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dc.contributor.authorKomakech, Allan 
dc.contributor.author Whitmer, Shannon
dc.contributor.author Izudi, Jonathan
dc.contributor.authorKizito, Charles 
dc.contributor.authorNinsiima, Mackline 
dc.contributor.author Ahirirwe, Sherry R.
dc.contributor.authoret al
dc.date.accessioned2024-05-31T09:35:10Z
dc.date.available2024-05-31T09:35:10Z
dc.date.issued2024
dc.identifier.citationKomakech, A., Whitmer, S., Izudi, J., Kizito, C., Ninsiima, M., Ahirirwe, S. R., ... & Harris, J. R. (2024). Sudan virus disease super-spreading, Uganda, 2022. BMC Infectious Diseases, 24(1), 1-14.en_US
dc.identifier.urihttp://ir.must.ac.ug/xmlui/handle/123456789/3694
dc.description.abstractBackground: On 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. Methods: In 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. Results: Two 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. Conclusion: Extended 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.en_US
dc.description.sponsorshipPresident’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI) through the US Centers for Disease Control and Prevention Cooperative Agreement number GH00135301 through Makerere University School of Public Health to the Uganda Public Health Fellowship Program, Ministry of Health.en_US
dc.language.isoen_USen_US
dc.publisherBMC Infectious Diseasesen_US
dc.subjectEbolaen_US
dc.subjectSuper-spreadersen_US
dc.subjectSudan virus diseaseen_US
dc.subjectUgandaen_US
dc.titleSudan virus disease super-spreading, Uganda, 2022en_US
dc.typeArticleen_US


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