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Pauline Cafferkey is a Scottish
nurse Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health c ...
and aid worker who contracted Ebola virus disease in 2014 while working in
Sierra Leone Sierra Leone,)]. officially the Republic of Sierra Leone, is a country on the southwest coast of West Africa. It is bordered by Liberia to the southeast and Guinea surrounds the northern half of the nation. Covering a total area of , Sierr ...
as part of the medical aid effort during the
West African Ebola virus epidemic The 2013–2016 epidemic of Ebola virus disease, centered in Western Africa, was the most widespread outbreak of the disease in history. It caused major loss of life and socioeconomic disruption in the region, mainly in Guinea, Liberia and S ...
. She survived the illness.


Initial admission to hospital

On 29 December 2014, Cafferkey, who had just returned to
Glasgow Glasgow ( ; sco, Glesca or ; gd, Glaschu ) is the most populous city in Scotland and the fourth-most populous city in the United Kingdom, as well as being the 27th largest city by population in Europe. In 2020, it had an estimated popul ...
from Sierra Leone via Casablanca Airport and
London Heathrow Airport Heathrow Airport (), called ''London Airport'' until 1966 and now known as London Heathrow , is a major international airport in London, England. It is the largest of the six international airports in the London airport system (the others be ...
, was diagnosed with Ebola virus disease at Glasgow's Gartnavel General Hospital. She had been working at an Ebola treatment centre in Kerry Town in Sierra Leone, and it is thought she contracted the virus as a result of wearing a visor, as recommended by the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
and the UK Ministry of Defence, instead of goggles. After initial treatment in Glasgow, she was transferred by air to
RAF Northolt ("Ready to carry or to fight") , pushpin_map = Greater London , pushpin_label = RAF Northolt , pushpin_map_caption = Shown within Greater London , coordinates = , type = Royal Air Force station , code = , site_area = , height = , owner ...
, then to the specialist high-level isolation unit at the Royal Free Hospital in
London London is the capital and List of urban areas in the United Kingdom, largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary dow ...
for longer-term treatment. A Scottish government spokesman described the risk to the general public as "extremely low to the point of negligible" due to the very early stage of the infection at the time of detection.
Contact tracing In public health, contact tracing is the process of identifying persons who may have been exposed to an infected person ("contacts") and subsequent collection of further data to assess transmission. By tracing the contacts of infected individua ...
was carried out on the other passengers who traveled on the flight from London to Glasgow with her. Medical staff described her condition at the time as "as well as we can hope for at this stage." On 4 January 2015, the Royal Free Hospital announced that her condition had deteriorated to critical, with her health later stabilising before she was declared no longer critically ill on 12 January. Cafferkey received
blood plasma Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the intr ...
from William Pooley and has been treated with experimental drugs as part of her treatment. On 24 January, she was declared to be free of infection, and released from hospital.


2015 readmission to hospital

The prognosis after recovery from Ebola virus disease can include joint pains, muscular pain, skin peeling, or
hair loss Hair loss, also known as alopecia or baldness, refers to a loss of hair from part of the head or body. Typically at least the head is involved. The severity of hair loss can vary from a small area to the entire body. Inflammation or scar ...
. In a media interview in September 2015, Cafferkey said "I’ve had trouble with my thyroid, lost some of my hair and get really sore joints but I guess side effects are to be expected." It was found in 2015 that, after an apparent complete cure, with the bloodstream, saliva and organs such as the liver free of the Ebola virus, it can linger on in parts of the body not protected by the
immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splint ...
, including fluid in the eye, the central nervous system and, in men, the
testes A testicle or testis (plural testes) is the male reproductive gland or gonad in all bilaterians, including humans. It is homologous to the female ovary. The functions of the testes are to produce both sperm and androgens, primarily testoste ...
and
semen Semen, also known as seminal fluid, is an organic bodily fluid created to contain spermatozoa. It is secreted by the gonads (sexual glands) and other sexual organs of male or hermaphroditic animals and can fertilize the female ovum. Sem ...
. Cafferkey went to a 24-hour GP clinic in
New Victoria Hospital The New Victoria Hospital is an ambulatory care hospital situated at Langside/Battlefield in the south-east of Glasgow. It is managed by NHS Greater Glasgow and Clyde. History The hospital, which was commissioned to replace the outpatient h ...
in Glasgow on the night of 5 October 2015 and was diagnosed with "a virus" (unspecified) and sent home. 24 hours later she was admitted to
Queen Elizabeth University Hospital The Queen Elizabeth University Hospital (QEUH) is a 1,677-bed acute hospital located in Govan, in the south-west of Glasgow, Scotland. The hospital is built on the site of the former Southern General Hospital and opened at the end of April 2015. ...
where she was diagnosed with late complications caused by the Ebola virus hitherto considered unusual, and was flown by military jet to London, to the Royal Free Hospital. Her condition was initially described as serious and she was being treated in the high-level isolation unit. Doctors discovered that, after she had been deemed cured, the virus had remained in her
cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the ...
and feared that it might be in her central nervous system. Personnel in Scotland monitored those whom she had come into contact with, since the virus can be spread through exposure to the infected person's body fluids, though they said the risk was likely to be small. Cafferkey's condition declined rapidly, and on 14 October 2015 she was reported to be critically ill. Five days later, on 19 October 2015, the Royal Free Hospital announced that: "Pauline Cafferkey's condition has improved to serious but stable". On 21 October 2015 Dr Michael Jacobs, Cafferkey's doctor at the Royal Free Hospital, said at a televised press conference that Cafferkey was suffering from neurological complications from meningitis caused by Ebola virus, and had not been re-infected with Ebola, was being treated using a highly experimental anti-viral agent called GS5734, and had significantly improved, although she remained in an isolation tent and was not well enough to get out of bed. On 12 November the Royal Free Hospital said that Cafferkey had made a full recovery and was no longer infectious. She was transferred to Glasgow's
Queen Elizabeth University Hospital The Queen Elizabeth University Hospital (QEUH) is a 1,677-bed acute hospital located in Govan, in the south-west of Glasgow, Scotland. The hospital is built on the site of the former Southern General Hospital and opened at the end of April 2015. ...
.


2016 readmissions

In February 2016, Cafferkey was admitted to Glasgow's
Queen Elizabeth University Hospital The Queen Elizabeth University Hospital (QEUH) is a 1,677-bed acute hospital located in Govan, in the south-west of Glasgow, Scotland. The hospital is built on the site of the former Southern General Hospital and opened at the end of April 2015. ...
after "routine monitoring by the Infectious Diseases Unit". On the same day she was transferred by a
RAF The Royal Air Force (RAF) is the United Kingdom's air and space force. It was formed towards the end of the First World War on 1 April 1918, becoming the first independent air force in the world, by regrouping the Royal Flying Corps (RFC) and ...
plane to London where she was readmitted to the Royal Free Hospital. In a statement the Royal Free said she had been transferred to the hospital "due to a late complication from her previous infection by the Ebola virus" and that she was being treated by the hospital's infectious diseases team. On 24 February the hospital described her condition as "stable". On 28 February Cafferkey was discharged by the Royal Free Hospital. A spokesman said, "We can confirm that Pauline is not infectious. The Ebola virus can only be transmitted by direct contact with the blood or bodily fluids of an infected person while they are symptomatic." On 6 October 2016 she was readmitted to the
Queen Elizabeth University Hospital The Queen Elizabeth University Hospital (QEUH) is a 1,677-bed acute hospital located in Govan, in the south-west of Glasgow, Scotland. The hospital is built on the site of the former Southern General Hospital and opened at the end of April 2015. ...
to be monitored by the infectious diseases team. A
NHS Greater Glasgow and Clyde NHS Greater Glasgow and Clyde is an NHS board in West Central Scotland, created from the amalgamation of NHS Greater Glasgow and part of NHS Argyll and Clyde on 1 April 2006. It is the largest health board in both Scotland, and the UK, which c ...
spokeswoman said that she was in a stable condition and undergoing investigations. In the evening of the same day a statement was issued stating that tests for the Ebola virus were negative.


Investigations

In 2014, due to the fact that Cafferkey had passed through border controls and travelled on a domestic flight from Heathrow to Glasgow, criticism was levelled at current screening protocols at UK points of entry, which mainly consisted of taking a person's temperature and asking a series of questions. Public Health England stated that they were planning a review of the screening procedures. In 2016, the
Nursing and Midwifery Council The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to pra ...
initiated proceedings against Cafferkey, alleging that she had allowed an incorrect temperature to be recorded during the screening process upon returning to the UK from Sierra Leone in 2014. Following a two-day hearing in Edinburgh during September 2016, the charges against Cafferkey were dismissed and she was cleared of any wrongdoing. The disciplinary panel was told that she had been impaired by illness at the time and heard evidence about how the Public Health England screening centre at Heathrow Airport had been unprepared for a large influx of passengers and that it was "busy, disorganised and even chaotic". BBC Scotland reporter Philip Sim wrote: "It now seems as if the case against Pauline Cafferkey had fallen apart before the hearing even began - raising questions as to why she had to go through it in the first place". In November 2016, a second panel criticised fellow volunteer senior nurse Donna Wood for suggesting "let's put it down as 37.2 and get out of here and sort it out later". Wood was suspended for two months for failing to alert the authorities about Cafferkey's condition. Hannah Ryan, the doctor that agreed to record the incorrect temperature, was suspended for one month by the Medical Practitioners Tribunal in March 2017.


Subsequent events

In April 2017, Cafferkey announced she would return to Sierra Leone in May to raise funds for Ebola survivors and children orphaned by the disease. In June 2019, Cafferkey gave birth to twin sons in a hospital in Glasgow, at the age of 43. In a statement, she said "this shows that there is life after Ebola and there is a future for those who have encountered this disease".


See also

*
Ebola virus disease in the United Kingdom Ebola virus disease in the United Kingdom has occurred rarely in four cases to date, namely three health workers returning from treating victims of the Ebola virus epidemic in West Africa in 2014 and 2015, and a single case in 1976, when a laborato ...


References


External links


BBC News profile of Pauline Cafferkey

''The Scotsman'': Scottish nurse Pauline Cafferkey’s Ebola diary
{{DEFAULTSORT:Cafferkey, Pauline Living people Year of birth missing (living people) 1970s births Ebola survivors Scottish nurses