EBOLA Ebola nurse Pauline Cafferkey 'in serious condition'

JohnGaltfla

#NeverTrump
Ebola nurse Pauline Cafferkey 'in serious condition'

BBC NEWS
OCTOBER 9, 2015 12:30 PM ET


A Scottish nurse who contracted Ebola in Sierra Leone last year is in a "serious condition" after being readmitted to an isolation unit in London.


NHS Greater Glasgow and Clyde confirmed that the virus is still present in Pauline Cafferkey's body after being left over from the original infection.


She is not thought to be contagious.


The 39-year-old has been flown back to the isolation unit at the Royal Free Hospital in London.


Bodily tissues can harbour the Ebola infection months after the person appears to have fully recovered.


Ms Cafferkey, from Cambuslang in South Lanarkshire, spent almost a month in the unit at the beginning of the year after contracting the virus in December 2014.

NHS Greater Glasgow and Clyde (NHSGGC) said she had been admitted to the Queen Elizabeth University Hospital in Glasgow on Tuesday after feeling unwell and was treated in its infectious diseases unit.
She was then transferred to the Royal Free Hospital in the early hours of Friday morning due to an "unusual late complication" in her illness.


Dr Emilia Crighton, NHSGGC director of public health, said: "Pauline's condition is a complication of a 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."


Government sources have described her transfer to the specialist unit as a "highly precautionary process".

He said the effects of the virus on the body could last for up to two years, although it was difficult to know how long it could actually persist.
He added: "The nice news here is that she's beaten the virus once so she can probably beat it again.


"The odds are that she has actually 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. The outlook's good."


Ebola is passed on through bodily fluids. It is not transmitted through casual contact.

Last week Ms Cafferkey, who works at the Blantyre Health Centre, was in London receiving an award at the Pride of Britain ceremony which recognised the risks aid workers took with their own health.


There are not thought to be any concerns about contact she had with people at the event but health officials in Scotland are focusing on who she had seen since her return home.


Ms Cafferkey contracted Ebola while working as a volunteer with Save the Children at a treatment centre in Kerry Town, in Sierra Leone.


She was diagnosed on 29 December last year, after returning to Glasgow via London.
Image copyright Getty Images Image caption Ms Cafferkey contracted Ebola while working as a volunteer in Sierra Leone last year Her temperature had been tested seven times before she flew from Heathrow to Glasgow and she was cleared to travel, before later falling ill.


She was placed in an isolation unit at Glasgow's Gartnavel Hospital after becoming feverish, before being transferred by an RAF Hercules plane to London on 30 December.


She was then transferred to the specialist isolation unit at the Royal Free.
After a few days Ms Cafferkey's condition began to deteriorate, with the hospital announcing she had become critically ill on 4 January.


After leaving hospital later the same month, Ms Cafferkey said she was "very happy to be alive" and was looking forward to returning to "normal life".



An investigation by Save the Children later concluded that the nurse had probably caught Ebola by wearing a visor instead of goggles while treating patients.


Ebola virus disease (EVD)

Image copyright SPL
  • Symptoms include high fever, bleeding and central nervous system damage
  • Spread by body fluids, such as blood and saliva
  • Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
  • Incubation period is two to 21 days
  • There is no proven vaccine or cure
  • Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
  • Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host
At the time, Dr Michael Jacobs, from the Royal Free's infectious diseases team, said Ms Cafferkey had completely recovered and was "not infectious in any way".


NHS Lanarkshire said she had begun a phased return to work in mid-March, and had last been at work on 1 October.


Consultant in Public Health David Cromie 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 in cases such as this, a small number of close contacts of Pauline 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."
 

WestGardener

Senior Member
Ebola Back In The News - Ebola Nurse Back In The Hospital

Well this makes me feel warm and fuzzy.

Ebola Back In The News - Ebola Nurse Back In The Hospital With 'Unusual Late Complications' Months After Being 'Cured' Of Ebola And Discharged



By Susan Duclos - All News PipeLine

A concerning situation was brought to our attention by an ANP reader, highlighting a RT article about an Ebola nurse that had been disagnosed, treated and discharged earlier in the year, but has now been readmitted to the hospital with an ""unusual late complication" linked to the Ebola virus, and she is now in "serious condition."

Pauline Cafferkey was transported from Glasgow to the Royal Free Hospital in Hampstead, London, in a military plane under strict supervision. She will be kept in isolation and closely monitored, but Public Health England say there is very little risk to the general public.

Doctors at the hospital have said she is in a "very serious condition".

People who have been in close proximity with the nurse are also being monitored by Scottish health authorities.

While the RT article was short on details of exactly what the unusual late complication was, further research shows a report from BBC that expands on that explanation, stating " NHS Greater Glasgow and Clyde confirmed that the virus is still present in Pauline Cafferkey's body after being left over from the original infection.

According to CNN "In December, the Glasgow resident became the first person to be diagnosed with the virus on UK soil shortly after returning from Sierra Leone."

A more technical explanation on how "cured" Ebola patients can fall sick again months after recovery can be found at The Conversation, who details past occurrences and the dangers very well.

This brings Ebola back into the news, but the question is, did it ever really leave the news or did it just leave the majority of U.S. news outlets after reports that the Obama administration "pressured" media outlets to not report on Ebola news?

WHAT ABOUT THE PATIENTS THAT WERE BROUGHT TO THE U.S.?

As many may remember American doctors that had contracted the Ebola virus in West Africa were brought back into the U.S. for treatment then were discharged. There were also reports from October 2014 saying the U.S. had "quietly made plans" to bring foreign Ebola patients to the U.S. for treatment.

This brings about the very real concern and question about whether the virus is still present in the patients diagnosed, treated and discharged here in the states? What are the chances this type of "complication" can occur in those patients? Has it already happened to any and the government has kept it quiet? Would the media have reported it after agreeing to not report suspected cases?

According to USA Today on September 22, 2015, The U.S. "hasn't learned key lessons from Ebola experience," with experts questioning "whether the country is prepared to deal with the next outbreak of a serious infectious disease."

The concern is real as we are reminded of an article Stefan Stanford wrote at ANP just days ago, where he stated "A Google search for mystery illnesses during the past month alone brings up more than 220 entries and looking through them we find Hollywood 'stars', athletes, animals and ordinary day-to-day people like you and I, suffering from illnesses and diseases that doctors are unable to put a label on."

Make no mistake, we are not saying these mystery illnesses are in any way related to Ebola, we are reminding people they are out there and due to the MSM's downplaying and in some cases refusing to report on Ebola news in U.S., pointing out that there are questions that need to be asked.... as shown below.

I, for one, would like to know where the patients treated and discharged here in America are, if they are still being monitored, if they are exhibiting any symptoms of sickness? Do any of the people suffering from these "mystery" illnesses showing any Ebola-like symptoms?

Lat but not least..... would the MSM even tell us if the did?


http://allnewspipeline.com/Ebola_Back_In_The_News.php

......................................................................................


Ebola nurse Pauline Cafferkey 'in serious condition'

http://www.bbc.com/news/uk-scotland-34483584




Ebola nurse Pauline Cafferkey 'in serious condition'


A Scottish nurse who contracted Ebola in Sierra Leone last year is in a "serious condition" after being readmitted to an isolation unit in London.

NHS Greater Glasgow and Clyde confirmed that the virus is still present in Pauline Cafferkey's body after being left over from the original infection.

She is not thought to be contagious.

The 39-year-old has been flown back to the isolation unit at the Royal Free Hospital in London.

Bodily tissues can harbour the Ebola infection months after the person appears to have fully recovered. (continued at link)
 

Housecarl

On TB every waking moment
However you slice this, the toll this disease is going to have on her is going to leave her a wreck, if for no other reason than the end result of the repeated long term fevers she's experienced.
 

JohnGaltfla

#NeverTrump
However you slice this, the toll this disease is going to have on her is going to leave her a wreck, if for no other reason than the end result of the repeated long term fevers she's experienced.

But don't worry, she didn't expose herself to ANYONE at grocery stores, etc. :whistle:
 

Ordinary Girl

Veteran Member
Nearly a year later, she still has active virus in her??? How many other "recovered patients" are still infected?
 

Countrymouse

Country exile in the city
Nearly a year later, she still has active virus in her??? How many other "recovered patients" are still infected?

What you want to bet it's like shingles...




lives in your body FOREVER, and re-activates without warning-----like (pardon the reference, given the forum) a ticking time bomb?
 

Hfcomms

EN66iq
She is not thought to be contagious.

That should give everyone she comes into contact with a warm fuzzy feeling all over.
 

Ordinary Girl

Veteran Member
Remember all those mutations it made? What if one or many of those people who got Ebola did have malaria. Malaria is like shingles. It can lay dormant. Suppose Ebola is now a relapsing/remitting disease...

Is that too woo woo? ....I will go back to my lurking corner of it is....
 

Melodi

Disaster Cat
My heart goes out to her (and everyone affected) from what I can tell at a distance she is a lovely person who would never intentionally endanger others - this is a big flashing warning sign, that Ebola is potentially even worse than a bio-level 4 hazard that the US in its hubris thought they could just "treat" as a level 2 disease (and therefore exposed more nurses and people who died or became very ill without need).

It is a bio-four level illness that may continue to lurk in the body; but unlike some diseases that do this (TB is another one) it probably "goes hot" a lot easier and "may" be more infectious - we simply don't know and they can say what they like to calm the public down, but this all depends on if she has a "secondary" infection indirectly cause by what the Ebola did to her system (probably safe then) or if she as a second ACTIVE case of Ebola (then likely just as dangerous as the first time).

This gets more complicated if it is the second case, because the US "non-care" system for people who are under or not-insured; means that some previously affected people may not go to the doctor right away if they start feeling bad. Heck, even people who are insured and have massive co-pays may not do this; not to mention people who have been in US system for quarantine, especially those from families who got shoved hither and yon by untrained police and local authorities are NOT going to want to repeat the process.

A nurse is going to understand the danger, and a nurse on the NHS knows that she will be care for and the family not reduced to bankruptcy; but consider some of the folks who were affected in the US a run and hide hoping for the best, strikes me as more likely than coming forward (the doctors and nurses, most of them excepted; again they know better).

I think we can be really-really grateful that not many people in the West were affected in the first breakout and most that were both infected overseas and Stateside were health care workers; otherwise I would be a lot more concerned.

We may not be so lucky the next time the CDC and health authorities ignore the warnings on the need for level four precautions
 

raven

TB Fanatic
"The odds are that she has actually 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

It appears that some people naturally have immunity to Ebola.
 

pinkelsteinsmom

Veteran Member
Nearly a year later, she still has active virus in her??? How many other "recovered patients" are still infected?

All of them. You feel better though now that the obola news has been shut down by the black tyrant. It worked like magic. We have no way of knowing how many have been brought here, how many are walking the streets with it. The news of the obola crisis in Afrika, just flitted away like smoke from a cigarette, it just magically stopped.

As you read here though, "she is not thought to be contagious" the medical and scientific community now are a very dangerous joke.:mad: :bhrt:
 

Kook

A 'maker', not a 'taker'!
All of them. You feel better though now that the obola news has been shut down by the black tyrant. It worked like magic. We have no way of knowing how many have been brought here, how many are walking the streets with it. The news of the obola crisis in Afrika, just flitted away like smoke from a cigarette, it just magically stopped.

As you read here though, "she is not thought to be contagious" the medical and scientific community now are a very dangerous joke.:mad: :bhrt:

Two 'communities' that are dependent on government handouts for its existence. You can depend on medical 'professionals' and 'scientists', for the most part, to tow the official government approved line every time. Gotta keep those grants rolling in!
 

Faroe

Un-spun
I am sad for her.
To go through all that, to think you are cured, and to later find out you were only in remission.

I'm thinking, no one is ever really "cured."
 

Melodi

Disaster Cat
I am sad for her.
To go through all that, to think you are cured, and to later find out you were only in remission.

I'm thinking, no one is ever really "cured."

I know they have been having issues with this in Africa, it may be like TB or Malaria where it never really totally goes away but of course it is much more deadly than both - Malaria does kill of course (many many millions) but there are drugs to contain it these days.

It would be extremely sad if ultimately former Ebola patients find they have to live their lives in isolation, which of course would simply not be possible in the third wold; instead my hunch is people might just murder them (I hope not) but if it because a big problem, I could see it happening.
 

pinkelsteinsmom

Veteran Member
Wait till it gets in the blood supply.

They use to isolate leprosy victims (and they are coming over the border with right now), today it's racist to not let ebola run free.

The idiocy that is demonstrated daily now in obama's idiocracy and the world is mind boggling.
 

China Connection

TB Fanatic
A friends wife has this below. She has had it for over a year now. It is making her life a bit of a hell.



Ross River virus (RRV) is a small encapsulated single-strand RNA alphavirus endemic to Australia, Papua New Guinea and other islands in the South Pacific. It is responsible for a type of mosquito-borne non-lethal but debilitating tropical disease known as Ross River fever, previously termed "epidemic polyarthritis".
Ross River virus - Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Ross_River_virus
Feedback
Ross River fever - Wikipedia, the free encyclopedia
https://en.wikipedia.org/wiki/Ross_River_fever
Jump to Symptoms - Ross River Fever is a mosquito-borne infectious disease caused by infection with the Ross River virus. The illness is typically characterised by an influenza-like illness and polyarthritis.
‎History - ‎Incidence and epidemiology - ‎Transmission - ‎Symptoms
 

Housecarl

On TB every waking moment
Remember all those mutations it made? What if one or many of those people who got Ebola did have malaria. Malaria is like shingles. It can lay dormant. Suppose Ebola is now a relapsing/remitting disease...

Is that too woo woo? ....I will go back to my lurking corner of it is....

My concern is something like Ebola getting with an influenza strain and exchanging RNA between them. Remember the film "The Satan Bug" and King's "The Stand"?
 

Melodi

Disaster Cat
From the UK Guardian newspaper:

Nurse with Ebola visited school day before being readmitted to hospital

But don't worry, the NHS, the same wahoos which said she was "cured" said she can not transmit the disease via 'social contact' in public. :kk2: :eek:
Very little to do with it being the NHS, more likely under "orders" from the UK Government; the CDC in Atlanta "declared" the "precautions" taken in the Texas hospital to be just fine too and they told the Nurse in the US that she was "free to travel" when it went against common sense much less good medical practice.

The NHS has a lot of issues, but not knowing that this was a serious potential probably probably can not be laid totally at their doorstep, I mean we haven't heard about the American doctors or nurses who have "recovered" being told not to treat patients, visit their friends etc.

This women was visiting a school because she is basically a good person and trying to do nice things for people, she had been told it was fine...

Now I wonder if the US (or the insurance companies for hospitals) are going to order all the "recovered" health care workers to quit working (and if they do, then the issues of support and automatic disability for anyone who ever catches this disease if they are declared unemployable becomes very interesting).
 

Melodi

Disaster Cat
My concern is something like Ebola getting with an influenza strain and exchanging RNA between them. Remember the film "The Satan Bug" and King's "The Stand"?
From what I am seeing in the medical articles (and I haven't had a chance to ask Nightwolf on this one yet) it looks like the virus is able to act somewhat like the HIV virus - they are NOT related, but HIV is able to "hide" in the body, sometimes for years. All the test comes back negative, which is why so many times people were declared "cured" only eventually it came back - now it is simply accepted that except for a few people with lucky genes, HIV is a chronic condition that always needs some treatment because it WILL come back. Or it will do so until science comes up with a way to ferret out the hidden viruses that are hiding.

It looks like Ebola may work the same way, which is terrifying because while even without treatment many people can live a few years with HIV and it is never the HIV itself that kills (it just destroys the immune system so something else does) Ebola on the other hand is one of the most deadly diseases on Earth and unlike HIV, it can be spread by touching or interacting closely with a sick person (cleaning them up, holding their head while they vomit, preparing them for burial etc).

HIV is a lot harder to catch than that, not to mention there are some indications that Ebola in some forms may be starting to be not medically airborne but transferable if you are close enough to someone that is breathing germs directly on you. That isn't certain but is currently accepted as possible, the CDC and other can still claim "it isn't airborne" because that is a very technical medical definition and doesn't cover close enough to be breathed on directly and rather refers to a virus that hangs in the air for awhile and spreads in it, like the nasty head cold I've got at the moment.

If you walk in a room a hour after someone with a cold is in there, you may catch the virus and that is not what happens with Ebola (at least not now) but if you were caring for a sick child and they sneezed on you with Ebola it could be transmitted.
 

Melodi

Disaster Cat
One more quickie: The 64 thousand dollar question here is, Is a secondary infection or flare up as contagious as an first infection? No one, not the NHS or anyone else knows yet...stay tuned...
 

Plain Jane

Just Plain Jane
H/T https://flutrackers.com/forum/forum...d-for-ebola-complication-in-serious-condition

http://virologydownunder.blogspot.com/

Is the next Ebola virus revelation...reactivating infection?
Update #1 11OCT2015 AEST
Update #2 11OCT2015 AEST


Great. Are members of the Zaire ebolavirus (EBOV) species the most educational viruses of modern times or what? I mean, we've "known" about EBOV since 1976, but the West Africa Ebola virus disease (EVD) epidemic is the epidemic that keeps on giving - we seem to learn a brand new thing every few months.

And the latest is a doozy although we don't know many of the details yet.

So what do we know about this new finding of a seeming return of infection in a former EVD case? Or is this new disease because of damage from the old infection?
1. A 39 year old nurse, PC, was originally infected with EBOV while working for 3 weeks in the Save the Children’s Kerry Town Treatment Centre in Sierra Leone. She did not show signs of illness until after arriving home in Scotland [1,11]
2. PC was believed to have become infected while treating EVD patients in some way related to her use of a visor as part of her personal protective equipment, rather than goggles, [10]
3. PC entered a Gartnavel Hospital isolation unit on 29-DEC-2014, and was subsequently flown to the Royal Free Hospital (RFH) in Hampstead, North London on 30-DEC-2015. She stayed there for around a month [2,4]
4. During her time in the RFH, PC was treated with convalescent blood plasma and an experimental antiviral drug
5. PC was declared free of EBOV and discharged from the RFH on 24-JAN-2015 but continued to report thyroid problems afterwards as she described just a week ago [3,4,12]
6. On Monday evening, PC went to a GP service at Victoria Hospital with a temperature, headache, sore neck and sensitivity to light (photophobia). [15] She was sent home.
7. On Wednesday 07-OCT-2015, PC was admitted to the Queen Elizabeth University Hospital (QEUH) in Glasgow, Scotland. Tests revealed that EBOV (presumably) RNA was present.[13]
8. On Friday 09-OCT-2015, PC was admitted to the RFH, 8 months and 15 days after being declared free of Ebola virus and discharged.[16]
9. She is described as being in serious condition. However, it is unclear what her signs and symptoms were at presentation, or have become since.[4]

Descriptions note that PC is "not thought to be contagious". Presumably this means she is not symptomatic with EVD and if so the testing that must have identified EBOV somewhere in her system must have does so from a part of her system that is not readily in contact with the environment. Nonetheless, she is once again isolated at one of the world's best infectious diseases hospitals.[4]

There are also recent reports of PC having had thyroid problems after recovering-perhaps virus has been replicating in this tissue. PC's "condition is a complication of a previous infection with the Ebola virus".[4] Which leaves a lot of room for idle speculation but could just be that she is ill because of what the fallout from what EBOV previously did to a tissue/organ rather than because of EVD itself. Perhaps follicles in the scalp have been a site for virus replication, relating to her earlier hair loss. Another site may be the central nervous system...

@amymaxmen I've heard she has a meningitis like syndrome, probably CSF is where #Ebola virus is replicating
— Ahmed Tejan-Sie MD (@AhmedTejanSie) October 9, 2015

All speculation. Again, nothing is known about PC's signs and symptoms of disease when she presented herself to the QEUH, what tissue(s) are involved in her current illness, which samples tested positive first, whether viral culture has been conducted or just RT-PCR and where the virus may have been replicating all this time. While we understand that some tissues are sites for EBOV persistence, there is clearly much more to learn about the frequency and full range of tissues that harbour infectious EBOV once it becomes undetectable in the blood.

Apart from how shocking and scary this must be for PC herself, another issue is how this will impact on the fragile processes of accepting of EVD survivors back into their West African communities. Extending the length of time that some male survivors are known to harbour EBOV already put pressure on their acceptance by some, but the potential for virus to return to the blood or other tissues - if indeed that is what has happened here - even after that time frame, will require a lot of communication to explain. It will be vitally important for this process that the facts underpinning what's happened here are deduced soon and communicated in ways that can be understood in West Africa. This is a chance for the World Health Organization to show off their shiny new intent to do better at communicating and reacting.

This is not the first time EBOV has been found to persist in a convalescent former EVD case.[5,6,7,8,9] But this may be the first documented time that the virus has re-emergedfrom an immune privileged site and returned to the blood, possibly causing EVD symptoms in the same former EVD case (recent media article mentions that this is the 2nd such case[15]).

The comments about PC's photophobia are similar to those from Dr Ian Crozier - who was found to have persistent infectious virus in the aqueous humor collected by needle from the anterior chamber of his eye causing uveitis-14 weeks after his EVD diagnosis.[6,17] His blood did not become EBOV positive again.[17] The virus found in his blood earlier and his ocular fluid 14 weeks later were nearly identical-just five mutations differentiating the genomes. Could the eye be a site of PC's hidden virus also? Perhaps the central nervous system the reservoir given the meningitis-like symptoms PC's family mention?[15] Again, all speculation.

Shingles has been thrown up as an example of a similar disease that results from a virus recurring but it's not the same thing at all. Although, we don't know that with absolute certainty. The viruses are very different - that we know for certain. Varicella zoster virus (VZV) is the herpesvirus that first causes chickenpox (doctors call it 'varicella'), usually in childhood. The virus then goes dormant in your nerves. In this state, the virus is not producing full virus particles and so VZV no longer excites our (cellular) immune system, which can eventually "forget" it. Decades later (again, usually) after lying dormant and because of triggers and a lack of suitable immune memory VZV may arise from dormancy (reactivate) to produce lots of whole virus and cause shingles (doctors call this 'herpes zoster' - still the VZV though).[14] As far as we know, EBOV does not go dormant or become latent, but remains active at some sites, like the testes and the eyeball,[5,7] where our immune system is programmed not to venture in full force, so as to protect those sites from unwanted inflammation (in a nutshell). There may well be other sites.

Hopefully, more official key information will be made clear soon (as opposed to in the scientific literature weeks or months from now) as it will be vitally important for the continued management and support of EVD survivors in West Africa. It is also important knowledge for communicating real risks, and informing and toning down perceived but unrealistic ones. What falls into which category is however becoming harder and harder to discern.

I'll update this blog post as more information comes to hand.

References...
1. http://www.bmj.com/content/350/bmj.h36.long
2. http://www.bbc.com/news/uk-scotland-30629397
3. http://www.independent.co.uk/news/u...issue-for-months-after-recovery-a6687571.html
4. http://www.bbc.com/news/uk-scotland-34483584
5. http://virologydownunder.blogspot.com.au/2015/08/post-ebola-syndrome-or-just-chronic.html
6. http://virologydownunder.blogspot.com.au/2015/05/ibola-and-speed-of-research-reporting.html
7. http://virologydownunder.blogspot.com.au/2014/08/ebola-virus-in-semen-is-real-deal.html
8. http://virologydownunder.blogspot.com.au/2015/03/liberia-enters-next-phase-of-ebola.html
9. http://virologydownunder.blogspot.com.au/2015/03/catching-ebola-mistakes-messages-and.html
10. http://www.theguardian.com/world/20...-pauline-cafferkey-royal-free-hospital-london
11. http://america.aljazeera.com/articles/2015/1/3/scottish-nurse-ebola.html
12. http://metro.co.uk/2015/01/24/briti...omplete-recovery-and-leaves-hospital-5035112/
13. http://www.bbc.com/news/uk-scotland-34495250
14. http://www.nytimes.com/ref/health/healthguide/esn-shingles-expert.html?pagewanted=all
15. http://www.dailyrecord.co.uk/news/scottish-news/family-condemns-hospital-failures-after-6612236
16. https://www.royalfree.nhs.uk/news-media/news/update-on-pauline-cafferkey/
17. Persistence of Ebola Virus in Ocular Fluid during Convalescence

http://www.nejm.org/doi/full/10.1056/NEJMoa1500306
Updates...

1. Added dates for PC being initially released from the RFH and that she was tested at the QEUH; described "dormant" and qualified that chickenpox and shingles can occur at any times but usually as a child and adult respectively; provided references about chickenpox

2. Updated information from Ref 15 including dates, new calculation of time between RFH 1st discharge and admission and some symptom information from famliy
Posted by Ian M Mackay
 

Melodi

Disaster Cat
It is true that she was sent home from an NHS "out-of-hours" clinic based on the symptoms she had at the time, the family is furious but honestly I think any US "night" clinic, Kasier "After hours clinic" or designated ER would probably have done the same. Her symptoms were "mild" at that point and no health system tends to throw people in the hospital for them, even a former Ebola patient that was declared "Cured."

Now, that had better change, because it looks like this disease either goes dormant itself and can flare up at any time and/or it allows conditions that most people have in tiny amounts in their system to flare out of control (like various forms of the herpes virus - and yes most people have variations of this in their systems and most are NOT sexually transmitted).

HIV also does this by hiding in the body (making it hard to kill) and lowering the immune system so that things the body naturally handles every day, suddenly explode and make the person very ill; perhaps allowing the Ebola to come roaring back into full force (the same way untreated HIV does).

Now push this forward, what if this is true of many; even say a third of people who "recover" from the disease; think of what it does to a health care system; any health care system single payer or for profit, that now has to treat every sniffle, flu or small rash as a need for hospitalization "just in case" for any person who has recovered from this disease?

I mean right now in the West, there are not that many people; but if say all the health workers are suddenly banned from working because they might go contagious and become essentially wards of the State (unless their families have money) then even the public health care costs just for them could be in the millions (not their fault, no one knew; this is all virgin territory).

My hunch is going to be that especially in the US, either this risk will be ignored until something horrible happens and/or health care providers will simply fire these people en mass (there are not that many of them) some will go on insured disability if their hospital had it, others will just have to hope for the best and the CDC might ultimately have to take on their care.

The real kicker is not the first world (no yet anyway) where most countries have no more than a few affected people, most of whom are health workers and will cooperate with with the situation as much as they can; but in Africa where there is almost no real health system and where if this turns out to be the case; few people will be able to risk volunteering.

It is one thing to risk a possibility of death doing volunteer work, quite another to risk a need for partial to total isolation if you live; or even repeated hospitalizations in isolation every time you get a cold (and you risk infecting everyone you love).

Africa could be essentially cut off, as there is no way their system can deal with patients who require this sort of repeated treatment in isolation wards; instead they will just be out in the population and hope for the best.

I hope things are not really this grim and that this is a rare side effect...but I'm just not sure.
 

Plain Jane

Just Plain Jane
Melodi said:
My hunch is going to be that especially in the US, either this risk will be ignored until something horrible happens and/or health care providers will simply fire these people en mass (there are not that many of them) some will go on insured disability if their hospital had it, others will just have to hope for the best and the CDC might ultimately have to take on their care.


I agree that this is likely to happen. The other thing is that they have not been able to develop a vaccine for HIV because it mutates too rapidly. I think it's possible that Ebola has aquired that same capability. Why aren't we seeing cases like this in West Africa? Or are they going unnoticed, mistaken for something else?
 

almost ready

Inactive
Melodi said:


I agree that this is likely to happen. The other thing is that they have not been able to develop a vaccine for HIV because it mutates too rapidly. I think it's possible that Ebola has aquired that same capability. Why aren't we seeing cases like this in West Africa? Or are they going unnoticed, mistaken for something else?

There have been many. The solution has been mainly to forbid reporters visiting hospitals or reporting on anything ebola without government clearance. Thus, a news blackout, perhaps more of a brown out, as some things continued to leak through for awhile. Cases that have relapsed include hospital personnel and others.

Besides the active relapses, the more serious problems after ebola include physicial deterioration and blindness, as well as social ostracism.

EDITED to clarify: "Many" referring to the relapsed cases doesn't mean a high percentage back in the hospital, but more than a few have made the news in Africa. Even 1/10 of 1% of the 11,000 cases in Western Africa, which may be more accurate than "many", is a number to consider seriously, as each can begin the cycle again.
 
Last edited:

Melodi

Disaster Cat
There have been many. The solution has been mainly to forbid reporters visiting hospitals or reporting on anything ebola without government clearance. Thus, a news blackout, perhaps more of a brown out, as some things continued to leak through for awhile. Cases that have relapsed include hospital personnel and others.

Besides the active relapses, the more serious problems after ebola include physicial deterioration and blindness, as well as social ostracism.

I have heard rumors along these lines as well; in Africa most people never see a doctor unless they collapse in the street or are wealthy; people with milder symptoms will just stay home and quite a few probably just die in their beds. Others do end up back in the hospital where there is a news black out of sorts; for one thing it isn't "good" for a very poor country to go public that it might have an out-of-control disease that is making a come back; so they will hide it as long as they can't to prevent travel and trade restrictions and just hope for the best.

Of course if massive numbers fall ill, it will get out; but this is also why scientists simply don't know yet how common the relapses are and if the carriers are only sick themselves or if the virus goes "hot" again.
 

almost ready

Inactive
There was some mention of this in the press last Spring.

Here is a Reuters article:

http://af.reuters.com/article/topNews/idAFKCN0QD08120150808



LONDON (Reuters) - Thousands of West Africans who were infected with the Ebola virus but survived it are suffering chronic conditions such as serious joint pain and eye inflammation that can lead to blindness, global health experts said on Friday.

Ebola survivors who fought off the most severe bouts of infection are the most likely to suffer ongoing medical problems, World Health Organization experts said, and their health is becoming "an emergency within an emergency".

"The world has never seen such a large number of survivors from an Ebola outbreak," said Anders Nordstrom, a WHO representative in Sierra Leone who took part in a five-day conference this week about Ebola survivors.

"We have 13,000 survivors in the three countries (Guinea, Liberia and Sierra Leone). This is new - both from a medical and from a societal point of view," he told reporters on a telebriefing.

Daniel Bausch of the WHO's clinical care team on Ebola survivors said about half of all those who fought off the virus now report joint pain, with some suffering such severe effects that they can't work.

Eye problems including inflammation, impaired vision and - in severe but rare cases - blindness, have been reported by about 25 percent of survivors, Bausch said.

Less measurable but equally serious long-term problems, such as increasing rates of depression, post traumatic stress disorder and social exclusion, are also affecting survivors.

Since West Africa's devastating Ebola epidemic was by far the largest ever seen - infecting more than 27,000 people and killing almost 11,300 of them - scientists are not able to say whether survivors' chronic health problems are unusual.



The Ebola virus is thought to be able to survive no more than 21 days in most body fluids, such as blood and vomit, which are the primary means of transmission.

But it is also known to be able to lurk in semen and in the soft tissues of the eye for up to several months after recovery.


Scientists believe the vision impairments reported by survivors of the current outbreak are probably linked to the virus persisting in the eyes.

Bausch said sight problems, joint pain and headaches have been reported in a few survivors of previous outbreaks since the disease was first detected in 1976. But past epidemics were much smaller, meaning survivor numbers were too small to study or draw any meaningful scientific conclusions.

Specialists say, however, that it is not surprising that a virus as dangerous as Ebola could have long-term impacts, and the unprecedented outbreak in West Africa offers a unique opportunity to learn more about how to help survivors.


****

What we are seeing now is an extension of the known time it can lurk, not a new phenomenon.
 

almost ready

Inactive
Yes, Melodi, you are so right. Most relapses in West Africa will be hidden from the authorities. Nobody wants to have their entire family or neighborhood quarantined again.
 

JohnGaltfla

#NeverTrump
Pauline Cafferkey: 58 close contacts of Ebola nurse being monitored

Vaccine offered to some in the group while all face twice-daily temperature checks and travel restrictions after nurse developed an Ebola-related illness


UK GUARDIAN
Monday 12 October 2015 18.24 BST
LIBBY BROOKS

Health officials have imposed twice-daily temperature checks and travel restrictions on 58 people who had close contact with Pauline Cafferkey, the Scottish nurse who was diagnosed with Ebola in December and fell ill again last week with complications related to the disease.

Of the 58, 40 were confirmed as having had direct contact with the nurse’s bodily fluids and were offered an Ebola vaccine in line with criteria set out by an expert advisory group that includes Health Protection Scotland, Public Health England and the Scottish government. Of those 40, 25 have accepted the vaccine and a further 15 have either declined it or were unable to receive it due to existing medical conditions.

NHS Greater Glasgow and Clyde confirmed that the group who had close contact with Cafferkey since she started to show symptoms of the Ebola-related illness includes healthcare workers, friends, family and community contacts but would not comment on their age range.

The nurse visited a primary school in East Kilbride, South Lanarkshire, the day before her re-admission to hospital to thank children for their fundraising efforts.

All 58 people will continue to be closely monitored for 21 days since their last contact with Cafferkey. The healthcare workers involved have been asked not to have any direct patient contact during this period.

Cafferkey is being treated at the Royal Free hospital in north London where her condition remains serious.

In a statement, NHS Greater Glasgow and Clyde said: “All close contacts of Pauline Cafferkey since she became symptomatic have now been identified.

“[The expert group] has agreed that, as a precautionary measure, close contacts who have been established as having had direct contact with any bodily fluids would be offered vaccination. These vaccinations have now taken place.

“It is important to stress once again that there is no risk to the general public. Ebola is not spread through ordinary social contact, such as shaking hands or sitting next to someone. Nor is it spread through airborne particles.”

The vaccine offered was the unlicenced rVSV-ZEBOV vaccine, which is currently being trialled in collaboration with the World Health Organisation and has been tested on more than 7,000 people during the recent outbreak of Ebola in Guinea.

On Sunday, Cafferkey’s sister Toni said that doctors missed an opportunity to diagnose that she had fallen ill with an Ebola-related condition up to 24 hours before it was eventually recognised.

Toni Cafferkey said her sister went to an out-of-hours GP clinic at the New Victoria hospital in Glasgow on Monday night where the doctor who assessed her diagnosed a virus and sent her home.
 

Caplock50

I am the Winter Warrior
From what I am seeing in the medical articles (and I haven't had a chance to ask Nightwolf on this one yet) it looks like the virus is able to act somewhat like the HIV virus - they are NOT related, but HIV is able to "hide" in the body, sometimes for years. All the test comes back negative, which is why so many times people were declared "cured" only eventually it came back - now it is simply accepted that except for a few people with lucky genes, HIV is a chronic condition that always needs some treatment because it WILL come back. Or it will do so until science comes up with a way to ferret out the hidden viruses that are hiding.

It looks like Ebola may work the same way, which is terrifying because while even without treatment many people can live a few years with HIV and it is never the HIV itself that kills (it just destroys the immune system so something else does) Ebola on the other hand is one of the most deadly diseases on Earth and unlike HIV, it can be spread by touching or interacting closely with a sick person (cleaning them up, holding their head while they vomit, preparing them for burial etc).

HIV is a lot harder to catch than that, not to mention there are some indications that Ebola in some forms may be starting to be not medically airborne but transferable if you are close enough to someone that is breathing germs directly on you. That isn't certain but is currently accepted as possible, the CDC and other can still claim "it isn't airborne" because that is a very technical medical definition and doesn't cover close enough to be breathed on directly and rather refers to a virus that hangs in the air for awhile and spreads in it, like the nasty head cold I've got at the moment.

If you walk in a room a hour after someone with a cold is in there, you may catch the virus and that is not what happens with Ebola (at least not now) but if you were caring for a sick child and they sneezed on you with Ebola it could be transmitted.

Want the 'ancient' links that say ebola *is* airborne? Read again the book, "The Hot Zone".
 
Top