October 14, 2015

expert reaction to reports that Ebola patient Pauline Cafferkey’s condition has worsened and that she is now critically ill at the Royal Free Hospital

The Royal Free Hospital has released a statement saying that Pauline Cafferkey, a British nurse who was infected with Ebola in 2014, is now critically ill after being readmitted to hospital last week following an “unusual late complication” from the original infection.

Prof. Jonathan Ball, Professor of Molecular Virology, University of Nottingham, said:

“We know that Ebola can linger for many months after visible symptoms have cleared. We also know from outbreaks in the past that survivors can show a variety of symptoms, and the debilitating effect of these can last for a very long time.

“But this is frankly staggering. I am not aware from the scientific literature of a case where Ebola has been associated with what we can only assume as life threatening complications after someone has initially recovered, and certainly not so many months after.

“Without knowing the full details it is difficult to comment but I know that the team at the Royal Free will be doing everything in their powers to help her recover. Whilst we don’t know her specific symptoms we have been reassured that before she was admitted to the Royal Free she wasn’t exhibiting any that we’d associate with a transmission risk to others, so contact monitoring and vaccination is a precautionary measure.”

Dr Nathalie MacDermott, Clinical Research Fellow, Imperial College London, said:

“It is with regret that we learn that Pauline Cafferkey’s condition has deteriorated. She will be receiving the best available care at the Royal Free Hospital but this is an unprecedented situation in medical terms and an uncertain time for Pauline and her family.

“The change in her condition does not imply any increased risk to the general public, as stated previously the risk to the general public who may have had contact prior to her deterioration remains extremely low.

“It is unlikely that anything could have been done to prevent this relapse, this is an unexpected situation which could not have been anticipated. It is difficult to know whether any earlier intervention may have altered her current condition as we are only just learning about the potential long term effects of Ebola virus disease and management of complications/secondary effects. Similarly there is still currently no proven effective treatment for Ebola virus disease that would be known to prevent or manage secondary recurrence.”

Royal Free statement: https://www.royalfree.nhs.uk/news-media/news/update-on-pauline-cafferkey/

All our previous output on this subject can be seen at this weblink: http://www.sciencemediacentre.org/tag/ebola/

Declared interests

Prof. Jonathan Ball: No conflicts of interest although I am doing Ebola research

Dr Nathalie MacDermott: I am writing the paediatric Ebola survivor guidelines for the WHO and am doing a PhD at Imperial College London, looking at aspects of Ebola virus disease which is funded by the Wellcome Trust ISSF scheme and the Institute of Global Health Innovation.