U.K. Nurse With Ebola in Critical Condition

By Peter Russell
WebMD Health News

Reviewed by Arefa Cassoobhoy, MD, MPH

Jan. 5, 2015 -- Pauline Cafferkey's battle with Ebola took a turn for the worse over the weekend. The 39-year-old nurse from Scotland is in critical condition, London's Royal Free Hospital said on Saturday. She's receiving treatment there in an isolation unit.

Cafferkey caught Ebola while working in Sierra Leone at the Kerry Town Ebola Treatment Center, which is managed by Save the Children, an international charity.

Save the Children says it's looking into how she got infected.

Experimental Treatment

Cafferkey was diagnosed with the disease after returning to Glasgow, Scotland, on Dec. 28. She was soon transferred to an isolation unit at the Royal Free Hospital.

At first, she was sitting up in bed, talking, and reading, the hospital said. But that changed on Saturday, when they said her condition had worsened.

Cafferkey opted to have a treatment that uses the blood of Ebola survivors. She also chose to take an experimental antiviral drug.

Professor Peter Horby, from the Epidemic Diseases Research Group at the University of Oxford, says in a statement: " Even with advanced medical care Ebola remains an extremely serious disease.

"We desperately need a better understanding of the disease process and better, specific treatments.

"Pauline Cafferkey has reportedly received both an antiviral drug and convalescent plasma, but we do not know if these treatments are effective, useless, or perhaps even harmful. This underlines the urgent need to properly evaluate experimental therapies for Ebola, including convalescent plasma, so we know what works and what does not."

Shortly before she was hospitalized, Cafferkey flew from West Africa back to Glasgow via Morocco and London. During a stopover at London's Heathrow Airport she told officials she might be getting a fever. But seven tests recorded her temperature as normal and she was allowed to resume her journey home.

She fell ill the following day and was admitted to the Brownlee Unit for Infectious Diseases at Gartnavel Hospital. On Dec. 30, she was transferred to the high-level isolation unit in the Royal Free Hospital.

Last year British volunteer nurse William Pooley was successfully treated at the same unit after catching Ebola while also working in Sierra Leone.

Training and Safety Review

The Kerry Town Ebola Treatment Center opened in November last year. It has so far treated 220 patients, and it has a staff of more than 500.

Save the Children says its review will look at training, safety rules, the use of equipment, and working practices.

The charity says it began investigating what led to Cafferkey's infection the moment she was diagnosed with the disease. "The findings of the review will be considered by a panel including independent health experts, which will support Save the Children and make recommendations for any actions if necessary. The early findings of the review will be made available by Save the Children as soon as possible," the charity said in a statement.

"As with other Ebola infections in health facilities, it may never be possible to be 100% sure how the patient was infected. The work of these brave health workers is never risk-free, but we are committed to doing everything possible to learn what happened and, if necessary, to make changes to our protocols and practice.

"Staff safety is our number one priority, and our thoughts are with Pauline and her family at this very difficult time."

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SOURCES: Save the Children. Royal Free Hospital, London. Professor Peter Horby, University of Oxford. Science Media Centre.

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