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Ebola case confirmed in Glasgow Ebola case confirmed in Glasgow
(about 1 hour later)
A healthcare worker who returned from Sierra Leone on Sunday night has been diagnosed with Ebola and is receiving treatment in Glasgow, the Scottish government has said. A Scottish nurse is being treated in an isolation unit in Glasgow after being diagnosed with the Ebola virus hours after arriving home from west Africa via a British Airways flight from Heathrow.
The woman has been isolated and is receiving treatment in the specialist Brownlee unit for infectious diseases on the Gartnavel hospital campus. The healthcare worker was admitted to Gartnavel hospital after feeling unwell with a fever at 7.50am on Monday morning, having flown into the city at 11.30pm on Sunday following two months working as a volunteer in Sierra Leone to help combat the epidemic.
In a statement the Scottish government said the patient was a healthcare worker who was helping to combat the disease in west Africa. She returned to Scotland from Sierra Leone late on Sunday night via Casablanca and London Heathrow, arriving at Glasgow airport on British Airways flight BA1478 at about 11.30pm. It is the first case of Ebola to be diagnosed on UK soil.
The flight from Casablanca was with a Moroccan airline. The flight number is not yet known but Public Health England will be contacting passengers who were on board. Health experts treating the nurse said she was “quite stable” and showing few signs causing clinical concern, raising hopes she will survive the disease.
The patient was admitted to hospital early on Monday morning after feeling unwell and was put in isolation at 7.50am. The Scottish government added: “All possible contacts with the patient are now being investigated and anyone deemed to be at risk will be contacted and closely monitored. However, having been diagnosed in the very early stages of the illness, the risk to others is considered extremely low.” She had been volunteering at a newly built hospital at Kerry Town in Sierra Leone run by the charity Save the Children since 23 November. The charity said she had asked not to be named.
The first minister, Nicola Sturgeon, has chaired a meeting of the Scottish government resilience committee to ensure all necessary steps are being taken, and has also spoken to the prime minister, David Cameron. Urgent steps were being taken by officials with Health Protection Scotland and Public Health England to trace scores of passengers on the nurse’s Royal Air Maroc flight into the UK from Casablanca in Morocco, and the 71 passengers on her internal British Airways connection – BA 1478 – from Heathrow to Glasgow on Sunday night.
In a hastily arranged press conference, she said the risk to other people’s health was “extremely low given the early stage of diagnosis. The patient was displaying no symptoms of the kind that would lead to onwards transmission that would put other people at risk.” Nicola Sturgeon, the Scottish first minister and previously Scottish health secretary, said on Monday evening the search for passengers “was very much a precautionary measure”. The nurse, who is believed to be at the early stages of the infection, had been cleared by screening in Sierra Leone and at Heathrow at the weekend.
According to UK and Scottish protocol for anyone diagnosed with Ebola, the patient will be transferred to the high-level isolation unit in the Royal Free hospital, London, as soon as possible. This is where the facilities, staff and systems are in place to ensure the best quality and safest care. The British nurse William Pooley was successfully treated at the hospital after he contracted Ebola in Sierra Leone last year. “The risk to other people as a result of this Ebola case is deemed to be extremely low,” Sturgeon told a press conference. “Given the early stage of diagnosis, the patient was showing no signs of the symptoms which lead to transmission [of the virus] to other people.” She said the risk to the general public was “extremely low to the point of negligible” and added: “There’s no reason for the wider public in Scotland to be at all concerned.”
Dr Alisdair MacConnachie, the NHS Greater Glasgow and Clyde consultant in infectious diseases, who has been treating the patient, told the press conference the patient had identified that she had a fever in the early hours of Monday morning. She was then transferred to the Brownlee centre using a specialist ambulance service and admitted to the isolation facility. Under an agreed protocol between all the UK’s health authorities, urgent preparations were also being made to transfer the nurse to the UK’s main Ebola treatment centre at the Royal Free hospital in London, where the British nurse William Pooley was successfully treated after contracting Ebola in Sierra Leone last year. Scotland has no dedicated facilities for treating the disease.
She had no contact with other parts of the NHS or any accident and emergency facility. MacConnachie described her condition as “quite stable and not showing any great clinical concern at the minute”. Asked about the patient’s prospects, he said being clinically stable at this stage “should translate into a good prognosis”. Since this Ebola outbreak began in December 2013 in the west African country of Guinea, there have been nearly 20,000 cases of the disease and more than 7,500 deaths, centred in Liberia, Guinea and Sierra Leone.
A telephone helpline has been set up for anyone who was on the Heathrow to Glasgow flight. The number is 08000 858531. The nurse had contacted an NHS helpline from home after feeling unwell with a fever, one of the first symptoms of the disease, early on Monday morning. Sturgeon said she was then picked up from home by a specialist ambulance, and was immediately admitted into the Brownlee infectious diseases unit at Gartnavel.
Sturgeon said: “Our first thoughts at this time must be with the patient diagnosed with Ebola and their friends and family. I wish them a speedy recovery. Ebola symptoms can take up to 21 days to show, but more normally five to seven days. The Ebola virus is transmitted in the bodily fluids of people seriously ill with the virus, who are likely to be vomiting, bleeding or have diarrhoea, but there is no evidence that the virus is airborne.
“Scotland has been preparing for this possibility from the beginning of the outbreak in west Africa and I am confident that we are well prepared. The nurse’s partner is thought to be the only other person who has been in contact with her since she arrived home, and is now being screened by medical staff.
“We have the robust procedures in place to identify cases rapidly. Our health service also has the expertise and facilities to ensure that confirmed Ebola cases such as this are contained and isolated effectively minimising any potential spread of the disease. Save the Children said that since its Kerry Town clinic had opened, nearly 200 people had received treatment or continued to be treated at the site, with 66 cured and discharged. In a statement, the charity noted that early treatment in Ebola cases “maximises the chances of survival of those who are infected, and can make the difference between life and death”.
“Scotland’s NHS has proved it is well able to cope with infectious diseases in the past, such as swine flu, and I am confident we will be able to respond effectively again.” Almost all the health workers who have contracted Ebola in west Africa and who got early treatment have survived, including Ian Crozier, a World Health Organisation doctor, who became so ill he ended up on life support at a hospital in the US.
A handful of Ebola cases are expected in the UK in the coming months, the chief medical officer has said. Not only did Crozier have state-of-the-art medical support with dialysis machines used when he developed renal problems, he also had a donation of plasma packed with Ebola antibodies from Pooley, who contracted the virus weeks before at the same hospital in Kenema, in Sierra Leone.
Dame Sally Davies said the NHS remained “well prepared” for the deadly virus, which has claimed more than 7,000 lives across west Africa. There is no cure for Ebola but the survival rate is about 50% if patients are quickly treated with hydration, anti-malarial drugs and antibiotics.
The health secretary, Jeremy Hunt, told MPs in October that a number of Ebola cases were expected in the UK by Christmas as he introduced screening for the disease at some of the country’s airports. During the course of the disease, patients can lose up to 10 litres of liquid a day from diarrhoea and vomiting and if they don’t develop sufficient numbers of antibodies quickly enough the virus will attack their internal organs making survival challenging. Statistically in this outbreak, the chances of survival are much higher for those who have been treated in a US or European facility.
But figures from Public Health England show that 112 of the 113 tests on suspected Ebola sufferers were negative up to 4 December. Sturgeon had earlier spoken to David Cameron, the prime minister, to discuss the case. Both governments had convened their emergency response committees, with the UK health secretary, Jeremy Hunt, chairing a Cobra meeting at Downing Street.
Pooley, 29, contracted the virus while working in Sierra Leone. He was given the all-clear in September following treatment at the Royal Free hospital. A No 10 spokesman said Cameron had telephoned Sturgeon regarding the case, stressing that the UK government stood ready to assist “in any way possible”, and confirmed that the strictest procedures possible were being followed.
Davies said: “The risk of the general public in this country catching Ebola remains very low. However, we still estimate that there could be a handful of cases in this country over the coming months. “They agreed that both governments would remain in close touch and ensure everything possible was done to support the patient and, although the risk to the general population remained low, all measures would be taken to protect public health,” the spokesman said.
“The NHS is very well prepared for Ebola and the requirement for screening at selected ports of entry is being kept continually under review.” Dr Alisdair MacConacchie, a consultant in infectious diseases for NHS Greater Glasgow and Clyde Consultant, who has been treating the patient, said she had had no contact with other parts of the NHS or any accident and emergency facility.
“The patient identified themselves as having a fever in the early hours of this morning and contacted the NHS,” he said. “She was transferred to the Brownlee centre using a specialist ambulance service and is being managed in an isolation facility by staff who are comfortable managing patients in such situations. She herself is quite stable and not showing any great clinical concern at the minute.”
Asked about the patient’s prospects, he said that being clinically stable at this stage “should translate into a good prognosis”.
Save the Children and the Department for International Development had faced great criticism after the 80-bed hospital at Kerry Town had first opened because it would not run at full capacity for two months. The charity insisted its first priority was the safety of the health workers and it was paramount that the facility was phased in slowly.
Infectious disease consultants are also likely to consider the option of giving the nurse some of the plasma donated by Pooley before he returned to Sierra Leone in October.
Pooley banked 1.2 litres of plasma in a lab in Birmingham, consenting for it to be potentially used on a patient and for research for “convalescent therapy serum”.
However, his plasma will only be relevant if the new patient’s blood type matches his.
Sources in Freetown say Save the Children has been extra vigilant about the health of the volunteers who work with them at Kerry Town. They are all required to stay at a hotel the charity has block-booked at Lumley Beach in Freetown, and staff are bussed out to the hospital daily with little interaction with any locals.
The number of people infected by Ebola in the three countries worst affected by the outbreak has passed 20,000, with more than 7,842 deaths in the epidemic so far, according to the World Health Organisation. Cumulative case numbers in Sierra Leone, Liberia and Guinea stood at 20,081, the WHO said in a statement. More than a third are laboratory-confirmed cases in Sierra Leone, which has become the worst-hit country in the worst outbreak of the disease on record.