Scottish Ebola nurse faces critical days ahead

A SCOTTISH nurse diagnosed with Ebola is receiving an experimental anti-viral drug as she faces a “critical” few days in her fight against the disease, the doctor in charge of her care has revealed.

Pauline Cafferkey. Picture: TSPL

Pauline Cafferkey is being given the drug, which doctors have refused to name, as well as blood from survivors of the disease.

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The 39-year-old is being treated in an isolation ward at the Royal Free Hospital in London after returning from Sierra Leone with the virus at the weekend. Dr Michael Jacobs, an infectious diseases consultant at the hospital, said he was pleased with how the nurse had so far responded to treatment, but said it could be a week before doctors were able to fully assess her condition.

He said she was being treated with an experimental drug, which is not yet proven to work.

Last night, staff at the London hospital said the Scot was not the first person to be given the drug but declined to disclose any further details. Dr Jacobs revealed there are currently no stocks anywhere in the world of another drug, ZMapp, which has been used to treat Ebola patients in the past.

“Ebola runs a very variable course,” Dr Jacobs said. “The next few days are going to be very critical for us. Things may get worse. We hope that the treatment will work, will make her better. But it’s very difficult to predict. We’ll know much more in about a week’s time as to where we stand.”

Two of the most promising anti-virals to treat Ebola are brincidofovir and favipiravir. Tests suggest the anti-virals have the potential to stop Ebola replicating once it infects cells.

Brincidofovir has been tried on patients in the US and both drugs have entered clinical trials in West Africa. However, results are not expected until February.

Ms Cafferkey, a public health nurse at Blantyre Health Centre in South Lanarkshire, was part of a team which travelled to West Africa with Save the Children.

The drug and the “convalescent plasma” from other patients are part of a tranche of experimental treatments, Dr Jacobs said. Asked about Ms Cafferkey’s chances of survival, he said: “We are naturally cautious as physicians, particularly when we’re aware that this disease is so variable in what it does.

“Although we couldn’t be more pleased about where we are today, I make no prognosis about tomorrow or the next day until I see what happens.”

“Pauline is sitting up, talking. She’s able to read. She’s been eating a bit, drinking and she’s been in communication with her family, which has been really nice. In terms of the treatment, we’ve had very detailed discussions with her. Of course, she is a nurse, a fellow professional.

“I’m sure this isn’t how she intended to spend New Year’s Eve – sitting in a tent in the Royal Free Hospital.

“Imagine what she’s been through, having had a journey back from where she had been working incredibly hard to control the disease in Sierra Leone.

“It’s been a very unsettling time for her, which she has coped with remarkably. She remains in a positive frame of mind, but of course she has experience of what this disease can do, and she’s realistic as well.”

He added: “She’s not feeling well, but it would be fair to say that she’s as well as could be hoped for in this stage of the illness. I can’t emphasise enough that it’s very early on in the course of the illness for her.” Yesterday, it emerged Ebola screening is to be reviewed after Ms Cafferkey was allowed to travel from London to Glasgow with the virus, despite telling screening staff she felt unwell.

The UK government’s chief medical officer, Dame Sally Davies, said questions had been raised about the airport screening after it emerged the nurse’s temperature had been checked seven times before she was allowed to continue home.

Dame Sally said: “We regularly review what we are doing because this is a new process. Clearly, queuing and things like that are unacceptable and we will review. But we will let people who are well travel because they will not infect the public.”

She added: “(Ms Cafferkey) was well. She had no symptoms. Her temperature was within the acceptable range. She would not be transmitting the virus; therefore she was cleared as fit to fly.”

The nurse had been working with Save the Children at an Ebola treatment centre in Kerry Town, Sierra Leone.

She was initially placed in isolation at a Glasgow hospital on Monday after feeling feverish, before being transferred south on an RAF C-130 Hercules plane.

The healthcare worker had flown from Sierra Leone via Morocco to Heathrow, where she was considered a high risk due to the nature of her work but showed no symptoms during screening. However, while waiting for a connecting flight to Glasgow, she raised fears about her temperature and was tested six times in the space of 30 minutes.

She was given the all-clear and flew to Scotland where, after taking a taxi home, she developed a fever and raised the alarm.

A Department of Health spokesman said: “We have been clear: this person was tested as part of the screening process at Heathrow and, as with all health workers, she was advised to contact Public Health England if she had any concerns. She did this, while still at Heathrow, and went through a further six temperature checks. Her temperature was in acceptable ranges and she was cleared for onward travel, with the advice that if she did start to feel unwell, she should contact health authorities. After this person got home, she alerted health authorities that she was experiencing symptoms and was admitted to hospital for tests.

“We will be reviewing what happened and the screening protocols, and if anything needs to be changed it will be.”

Save the Children’s humanitarian director, Michael von Bertele, said the charity’s investigation into what happened would consider whether Ms Cafferkey contracted the disease outside the treatment centre in Sierra Leone.

He said: “I would say that protection, if people adhere to the protocols, is of a very high standard but nothing is risk-free, particularly when dealing with a disease like Ebola. I have ordered an investigation and started that already. Our workers don’t just work inside the red zone, which is a very high-risk area, they do also have contact outside of the treatment centre.”

Whereas medics returning to the UK from Sierra Leone are allowed to go home if they do not show any Ebola symptoms, those arriving in some US states are put into quarantine even if they have no signs of the virus.

In New York, New Jersey and Georgia, such passengers are put under a three-week quarantine period at home during which health officials check for symptoms.

Professor John Oxford, a virology expert at Queen Mary University of London, said: “I’m very sorry for the nurse, I must say, but one case does not transform the whole situation. If we see another worker infected in that way then I think that some serious changes must be made.”

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