Ebola in London

About nine months ago, Pauline Cafferkey was discharged from a London hospital — seemingly signaling her victory in beating Ebola. Now, not only is Cafferkey back in the hospital with a rare relapse of the deadly virus, but she’s gotten worse. London’s Royal Free Hospital announced Wednesday afternoon that “Cafferkey’s condition has deteriorated and she is now critically ill.” The hospital didn’t elaborate on the news about the Scottish nurse, who last year became the first person diagnosed with Ebola in the United Kingdom. But it’s not a good sign, coming five days after the same medical facility confirmed Cafferkey had been transferred there from Queen Elizabeth University Hospital in Glasgow “due to an unusual late complication of her previous infection by the Ebola virus.” That day, the Royal Free Hospital indicated that Cafferkey was in “serious condition” and being treated in a “high-level isolation unit.”

Since her January discharge, Cafferkey has been out and about, including receiving a Pride of Britain award late last month and paying a visit to 10 Downing Street, where pictures showed her with the prime minister’s wife, Samantha Cameron. Last week Dr. Emilia Crighton, director of public health for the National Health Service group NHS Greater Glasgow and Clyde, insisted that the risk of the 39-year-old Cafferkey inadvertently passing on Ebola to anyone else was “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,” Crighton said.

Like many other volunteers, Cafferkey had gone to West Africa knowing the dangers there. TheEbola virus had spread like wildfire, ultimately killing more than 11,000 people and infecting some 28,000, according to the World Health Organization. Yet that harsh reality didn’t stop the public health nurse in Scotland’s South Lanarkshire area from being part of a 30-person team deployed by the UK government to work in Sierra Leone with Save the Children.

She and other health care workers would later be credited with playing a significant part in corralling and ultimately ending the devastating outbreak. But, as Cafferkey learned, it came at a cost. She fell ill shortly after touching back down on UK soil. Her Ebola diagnosis came next, followed by intensive treatment at the Royal Free Hospital. That facility has an isolation unit tended by specially trained medical staff and a tent with controlled ventilation set up over the patient’s bed. Her road to recovery wasn’t always smooth. The Royal Free Hospital at one point noted that her condition had “gradually deteriorated over … two days” and that she was then critical. Cafferkey, though, managed to rebound and weeks later was allowed to go home. According to the WHO, Cafferkey was then and is still the lone Ebola case in the United Kingdom.

1311034Her relapse does not represent “a new case of Ebola (but rather) is a complication of her previous illness,” Scotland’s chief medical officer said Friday. It’s a rare thing, but not necessarily unprecedented. American doctor Ian Crozier was treated for Ebola in Atlanta last year and declared free of the virus in his blood. But less than two months after being discharged, Crozier started experiencing problems with his vision, and doctors were stunned to find traces of the virus in fluid from his eye. Despite the presence of the virus, samples from tears and the outer eye membrane tested negative, which meant the patient was not at risk of spreading the disease during casual contact, the hospital said at the time. Crozier received steroids and an antiviral agent, and his eye gradually returned to normal. His case prompted a warning to doctors to watch Ebola survivors for eye problems.





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