Anorak News | Ebola: Why wasn’t Pauline Cafferkey quarantined?

Ebola: Why wasn’t Pauline Cafferkey quarantined?

by | 31st, December 2014

Pauline Cafferkey


The Sun says the British nurse fighting Ebola was “tested seven times at Heathrow — then allowed home.”

Pauline Cafferkey, 39, got the all-clear after arriving from Africa then flew on to Glasgow. Her Ebola diagnosis is the first in the UK and has prompted a review of the screening process. Dr Martin Deahl who sat next to Ebola victim Cafferkey on a flight back from Africa has blasted checks at Heathrow as “shambolic”.

W can’t trust the boarder guards, goes the message.

Dr Deahl, a consultant psychiatrist from Shropshire, adds:

“We were told we could go home on public transport then told not to use buses and trains at home or go into crowded places. Pauline got a connecting flight to Glasgow, but would have been free to get on a crowded Tube.”

How did she contract the disease?

He believes the 39-year-old nurse got the disease after attending a church service on Christmas Day without her protective suit.

She was tested with an ear thermometer in the airport arrivals hall, but her reading was normal. After an hour she went back to the screening area complaining of a high temperature — a symptom of the disease.

Officials tested her six more times in half an hour, again using an ear thermometer. Her reading remained normal and she was given the all-clear. She then flew on to Scotland with 70 passengers and four crew on Sunday night, getting a taxi home.


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Dr Deahl adds:

Dr Deahl said that medical staff in Sierra Leone always wore hazard suits at work but some did not when they went out into the wider community.
A number of the 30 NHS staff out in Sierra Leone, including himself, worshipped at a local church on Christmas Day.

He also said that at Freetown airport in Sierra Leone all the volunteers were ‘kissing and hugging’ as they left the country, including Ms Cafferkey.

Dr Deahl said: ‘I would bet anything that she caught this while out in the community. I went to church myself on Christmas morning and I have no doubt Pauline probably contracted the virus doing something similar.

‘We had a rule known as ABC which stood for Absolute no Body Contact but when you are in the community it is difficult to stick to the rules and easy to become complacent. It is also difficult when children come up to you and hug you.’

Is quarantine the answer?

Last night the authorities moved to reassure the public the risk of infection was negligible and that the UK was prepared for the disease.  Professor Jonathan Ball, an expert in molecular virology at Nottingham University, said the case showed airport checks are unable to spot Ebola.
He said this was because symptoms such as a high temperature can take up to three weeks to develop.

‘When [screening] was introduced it was more a measure of reassurance rather than something that actually worked,’ he said. ‘Because the incubation period for Ebola is up to 21 days, it’s impossible to detect as you don’t show symptoms.’

What do we know about her?

The Indy:

Ms Cafferkey had worked as a nurse for 16 years before starting volunteering with Save the Children to help with the Ebola crisis..

Ms Cafferkey returned to the UK after four weeks via Casablanca and London Heathrow, arriving at Glasgow Airport at around 11.30pm on Sunday and took herself to hospital early yesterday morning after feeling feverish.

She kept an online diary for The Scotsman. It begins:

Pauline Cafferkey is an associate public health nurse at Blantyre Health Centre in South Lanarkshire. She has been a nurse for 16 years and says she was inspired to go into the profession after seeing images of the Ethiopian famine on the television in the 1980s. So she felt compelled to volunteer with Save the Children to help with the Ebola crisis, which has claimed the lives of more than 7,000 people to date. Pauline flew out to Freetown in Sierra Leone in November, along with another four Scottish volunteers, as part of a UK group of 30 NHS medical staff.

A few highlights:

Feel like the work I am doing is a normal part of life. My nice community- nursing job in Blantyre is far removed from this but at the moment this seems a lot more real. The dreams that I do remember always seem to have an Ebola theme, it seems to be all consuming.

The PPE [personal protective equipment] alien-type suit that I have to wear when going into the positive Red Zone is horrendous. It takes about 20 minutes to dress and 15 minutes to take the suit off at the other end. They would certainly be beneficial on a cold winter’s night in Scotland but working in them in 30-degree heat is uncomfortable to say the least. On the up side, I feel very well protected…

The Sierra Leonean’s are normally very tactile people who, prior to Ebola would hug and shake hands as a normal greeting and now have to change their culture. Even for us NHS staff, when we accidentally touch each other we call out “no touch” in a humorous manner.

What’s happening now?

The Mail:

…the authorities have been desperately trying to trace the 70 other people who were on board the same internal flight, and the 133 who were on her plane from Casablanca. Passengers on the plane will now be monitored by NHS officials via phone.

Is fighting Ebola a clinical measure only? The NY Times:

International health groups had largely pulled out of West Africa during the civil wars that devastated Liberia and Sierra Leone during the 1990s. When the Ebola outbreak began, the C.D.C.’s staff in the region consisted of one malaria researcher in Guinea.

Complicating matters, the same ethnic group — the Kissi — inhabited the forested region across all three nations, and extended families moved easily on foot and by dugout canoe across a pinwheel of disregarded national borders. Although roads were unpaved and bumpy, they were passable enough for villagers to ride motorcycles into dense capital cities, carrying the virus on board.

Distrust of government ran so high after decades of civil war and corruption that many West Africans had to be convinced Ebola was real and not a plot to attract foreign aid. They reacted with indignation to outsiders who demanded they stop providing hands-on care to the sick, considered a sacred obligation by many West Africans, whether Muslim, Christian or traditionalist.

Governments attempted to broadcast the message that Ebola was spread through contact with vomit, feces and blood, and that bodies remained highly contagious after death. But communities often continued to wash the bodies of the dead, a step considered essential to a dignified burial and a contented afterlife. The arrival of moon-suited health workers in convoys of white trucks, armed with chlorine sprayers and thermometers, bred resistance and secrecy.

“Old disease in new context will bring you surprises,” Dr. Margaret Chan, the director-general of the W.H.O., said in an interview in December in her office in Geneva…

In Meliandou, a leafy village in the hills of southern Guinea, a year-old boy named Emile had taken ill in late December with fever, vomiting and bloody stool. He died Dec. 28, and a W.H.O. investigation would later conclude he was probably the first Ebola casualty. Members of his family, a nurse, doctor and other health workers soon died also.

“We thought it was a mysterious disease,” said Dr. Kalissa N’fansoumane, the director of the nearby Guéckédou Hospital.

Local health officials accompanied by a Doctors Without Borders logistician investigated the cluster of deaths in January. They concluded that a cholera-like diarrhea had been the cause. Unaware of signs like persistent hiccups, health workers made faulty assumptions, and some paid with their lives.

Remarkably, it would take 12 weeks to diagnose the ravaging virus. Ebola was all but unknown in West Africa — there had been a single nonfatal case in Ivory Coast in 1994 — and its symptoms were similar to those of endemic diseases like malaria, cholera and Lassa fever.

Ebola roared back…

Posted: 31st, December 2014 | In: Reviews Comment | TrackBack | Permalink