Organization, Geneva, Switzerland.
Mary ChoiUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Caitlin M CossaboomUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Carrie EggersUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
John D KlenaUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Modupe O OsinubiUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Katrin S SadighUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Mary C WorrellUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Amy L BooreUnited States Centers for Disease Control and Prevention, Kampala, Uganda.
Trevor ShoemakerUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Joel M MontgomeryUnited States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Susan N NabaddaNational Health Laboratory and Diagnostic Services, Kampala, Uganda.
Michael MwangaMinistry of Health, Kampala, Uganda.
Allan N MurutaMinistry of Health, Kampala, Uganda.
Julie R HarrisUnited States Centers for Disease Control and Prevention, Kampala, Uganda.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundOn 20 September 2022, Uganda declared its fifth Sudan virus disease (SVD) outbreak, culminating in 142 confirmed and 22 probable cases. The reproductive rate (R) of this outbreak was 1.25. We described persons who were exposed to the virus, became infected, and they led to the infection of an unusually high number of cases during the outbreak.

methodsIn this descriptive cross-sectional study, we defined a super-spreader person (SSP) as any person with real-time polymerase chain reaction (RT-PCR) confirmed SVD linked to the infection of ≥ 13 other persons (10-fold the outbreak R). We reviewed illness narratives for SSPs collected through interviews. Whole-genome sequencing was used to support epidemiologic linkages between cases.

resultsTwo SSPs (Patient A, a 33-year-old male, and Patient B, a 26-year-old male) were identified, and linked to the infection of one probable and 50 confirmed secondary cases. Both SSPs lived in the same parish and were likely infected by a single ill healthcare worker in early October while receiving healthcare. Both sought treatment at multiple health facilities, but neither was ever isolated at an Ebola Treatment Unit (ETU). In total, 18 secondary cases (17 confirmed, one probable), including three deaths (17%), were linked to Patient A; 33 secondary cases (all confirmed), including 14 (42%) deaths, were linked to Patient B. Secondary cases linked to Patient A included family members, neighbours, and contacts at health facilities, including healthcare workers. Those linked to Patient B included healthcare workers, friends, and family members who interacted with him throughout his illness, prayed over him while he was nearing death, or exhumed his body. Intensive community engagement and awareness-building were initiated based on narratives collected about patients A and B; 49 (96%) of the secondary cases were isolated in an ETU, a median of three days after onset. Only nine tertiary cases were linked to the 51 secondary cases. Sequencing suggested plausible direct transmission from the SSPs to 37 of 39 secondary cases with sequence data.

conclusionExtended time in the community while ill, social interactions, cross-district travel for treatment, and religious practices contributed to SVD super-spreading. Intensive community engagement and awareness may have reduced the number of tertiary infections. Intensive follow-up of contacts of case-patients may help reduce the impact of super-spreading events.

Indexed as

Disease OutbreaksAdultCross-Sectional StudiesEbolavirusFemaleHemorrhagic Fever, EbolaHumansMaleUgandaWhole Genome SequencingEbolaSudan virus diseaseSuper-spreadersUganda

Identifiers

PMID38783244
PMCPMC11112911

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.