A
Scottish nurse who contracted Ebola in Sierra Leone has been readmitted
to an isolation unit in London following an "unusual late
complication".
NHS Greater Glasgow and Clyde confirmed that the
virus is present in Pauline Cafferkey but said it was left over from the
original infection.
It is not thought to be contagious.
The
39-year-old, from Cambuslang, South Lanarkshire, has been flown back to
an isolation unit at the Royal Free Hospital in London.
Ms
Cafferkey spent almost a month in an isolation unit at the Royal Free
Hospital at the beginning of the year after contracting the virus in
December 2014.
NHS Greater Glasgow and Clyde said she had been
admitted to the Queen Elizabeth University Hospital in Glasgow on
Tuesday after feeling unwell and was treated in the infectious diseases
unit.
She was transferred from Glasgow to the Royal Free Hospital
in London in the early hours of the morning due to an unusual late
complication in her illness.
Low risk
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."
Media captionJane Dreaper reports as Ebola nurse Pauline Cafferkey is readmitted to hospitalThere is not yet any information about Ms Cafferkey's
condition, but government sources described her transfer to the
specialist unit as a "highly precautionary process".
Ebola is passed on through bodily fluids. It is not transmitted through casual contact.
Last week Ms Cafferkey was in London receiving an award at the Pride of Britain ceremony.
Her award 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
that event but health officials in Scotland are focusing on who she saw
since her return home.
Critically ill
Ms Cafferkey spoke to BBC News about the difficulties she had encountered in her recovery.
She had experienced thyroid problems and her hair had fallen out.
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 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 a 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 in January, Ms Cafferkey said she was "very happy to
be alive" and was looking forward to returning to "normal life". She
also said she had no plans to return to West Africa.
Asked if she
wanted to return to Sierra Leone, she said: "I would have to think
seriously about it. I am definitely going to give aid work a break for a
while.
"I just want to go back to my normal job, my normal life and I think my family will be happy with that as well."
Ebola virus disease (EVD)
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
now completely recovered and was "not infectious in any way".
He
said Ms Cafferkey was treated with blood plasma from an Ebola survivor
and an experimental treatment drug closely related drug to ZMapp, which
UK nurse Will Pooley was treated with after he contracted Ebola.
Some survivors of the virus have had eye and joint problems, as well as ongoing fatigue.
The World Health Organisation admits not much is known about the long-term implications after having Ebola.
More than 11,000 people in West Africa died during this outbreak.
Last week there were no new cases for the first time since March 2014.
Liberia has opened a new national cemetery to provide safe burial sites for victims of the Ebola outbreak.
A Liberian official said the 50-acre site in Monrovia, half
of which is ready to use, will enable "dignified" burials instead of
cremations.
Meanwhile, the World Health Organization says the number of
people infected by Ebola in Liberia, Sierra Leone and Guinea has now
passed 20,000.
The virus has killed more than 7,800 people since it broke out a year ago.
The WHO said more than a third of the 20,081 cases in the
West African states were in Sierra Leone, which has become the worst-hit
country.
The situation in Liberia has improved in recent months but
health officials warned on Monday that dozens of new cases had emerged
near the country's border with Sierra Leone. Memorial
Liberian Assistant Health Minister Tolbert Nyenswah said the
new cases, mostly in Grand Cape Mount County were due to the movement of
people across the border and the traditional practice of washing
victims' bodies.
"In a very small population, an increase in the number of
[Ebola] cases raises high levels of concern that we need to take very
seriously - the people of Liberia and people of Grand Cape Mount in
particular," Mr Nyenswah said.
The new burial site in Liberia's capital has been created on
land acquired from the Disco Hill district at a cost of $50,000
(£32,000).
Mr Nyenswah said the new site would be staffed by trained burial teams and would accommodate Muslim and Christian ceremonies.
He said the site would allow "dignified and safe burials, where people can practise their rituals but not touch dead bodies".
A memorial to Ebola victims who have been cremated will also be erected there, he added.
Nearly 3,400 people have died from Ebola in Liberia over the past year with nearly 8,000 cases total.
Liberia has begun treating Ebola patients with serum therapy - a treatment made from the blood of recovered survivors.
Doctors hope the experimental treatment could help combat the
virus that has been sweeping West Africa and killing thousands of
people.
Up to 13 December, 6,841 people had been reported as having died from the disease.
The total number of reported cases is more than 18,000.
If a person has successfully fought off the infection, it
means their body has learned how to combat the virus and they will have
antibodies in their blood that can attack Ebola.
Doctors can then take a sample of their blood and turn it
into serum - by removing the red blood cells but keeping the important
antibodies - which can be used to treat other patients.
Ebola patients treated in the UK and the US have already received this type of treatment.
Doctors in Liberia will monitor how safe and effective the serum treatment being given at the ELWA Hospital in Monrovia is.
A number of Liberian health care workers have been trained to give the therapy.
Dr David Hoover, the programme's director, said: "This will
empower local health care systems to become more self-sufficient and
better serve their patients during this current epidemic as well as in
the future."
Scientists are also exploring other Ebola treatments.
The US, UK and Canada are testing different kinds of vaccine in controlled clinical trials.
The aim is to have 20,000 doses that could be used in West Africa by early next year.
FORT
KENT, Maine -- A nurse who treated Ebola patients in West Africa vowed
on Wednesday to end her voluntary quarantine, even going so far as to
step out of her home and shake a reporter's hand, signaling a showdown
with state police monitoring her and state officials seeking to legally
enforce her confinement.
Kaci Hickox broke her
quarantine by leaving her home with her boyfriend and speaking briefly
to reporters in her driveway Wednesday evening. State and local police
could only watch from across the street because a judge hadn't signed
off on a court order sought by state health officials.
She
reiterated that she planned to fight the state's quarantine and said
there was no need to stay inside because she's not exhibiting any
symptoms.
"I'm not willing to stand here and
let my civil rights be violated when it's not science-based," she told
reporters before returning inside.
One of her
lawyers, Norman Siegel, said she isn't willing to cooperate further
unless the state lifts "all or most of the restrictions." But state
officials continued to assert that she should remain in isolation until
Nov. 10, the end of the 21-day incubation period for Ebola.
A
judge would have to grant the state's request in what could serve as a
test as to the legality of state quarantines during the Ebola scare.
Until
an order is signed by a judge, state police will monitor Hickox's
movement and interactions if she leaves her home but can't physically
detain her, said Department of Health and Human Services Commissioner
Mary Mayhew.
Generally, states have broad
authority when it comes to such matters. But Maine health officials
could have a tough time convincing a judge that Hickox poses a threat,
said attorney Jackie L. Caynon III, who specializes in health law in
Worcester, Massachusetts.
"If somebody isn't
showing signs of the infection, then it's kind of hard to say someone
should be under mandatory quarantine," he said.
Ebola,
which is spread through direct contact with the bodily fluids of an
infected person, has killed thousands of people in Africa, but only four
people have been diagnosed with it in the United States. People can't
be infected just by being near someone who's sick, and people aren't
contagious unless they're sick, health officials say.
Guidelines
from the federal Centers for Disease Control and Prevention recommend
monitoring for health care workers like Hickox who have come into
contact with Ebola patients. But some states, including Maine, are going
above and beyond guidelines.
Hickox, who
volunteered in Sierra Leone with Doctors Without Borders, was the first
person forced into New Jersey's mandatory quarantine for people arriving
at the Newark airport from three West African countries. Hickox spent
the weekend in a tent in New Jersey before traveling to the home of her
boyfriend, a nursing student at the University of Maine at Fort Kent.
Gov.
Paul LePage commended all health care workers who have volunteered in
Africa to treat Ebola patients. But he said the state must be "vigilant"
to protect others.
Maine law allows a judge to
grant temporary custody of someone if health officials demonstrate "a
clear and immediate public health threat."
The
state's court filing was expected late Wednesday or early Thursday,
officials said. If a judge grants the state's request, then Hickox will
appeal the decision on constitutional grounds, Siegel said.
"Our position is very simple: There's no justification for the state of Maine to quarantine her," he said.
Hickox
made her point when she stepped outside the home. After speaking to
reporters, she shook a hand offered by one of the reporters.
A
man in the US state of Connecticut has sued after his daughter's school
barred her from attending amid fears she may have been exposed to
Ebola.
Ikeoluwa Opayemi, seven, who visited Nigeria with her father this month, was told to stay home until November.
Nigeria has had no new cases of Ebola since late August, and the family says the ban was a response to panic.
Meanwhile, the Pentagon has ordered US troops deployed to Ebola-hit countries in Africa quarantined for 21 days.
Ebola has killed roughly 5,000 people out of about 13,700
cases, with all but 27 cases occurring in the West African countries of
Liberia, Sierra Leone and Guinea.
The virus is only spread through close contact with the bodily fluids of an ill Ebola patient.
Police and media stand watch outside the
Maine home where Kaci Hickox, a nurse who treated Ebola patients in
West Africa, is staying under a voluntary quarantine
For American healthcare workers potentially exposed to the
Ebola virus in one of those countries, the US Centers for Disease
Control and Prevention (CDC) has recommended active monitoring of their
symptoms by a local health department upon their return, but not a full
quarantine.
President Barack Obama has warned against overreaching
quarantine measures, after three states ordered quarantine for such
health workers.
The president on Wednesday met US health workers who have
worked in West Africa, lauding them as "American heroes" who were
keeping the country safe by tackling the disease at source.
Meanwhile, on Wednesday US Defence Secretary Chuck Hagel
ordered all US troops returning from Ebola response missions to be kept
in supervised isolation for 21 days. Mr Obama has suggested it is
appropriate to treat the soldiers differently from civilian health
workers, in part because soldiers are not there by choice.
In Connecticut on Tuesday, the Opayemi family filed a lawsuit
in federal court seeking Ikeoluwa's immediate return to Meadowside
Elementary School, plus monetary damages.
Nada Tawfik, BBC News
Stephen Opayemi says his healthy daughter is battling
discrimination and ignorance from parents and school officials who are
letting fear and rumour cloud their better judgment. The reality is that
worries about the disease have caused some local and state officials,
even universities, to ignore federal guidelines based on science, in the
name of placating public panic.
Mr Opayemi's daughter has no symptoms of Ebola, never came in
contact with anyone who has Ebola, and Nigeria itself has been declared
Ebola-free.
Her father says she is suffering emotional distress and he
now worries about her confidence. She may not be one of Ebola's direct
victims, but she is now a casualty of the stigma surrounding it.
Ikeoluwa's father Stephen Opayemi is a native of Nigeria, and the family attended a wedding there from 2-13 October.
Nigeria has had no new cases of Ebola since late August, and
US health officials say anyone who travelled there after September is
not at risk for infection.
Upon their return to Connecticut, the family was told by Dr
Dennis McBride, a Milford health official, to keep Ikeoluwa out of
school until 3 November because teachers and students were concerned she
could transmit Ebola, according to the lawsuit.
Meanwhile, a nurse who returned from treating Ebola patients
in Sierra Leone has said she will no longer co-operate with a voluntary
quarantine order.
Kaci Hickox was briefly held in quarantine in New Jersey
after landing at Newark International Airport last Friday. After showing
no symptoms of Ebola she was flown back to her home state of Maine and
placed under quarantine there.
"I remain appalled by these home quarantine policies that
have been forced upon me even though I am in perfectly good health," Ms
Hickox told US media.
The state of Maine is seeking the authority to make the quarantine mandatory.
Hagel has ordered all US military personnel returning from Ebola missions to be isolated for 21 days
A
nurse quarantined in New Jersey after treating Ebola patients in Sierra
Leone will be discharged after being symptom-free for 24 hours.
Kaci Hickox will be flown to her home state of Maine, officials said.
She threatened legal action over the confinement, saying she felt like a criminal after returning to the US.
Also on Monday, the UN secretary general said health workers
returning from West Africa without symptoms should not be quarantined.
Ban Ki-moon has previously warned isolating those travelling to combat Ebola would hamper efforts to stop the disease.
The new rules in New York, New Jersey and Illinois require a
mandatory 21-day quarantine for all health workers who have had contact
with Ebola patients in West Africa upon their return to the US.
The measures were announced after a New York doctor who had treated patients in Guinea fell ill with Ebola last week.
Liberia remains the worst affected country, with 4,665 cases
Amid criticism the quarantine rules were overly strict, New
York Governor Andrew Cuomo eased the state's restrictions on Sunday,
allowing returning health workers to pass the quarantine period in their
homes.
More than 10,000 people have contracted the Ebola virus, with 4,922 deaths, according to the World Health Organization's latest figures.
All but 27 of the cases have occurred inside Sierra Leone, Liberia and Guinea.
Separately on Monday, a five-year-old boy was being tested
for Ebola at Bellevue Hospital in New York City after visiting an
Ebola-stricken country and developing a fever, hospital officials said.
Test results were expected later in the day.
The New Jersey health department said Ms Hickox had tested
negative for Ebola on Saturday and had been free of symptoms for 24
hours.
Governor Chris Christie, who had earlier defended his state's
quarantine procedures, said the US Centers for Disease Control and
Prevention (CDC) had been overseeing all her treatment in New Jersey,
and said he was "hopeful" the hospital would be able to release her on
Monday.
"I understand that she didn't want to be there," Mr Christie said.
"She made that very clear from the beginning, but my
obligation is to all the people of New Jersey and we're just going to
continue to do that."
BBC's Anne Soy: "The world is dealing with two epidemics - the bigger one is that of fear"
New York Mayor Bill de Blasio said the treatment of Ms Hickox was inappropriate
Ms Hickox, who worked for medical charity Medecins Sans
Frontieres (MSF), arrived at Newark Airport on Friday and was placed in
isolation after developing a fever, the state health department said.
New York Mayor Bill de Blasio has described Ms Hickox as a
"returning hero", but said that she had been "treated with disrespect"
when put into quarantine.
"We owe her better than that and all the people better than
that," he told reporters outside New York's Bellevue Hospital, where an
American doctor, Craig Spencer, is being treated for the virus.
The stricter measures were put in place after Dr Spencer
tested positive for Ebola on his return from Guinea last week and
unwittingly moved around the city before the symptoms developed.
Speaking alongside World Bank President Jim Yong Kim in
Nigeria, UN Secretary General Ban said he was "concerned" about recent
restrictions put in place in several countries and localities.
"Returning health workers are exceptional people who are
giving of themselves for humanity," a spokesman for Mr Ban said in a
statement.
"They should not be subjected to restrictions that are not
based on science. Those who develop infections should be supported, not
stigmatised."
Workers clean the apartment of Dr Craig Spencer, currently being treated for Ebola in New York City
Separately, the Pentagon has said about a dozen US troops
retuning from West Africa are being isolated at a base in Italy "out of
an abundance of caution".
Pentagon spokesman Col Steven Warren told reporters none of the soldiers displayed symptoms of Ebola.
A
nurse quarantined on her return to the US from treating Ebola patients
in Sierra Leone has criticised the way she was dealt with at Newark
airport.
Kaci Hickox said the experience was frightening and could
deter other health workers from travelling to West Africa to help tackle
the Ebola virus.
Illinois has become the third state after New York and New Jersey to impose stricter quarantine rules.
Meanwhile the US ambassador to the United Nations is to visit West Africa.
Samantha Power will travel to Guinea on Sunday, continuing later to Liberia and Sierra Leone - the three worst-hit countries.
"For me the benefits of having first hand knowledge of what
is happening in these countries gravely outweighs the almost nonexistent
risk of actually travelling to these countries, provided I take the
proper precautions," she said on Saturday.
She said she hoped her trip would "draw attention to the need for increased support for the international response".
The White House has expressed concern that strict quarantine
restrictions such as those imposed in New York, New Jersey and Illinois
could put off aid workers and others travelling to West Africa to help
mitigate the crisis at its source.
More than 10,000 people have contracted the Ebola virus, with 4,922 deaths, according to the World Health Organization's latest figures.
Only 27 of the cases have occurred outside Sierra Leone, Liberia and Guinea. Airport ordeal
Ms Hickox, of medical charity Doctors Without Borders,
described seeing a "frenzy of disorganisation, fear and most
frightening, quarantine" on her return from Sierra Leone on Friday. Writing for The Dallas Morning News, she asked whether fellow health workers would "face the same ordeal".
The WHO warns the number of Ebola cases may be much higher than the figures recorded
"Will they be made to feel like criminals and prisoners?" she questioned.
She said she was kept in isolation at the airport terminal for seven hours and given only a cereal bar to eat.
She also denied that she had had a fever, saying she was
merely flushed because of the upset caused by her treatment at the
airport.
Though Ms Hickox tested negative in a preliminary test for
the virus, she will remain under quarantine for three weeks and continue
to be monitored by health officials.
Stricter quarantine measures were put in place in New York
and New Jersey after a doctor, Craig Spencer, tested positive for the
virus on his return from Guinea last week.
He is currently being treated at New York's Bellevue Hospital in isolation. 'Facts not fear'
The new measures mean that anyone who has had contact with
Ebola victims in West Africa now faces a mandatory 21-day quarantine
period.
Illinois governor Pat Quinn announced on Saturday that his
state would start imposing the same measures, without providing further
details.
Health workers on the frontline have been hard hit by the virus
Meanwhile, New York City Mayor Bill de Blasio said he was not
consulted over the new rules, which were ordered by the state governors
of New York and New Jersey.
"The state has the right to make its decision, just like the
CDC [US Centers for Disease Control and Prevention] does, and we're
going to work with them," he told reporters on Saturday.
US President Barack Obama said in his weekly radio and online
address that Americans had "to be guided by the facts - not fear",
reiterating that people cannot contract Ebola unless they have come into
direct contact with an infected patient's bodily fluids.
His comments follow the release of the WHO's latest report,
which warned that the number of Ebola cases in West Africa could be much
higher than recorded, as many families were keeping relatives at home
rather than taking them to treatment centres.
Malian President Ibrahim Boubacar Keita sought to allay fears after Mali became the latest nation to record a death from Ebola.
He told French radio on Saturday that "all measures" had been
taken since the start of the epidemic, adding: "We are doing everything
to prevent panic and psychosis."
More than 40 people known to have come into contact with the
two-year-old girl who died have been quarantined, and the authorities
are still trying to track down others.
He said the border with Guinea would remain open.
However, officials in neighbouring Mauritania said it had closed its borders with Mali in response to the case.
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