Akunzirwe Rebecca, Whitmer Shannon, Stewart Miles, Harris Julie R, Wanyana Mercy W, Ahirirwe Sherry R, Ario Alex R, Kadobera Daniel, Kwesiga Benon, Migisha Richard, Rajan Abraham, Stock Nicole, Eng Julia, Klena John D, Shoemaker Trevor, Montgomery Joel, Choi Mary
Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda.
Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
PLOS Glob Public Health. 2025 Apr 21;5(4):e0004352. doi: 10.1371/journal.pgph.0004352. eCollection 2025.
On September 20, 2022, the Uganda Ministry of Health declared an outbreak of Sudan Virus Disease (SVD). As the outbreak grew, it became imperative to quickly visualize and analyze chains of disease transmission. Determining epidemiological links between cases is critical for outbreak control as incorrect linkages may result in missed case detection and undetected disease transmission. We describe the Uganda Ministry of Health's experience using Chainchecker, a computer application designed to visualize and verify transmission chain data. To use Chainchecker, a line list documenting the epidemiological details associated with individual cases is uploaded to the application. To verify epidemiologic linkages, the application calculates the exposure windows for each case based on user-defined incubation periods and dates of symptom onset. If genetic sequencing data is available, Chainchecker can overlay genetic distance data on top of the epidemiologic data. Chainchecker can also provide visualizations of hospitalization data, which can highlight potential instances of nosocomial disease transmission. Using the Chainchecker application, the case investigation team was able to connect 11 previously unlinked cases to the larger chain of disease transmission. The use of the application also led to the identification and correction of transmission chain errors for 13 SVD cases and the identification of 5 potential instances of nosocomial transmission. The use of the Chainchecker application in Uganda during the 2022 SVD outbreak allowed the response teams to rectify critical errors in transmission chains. Countries prone to Ebola Disease (EBOD) outbreaks should consider incorporating Chainchecker as an element of EBOD preparedness and response.
2022年9月20日，乌干达卫生部宣布苏丹病毒病（SVD）暴发。随着疫情蔓延，迅速可视化并分析疾病传播链变得势在必行。确定病例之间的流行病学联系对于疫情控制至关重要，因为错误的联系可能导致漏诊病例和未被发现的疾病传播。我们描述了乌干达卫生部使用Chainchecker的经验，这是一款旨在可视化和验证传播链数据的计算机应用程序。要使用Chainchecker，需将记录与各个病例相关流行病学细节的一览表上传到该应用程序。为了验证流行病学联系，该应用程序会根据用户定义的潜伏期和症状出现日期计算每个病例的暴露窗口。如果有基因测序数据，Chainchecker可以将基因距离数据叠加在流行病学数据之上。Chainchecker还可以提供住院数据的可视化，这可以突出医院感染传播的潜在情况。通过使用Chainchecker应用程序，病例调查团队能够将11例之前未关联的病例与更大的疾病传播链联系起来。该应用程序的使用还导致识别并纠正了13例苏丹病毒病病例的传播链错误，并识别出5例潜在的医院感染传播情况。在2022年苏丹病毒病疫情期间，乌干达使用Chainchecker应用程序使应对团队能够纠正传播链中的关键错误。容易发生埃博拉病毒病（EBOD）疫情的国家应考虑将Chainchecker纳入埃博拉病毒病防范和应对工作的一部分。
