Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in Uganda

Abstract Background On January 30, 2025, the Uganda Ministry of Health declared an outbreak of Sudan virus disease (SVD) following laboratory confirmation from postmortem samples of a suspected case identified through routine mortality surveillance for viral hemorrhagic fevers (VHFs) at Mulago Natio...

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Main Authors: Andrew Nsawotebba, Susan Nabadda, Valeria Nakintu, Isaac Ssewanyana, Misaki Wayengera, Jonathan Kabazzi, Stephen Balinandi, Godfrey Pimundu, Tonny Muyigi, Alisen Ayitewala, Samuel Gidudu, Morgan Otita, Ibrahim Mugerwa, Moses Rubangakene, Sulaiman Ikoba, Sam Kalungi, Rhoda Wanyenze, Kevin K. Ariën, Eunice Namboozo, Benedict Kanamwanji, Steven Ssekyondwa, Ronald Kasujja, Derrick Kitwe, Catherine Dambya, Innocent Morunyanga, Reginald Rony Bahatungire, Francis Kakooza, Moses Joloba, Atek Kagirita, Allan Muruta, Pontiano Kaleebu, Henry Kyobe, Charles Olaro, Diana Atwine, Jane Ruth Aceng
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11271-0
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author Andrew Nsawotebba
Susan Nabadda
Valeria Nakintu
Isaac Ssewanyana
Misaki Wayengera
Jonathan Kabazzi
Stephen Balinandi
Godfrey Pimundu
Tonny Muyigi
Alisen Ayitewala
Samuel Gidudu
Morgan Otita
Ibrahim Mugerwa
Moses Rubangakene
Sulaiman Ikoba
Sam Kalungi
Rhoda Wanyenze
Kevin K. Ariën
Eunice Namboozo
Benedict Kanamwanji
Steven Ssekyondwa
Ronald Kasujja
Derrick Kitwe
Catherine Dambya
Innocent Morunyanga
Reginald Rony Bahatungire
Francis Kakooza
Moses Joloba
Atek Kagirita
Allan Muruta
Pontiano Kaleebu
Henry Kyobe
Charles Olaro
Diana Atwine
Jane Ruth Aceng
author_facet Andrew Nsawotebba
Susan Nabadda
Valeria Nakintu
Isaac Ssewanyana
Misaki Wayengera
Jonathan Kabazzi
Stephen Balinandi
Godfrey Pimundu
Tonny Muyigi
Alisen Ayitewala
Samuel Gidudu
Morgan Otita
Ibrahim Mugerwa
Moses Rubangakene
Sulaiman Ikoba
Sam Kalungi
Rhoda Wanyenze
Kevin K. Ariën
Eunice Namboozo
Benedict Kanamwanji
Steven Ssekyondwa
Ronald Kasujja
Derrick Kitwe
Catherine Dambya
Innocent Morunyanga
Reginald Rony Bahatungire
Francis Kakooza
Moses Joloba
Atek Kagirita
Allan Muruta
Pontiano Kaleebu
Henry Kyobe
Charles Olaro
Diana Atwine
Jane Ruth Aceng
author_sort Andrew Nsawotebba
collection DOAJ
description Abstract Background On January 30, 2025, the Uganda Ministry of Health declared an outbreak of Sudan virus disease (SVD) following laboratory confirmation from postmortem samples of a suspected case identified through routine mortality surveillance for viral hemorrhagic fevers (VHFs) at Mulago National Referral Hospital, Kampala. This report describes the laboratory procedures used to confirm the 2025 SVD index case, emphasizing the vital role of rapid diagnostics in containing VHFs. Methods We leveraged existing surveillance infrastructure to collect, package, transport, test, and report results for the index-confirmed case. Testing was conducted within the framework of the established laboratory quality and bio-risk management system at the Central Emergency Response and Surveillance Laboratory. The workflow consisted of sample delivery, reception, preparation, nucleic acid extraction, master mix preparation, quantitative reverse transcriptase polymerase chain Reaction (RT-qPCR), differential diagnosis for VHFs, parallel PCR testing and typing for Sudan virus (SUDV) confirmation, result validation, and reporting. Results The sample tested negative for Marburg, Yellow fever, Rift Valley fever, and Crimean-Congo Hemorrhagic Fever viruses. However, it tested positive for SUDV. Four parallel tests utilizing the Real Star® Filovirus Screen RT-PCR Kit 1.0 (Altona Diagnostics GmbH, Hamburg, Germany) on CFX96 Bio-Rad platforms, with varying sample volumes (140 µL, 90 µL, 50 µL, and 30 µL diluted with nuclease-free water), confirmed the presence of SUDV. The 50 µL sample had the lowest Ct values for the Orthoebolavirus target, while the 30 µL sample had the lowest Ct values for the internal control target. The turnaround time, from sample reception to results reporting to the Ministry of Health leadership, was less than 12 h. Conclusion Mortality surveillance of VHFs is vital for the swift identification of Filovirus outbreaks in high-risk areas. Comprehensive VHFs panel testing is crucial for detecting pathogens in suspected cases. Sample dilution impacts diagnostic sensitivity, making optimized testing protocols crucial for precise molecular diagnostics. A rapid turnaround time is critical to outbreaks, enabling timely public health decisions such as case isolation, contact tracing, and resource allocation.
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spelling doaj-art-8ba6f0dbf99d4bc999db9a99456a2f9d2025-08-20T03:45:27ZengBMCBMC Infectious Diseases1471-23342025-07-012511810.1186/s12879-025-11271-0Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in UgandaAndrew Nsawotebba0Susan Nabadda1Valeria Nakintu2Isaac Ssewanyana3Misaki Wayengera4Jonathan Kabazzi5Stephen Balinandi6Godfrey Pimundu7Tonny Muyigi8Alisen Ayitewala9Samuel Gidudu10Morgan Otita11Ibrahim Mugerwa12Moses Rubangakene13Sulaiman Ikoba14Sam Kalungi15Rhoda Wanyenze16Kevin K. Ariën17Eunice Namboozo18Benedict Kanamwanji19Steven Ssekyondwa20Ronald Kasujja21Derrick Kitwe22Catherine Dambya23Innocent Morunyanga24Reginald Rony Bahatungire25Francis Kakooza26Moses Joloba27Atek Kagirita28Allan Muruta29Pontiano Kaleebu30Henry Kyobe31Charles Olaro32Diana Atwine33Jane Ruth Aceng34Department of National Health Laboratory and Diagnostic Services, Ministry of HealthMinistry of Health, Government of UgandaDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthMakerere University College of Health SciencesDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthUganda Virus Research InstituteDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthUganda National Institute of Public HealthInfectious Diseases Institute, Makerere UniversityDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthWorld Health Organization—Uganda OfficeDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthMulago National Referral Hospital, Ministry of HealthMakerere University School of Public HealthInstitute of Tropical MedicineDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthDepartment of National Health Laboratory and Diagnostic Services, Ministry of HealthCentral Emergency Response and Surveillance Laboratory, Department of National Health Laboratory and Diagnostic ServicesCentral Emergency Response and Surveillance Laboratory, Department of National Health Laboratory and Diagnostic ServicesCentral Emergency Response and Surveillance Laboratory, Department of National Health Laboratory and Diagnostic ServicesCentral Emergency Response and Surveillance Laboratory, Department of National Health Laboratory and Diagnostic ServicesCentral Emergency Response and Surveillance Laboratory, Department of National Health Laboratory and Diagnostic ServicesMinistry of Health, Government of UgandaInfectious Diseases Institute, Makerere UniversityMinistry of Health, Government of UgandaMinistry of Health, Government of UgandaMinistry of Health, Government of UgandaMinistry of Health, Government of UgandaMinistry of Health, Government of UgandaMinistry of Health, Government of UgandaMinistry of Health, Government of UgandaMinistry of Health, Government of UgandaAbstract Background On January 30, 2025, the Uganda Ministry of Health declared an outbreak of Sudan virus disease (SVD) following laboratory confirmation from postmortem samples of a suspected case identified through routine mortality surveillance for viral hemorrhagic fevers (VHFs) at Mulago National Referral Hospital, Kampala. This report describes the laboratory procedures used to confirm the 2025 SVD index case, emphasizing the vital role of rapid diagnostics in containing VHFs. Methods We leveraged existing surveillance infrastructure to collect, package, transport, test, and report results for the index-confirmed case. Testing was conducted within the framework of the established laboratory quality and bio-risk management system at the Central Emergency Response and Surveillance Laboratory. The workflow consisted of sample delivery, reception, preparation, nucleic acid extraction, master mix preparation, quantitative reverse transcriptase polymerase chain Reaction (RT-qPCR), differential diagnosis for VHFs, parallel PCR testing and typing for Sudan virus (SUDV) confirmation, result validation, and reporting. Results The sample tested negative for Marburg, Yellow fever, Rift Valley fever, and Crimean-Congo Hemorrhagic Fever viruses. However, it tested positive for SUDV. Four parallel tests utilizing the Real Star® Filovirus Screen RT-PCR Kit 1.0 (Altona Diagnostics GmbH, Hamburg, Germany) on CFX96 Bio-Rad platforms, with varying sample volumes (140 µL, 90 µL, 50 µL, and 30 µL diluted with nuclease-free water), confirmed the presence of SUDV. The 50 µL sample had the lowest Ct values for the Orthoebolavirus target, while the 30 µL sample had the lowest Ct values for the internal control target. The turnaround time, from sample reception to results reporting to the Ministry of Health leadership, was less than 12 h. Conclusion Mortality surveillance of VHFs is vital for the swift identification of Filovirus outbreaks in high-risk areas. Comprehensive VHFs panel testing is crucial for detecting pathogens in suspected cases. Sample dilution impacts diagnostic sensitivity, making optimized testing protocols crucial for precise molecular diagnostics. A rapid turnaround time is critical to outbreaks, enabling timely public health decisions such as case isolation, contact tracing, and resource allocation.https://doi.org/10.1186/s12879-025-11271-0Mortality surveillanceFilovirusesViral Hemorrhagic FeversSudan virus disease
spellingShingle Andrew Nsawotebba
Susan Nabadda
Valeria Nakintu
Isaac Ssewanyana
Misaki Wayengera
Jonathan Kabazzi
Stephen Balinandi
Godfrey Pimundu
Tonny Muyigi
Alisen Ayitewala
Samuel Gidudu
Morgan Otita
Ibrahim Mugerwa
Moses Rubangakene
Sulaiman Ikoba
Sam Kalungi
Rhoda Wanyenze
Kevin K. Ariën
Eunice Namboozo
Benedict Kanamwanji
Steven Ssekyondwa
Ronald Kasujja
Derrick Kitwe
Catherine Dambya
Innocent Morunyanga
Reginald Rony Bahatungire
Francis Kakooza
Moses Joloba
Atek Kagirita
Allan Muruta
Pontiano Kaleebu
Henry Kyobe
Charles Olaro
Diana Atwine
Jane Ruth Aceng
Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in Uganda
BMC Infectious Diseases
Mortality surveillance
Filoviruses
Viral Hemorrhagic Fevers
Sudan virus disease
title Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in Uganda
title_full Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in Uganda
title_fullStr Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in Uganda
title_full_unstemmed Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in Uganda
title_short Rapid laboratory confirmation of the 2025 Sudan Virus Disease (Svd) index case in Uganda
title_sort rapid laboratory confirmation of the 2025 sudan virus disease svd index case in uganda
topic Mortality surveillance
Filoviruses
Viral Hemorrhagic Fevers
Sudan virus disease
url https://doi.org/10.1186/s12879-025-11271-0
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