Pauline Cafferkey, Scots Ebola nurse in ‘serious condition’

Pauline Cafferkey was discharged from hospital earlier this year but has fallen ill again. Picture: Lisa Ferguson

Pauline Cafferkey, of Cambuslang, South Lanarkshire, was flown by military aircraft to the Royal Free Hospital in London yesterday morning from an isolation unit in Glasgow for treatment for “an unusual late complication” of the virus.

Officials have moved to reassure the public there is little risk of contagion after it emerged Ms Cafferkey had visited the Pride of Britain Awards, in London, as well as Mossneuk Primary School, East Kilbride, in the days before she fell ill.

People who have been in close contact with her are being monitored by health authorities as a precaution. Dr Emilia Crighton, NHS Greater Glasgow and Clyde director of Public Health, said it was not a new infection as Ms Cafferkey had contracted the virus in December 2014.

She said: “Pauline’s condition is a complication of 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.”

Ebola has been shown to persist for weeks or even months in parts of the body and in bodily fluids such as breastmilk, semen and fluid inside the eyeball.

A statement from the Royal Free Hospital 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 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.”

Catherine Calderwood, Scotland’s Chief Medical Officer, added: “Pauline is now being cared for in the best place possible, with specialists who have the most experience of looking after patients who have previously recovered from the Ebola virus.”

Ms Cafferkey had returned to her work as a public health nurse at Blantyre Health Centre in March but she did not show any Ebola symptoms, NHS

Lanarkshire confirmed.

She was understood to have been well when she was last at work on 1 October . She took herself to the Queen Elizabeth University Hospital, in Glasgow, on Tuesday after feeling unwell.

David Cromie, consultant in public health at NHS Lanarkshire, said: “Pauline was well while at work and there is no wider public health risk for patients treated by her or her staff colleagues.

“In line with normal procedures, a small number of close contacts have been identified and will be followed up as a precaution. Together with Pauline’s colleagues our thoughts are with Pauline and we wish her a full speedy recovery.”

Experts have said that the 39-year-old is one of very few patients to show signs of reactivated Ebola. Dr Ian Crozier, a US doctor who was treated at Emory Hospital in Atlanta, had viral persistence in the fluid in his eye, and there is evidence of acute eye inflammation among West African survivors.

David Evans, professor of virology at St Andrews University, said: “Persistent Ebola virus infections have rarely been reported previously. The majority of patients are considered non-infectious once symptoms and viremia – a virus in the blood – disappear.

“However, eye infections have been detected nine weeks after clearance of viremia and the virus is detectable in seminal fluid at least 14 weeks after the onset of symptoms in some patients.”

Virus can stay in body tissues

The Ebola virus can linger in bodily tissues even after the person appears to have made a full recovery, according to experts.

Parts of the body such as the eye, central nervous system and testes can harbour the virus, which can also behave in an unpredictable way.

Professor John Edmunds, from the London School of Hygiene and Tropical Medicine, said: “The Ebola virus can occasionally persist for some months in certain tissues.

“The risk of transmission from these individuals appears to be very low. However, with so many survivors in West Africa now, there is a risk that further outbreaks can be triggered, which is why authorities have to remain very vigilant.”

Dr Ben Neuman, a virologist at the University of Reading, said he believes the outlook for Pauline Cafferkey is good. He said: “The nice news here is that she’s beaten the virus once so she can probably beat it again.

“The odds are that she actually has inherited a lucky set of genes and these are probably what protected her the first time and probably what will keep her safe the second time, regardless of any treatment. I think the outlook’s good.”

He said scientists are still learning about the virus.

“It seems that some of the ongoing health problems with people’s eyes, joints and hair loss are actually caused not by the after-effects of Ebola, but by the small amounts of Ebola which is still residing in the body.”

Q&A

What is Ebola?

Ebola is one of the world’s deadliest diseases, with more than 50 per cent of cases resulting in death. The virus is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Outbreaks mainly occur in remote villages. Fruit bats are believed to be the natural host of the virus. The disease was first recorded in two simultaneous outbreaks in 1976 near the Ebola River in the Democratic Republic of Congo. The first cases of the current outbreak in West Africa were detected in 2014.

What are symptoms?

The symptoms of Ebola are severe, with patients often overcome by a sudden onset of fever as well as weakness, muscle pain and headaches. Vomiting, diarrhoea, rashes, kidney and liver problems follow as the virus grips the body. The incubation period - the time between infection and the onset of symptoms - ranges from two days to three weeks.

How is it spread?

Ebola spreads from person to person as a result of direct contact with the blood, organs or other bodily fluids of those infected, with healthcare workers among those who are most at risk. However, it is only contagious while an infected person is actually suffering from symptoms.