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Scottish Ebola nurse readmitted to hospital after infection complication
Scottish Ebola nurse readmitted to hospital in 'serious condition'
(about 1 hour later)
Pauline Cafferkey, the Scottish nurse who contracted Ebola in west Africa last year, has been flown to the Royal Free hospital in London for treatment of an unusual late complication of the infection.
Nurse Pauline Cafferkey is in a serious condition after being admitted to the Royal Free hospital in London with complications arising from the Ebola virus.
The 39-year-old was admitted to the Queen Elizabeth University hospital in Glasgow on Tuesday after feeling unwell. During her time there she was treated in the infectious diseases unit.
She contracted the disease when working in Sierra Leone on 29 December but was discharged three weeks later after being succesfully treated. She was readmitted to the Royal Free in the early hours of Friday morning.
Cafferkey was transported from Glasgow in the early hours of Friday morning in a military aircraft under supervision.
Related: Nurse who contracted Ebola released from hospital
Related: Nurse who contracted Ebola released from hospital
Dr Emilia Crighton, the NHSGGC director of public health, said: “Pauline’s condition is a complication of a previous infection with the Ebola virus. The risk to the public is very low. In line with normal procedures in cases such as this, we have identified a small number of close contacts of Pauline’s that we will be following up as a precaution.”
The 39-year-old was first taken to the Queen Elizabeth University hospital in Glasgow on Tuesday after feeling unwell. During her time there she was treated in the infectious diseases unit before being transferred to the Royal Free by military aircraft.
Cafferkey worked in Sierra Leone at the end of last year, and was diagnosed with the virus on her return to the UK in December. She recovered following treatment in isolation at the Royal Free, the UK’s specialist treatment centre for Ebola.
The hospital issued a short statement saying “Pauline Cafferkey is in a serious condition”.
The Greater Glasgow health board said the virus was present in Cafferkey but that it was left over from the original infection. A government source said the transfer to the specialist unit was a “highly precautionary process”.
Earlier on Friday the Royal Free said the risk to the public “remains low”, suggesting Cafferkey was not showing symptoms of the disease.
In a statement, the Royal Free said: “We can confirm that Pauline Cafferkey was transferred from the Queen Elizabeth University hospital in Glasgow to the Royal Free London hospital in the early hours of this morning due to an unusual late complication of her previous infection by the Ebola virus.
“The Ebola virus can only be transmitted by direct contact with the blood or body fluids of an infected person while they are symptomatic so the risk to the general public remains low and the NHS has well established and practised infection control procedures in place,” it said in a statement.
“She will now be treated in isolation in the hospital’s high-level isolation unit under nationally agreed guidelines.
Her condition, nine months after her recovery will come as a shock to scientists studying the virus in the US and Europe.
“The Ebola virus can only be transmitted by direct contact with the blood or bodily fluids of an infected person while they are symptomatic so the risk to the general public remains low and the NHS has well-established and practised infection control procedures in place.”
There is no known case of any Ebola survivor relapsing into a serious condition even though it is now known that the virus lingers on in some bodily fluids such as ocular and spinal fluid.
Last week she appeared fit and healthy when she attended the Pride of Britain awards in London but on Tuesday she was admitted to hospital in Glasgow after she began to feel unwell. She also recently met the prime minister’s wife, Samantha Cameron, at a reception for winners and families in Downing Street.
On Friday morning she was admitted to the Royal Free’s high level isolation unit.
Related: Ebola genetic code analysed to show evolution of worst ever outbreak
She had told the BBC in an interview ahead of the Pride of Britain awards that she had taken months to recover and had suffered from thyroid problems and a temporary loss of hair.
Dr Emilia Crighton, NHSGGC director of public health, said the risk to the public was very low: “Pauline’s condition is a complication of a previous infection with the Ebola virus.
“The risk to the public is very low. In line with normal procedures in cases such as this, we have identified a small number of close contacts of Pauline’s that we will be following up as a precaution.”
Peter Willis, weekday editor of the Daily Mirror, who met her last week at the Pride of Britain awards, said: “She was fine last week. She was in good health and excited to be here. Our thoughts are with her family and we wish her a speedy recovery.”
Long-term side effects of Ebola include loss of vision, chronic pain joints and hearing loss. One doctor in the US, Ian Crozier, was discovered to have the Ebola virus present in his eye months after recovery. One of his eyes even changed colour.
Related: UK expert warns of disaster if lessons are not learned from Ebola outbreak
Cafferkey contracted Ebola while working in a Save the Children treatment centre in Kerry Town, Sierra Leone. The nurse arrived at Heathrow on 28 December and complained that she was developing a fever. Her temperature was found to be in the normal range and she was allowed to fly on to Glasgow.
Cafferkey contracted Ebola while working in a Save the Children treatment centre in Kerry Town, Sierra Leone. The nurse arrived at Heathrow on 28 December and complained that she was developing a fever. Her temperature was found to be in the normal range and she was allowed to fly on to Glasgow.
Once home, her condition worsened and she was flown to the Royal Free, where she spent three weeks in a critical condition before recovering.
Once home, her condition worsened and she was flown to the Royal Free, where she spent three weeks in a critical condition before recovering.
She contracted the disease while using a visor rather than goggles to treat patients at the facility, an internal investigation by Save the Children found.
She contracted the disease while using a visor rather than goggles to treat patients at the facility, an internal investigation by Save the Children found.
“She was not able to use the standard protective goggles used there because she could not get them to fit properly,” the report said. “She acquired a visor that was the same as the one which she had used in her initial training but that was not used by Save the Children.
“She was not able to use the standard protective goggles used there because she could not get them to fit properly,” the report said. “She acquired a visor that was the same as the one which she had used in her initial training but that was not used by Save the Children.
“Both visors and goggles are equally safe but there are slight differences in the types of clothing worn with each, and in the protocols for putting the equipment on and taking it off.”
“Both visors and goggles are equally safe but there are slight differences in the types of clothing worn with each, and in the protocols for putting the equipment on and taking it off.”
The report added: “Although the procedures, equipment and protocols used at the ETC [Ebola treatment centre] are considered safe, they are only effective if applied as prescribed. Compliance (human factors) is a key factor.”
Last week, McCafferkey was in London to collect a Pride of Britain award at the Daily Mirror’s annual event. In an interview with the BBC before the awards, she told how she continued to be affected by the virus after her recovery, revealing her hair had fallen out.
Related: Ebola genetic code analysed to show evolution of worst ever outbreak
“So it’s taken me a good few months to recover from it. That’s the thing you don’t know long-term wise. Hopefully this is the end of it. You just don’t know,” she said.
More than a year after the epidemic, doctors are still learning about the long-term effects of Ebola. Before this latest outbreak it was it was known the virus remained in semen and vaginal fluid and survivors were advised to abstain from sex for three months after recovery.
Since the outbreak in west Africa, more research into the convalescent period has been conducted. US researchers and medics have discovered that the virus also continues to be present in ocular fluid in the eye and in spinal fluid.
One doctor in the US, Ian Crozier, who contracted the virus in Sierra Leone, reported a burning sensation in his eyes and worsening blurred vision two months after his recovery.
In an interview in the New York Times, he revealed that one of his eyes had changed colour about four months after being diagnosed. The pressure inside his eye, which had been dangerously elevated, began to drop. The eye became doughy to the touch, as if it were turning to mush. “The eye felt dead to me,” Crozier said.
The biggest shock came one morning about 10 days after his symptoms started, when he glanced in the mirror and saw that one eye, normally blue, had turned green.
Over the next few months his vision recovered and his eye returned to its natural colour. Scientists from Emory University School of Medicine found the fluid in his eye had live Ebola virus.
Related: UK expert warns of disaster if lessons are not learned from Ebola outbreak
Dr John S Schieffelin, a physician from the Tulane University School of Medicine in the US who studied survivors in Kenema in Sierra Leone, where both Crozier and British nurse Will Pooley contracted the virus, said the main problems seemed to be joint pains, chronic headaches and an interruption of menstrual periods in women.
“I have met one former patient who appears to be deaf,” he told the New York Times.
The hearing loss could result from brain inflammation or very low blood pressure for an extended period, both caused by Ebola, Schieffelin said.
Dr Russell Van Gelder, of the American Academy of Ophthalmology, said at the time: “This remarkable case now demonstrates that the virus can remain viable in ocular fluids long after the patient has recovered from the systemic infection. If the Ebola epidemic continues, ophthalmologists throughout the world will be seeing patients with post-Ebola uveitis [inflammation], and will need to recognise and treat this condition.
“However, I want to emphasise that as far as we know, the Ebola virus is not transmitted by casual contact. The current study does not suggest that infection can be transmitted through contact with tears of patients who have recovered from their initial infection.”
Further studies by Emory University suggest the virus could remain in other “immune privileged” sites such as the central nervous system, testicles and cartilage.
Orphan Dauda Fullah told the Guardian that he continued to have joint pains months after recovery.
