UK Ebola case confirmed but risk remains low

A case of Ebola has now been confirmed in the UK, but the risk to the general public remains very low. Ebola can only be transmitted by direct contact with the blood or bodily fluids of an infected person.

The UK case – in a healthcare worker in Scotland who arrived in Glasgow from Sierra Leone last week – has been confirmed by the Scottish government. The patient was placed in isolation at Glasgow’s Gartnavel Hospital and has been transferred for specialised care at the Royal Free Hospital in London.

The media has reported that the patient is called Pauline Cafferkey, a Scottish nurse who was working as a volunteer for Save the Children in Sierra Leone.

Ms Cafferkey left Sierra Leone on December 28 and was a passenger on flight AT596 from Freetown to Casablanca and flight AT0800 from Casablanca to London. She then transferred at Heathrow to flight BA1478 to Glasgow. 

The risk of infection to other passengers on the flights is considered extremely low. However, as a precaution, Public Health England has contacted all passengers and crew on the flight from Casablanca to Heathrow and provided them with health information.

Passengers who were sitting in the vicinity of Ms Cafferkey on these flights are being followed up. Health Protection Scotland has contacted all passengers on the Heathrow to Glasgow flight.

The UK has well-established and practised infection control procedures for dealing with cases of imported infectious disease, and these will be strictly followed to minimise the risk of transmission.

Professor Dame Sally Davies, Chief Medical Officer, said: “Our thoughts are with this individual who, along with other NHS and public health colleagues, has been doing a fantastic job saving lives.

“The English and Scottish governments and health authorities are working together to make sure that this individual receives the best possible care. UK hospitals have a proven track record of dealing with imported infectious diseases. 

“It is important to be reassured that although a case has been identified, the overall risk to the public continues to be low. 

“We have robust, well-developed and well-tested NHS systems for managing unusual infectious diseases when they arise, supported by a wide range of experts. The UK system was prepared, and reacted as planned, when this case of Ebola was identified.”

More than 19,000 cases of Ebola have been confirmed in West Africa, with over 7,500 deaths – a mortality rate of around 40%.

Outbreaks of Ebola are nothing new, but health professionals are concerned about the size of the outbreak.

What is Ebola?

Ebola is a virus that can be spread through blood and bodily fluids. The virus originated in the West African rainforest and is thought to have spread to humans by handling or butchering infected animals.

Once the virus enters the body it can replicate very quickly, causing a range of increasingly harmful symptoms, including internal bleeding. Left untreated, it can have a mortality rate as high as 90%.

What are the symptoms of Ebola virus?

An infected person will typically develop a fever, headache, joint and muscle pain, sore throat, and intense muscle weakness. These symptoms start suddenly 2 to 21 days after becoming infected.

Diarrhoea, vomiting, a rash, stomach pain, and impaired kidney and liver function follow. The infected person may then bleed internally, as well as from the ears, eyes and mouth.

How is the Ebola virus spread?

People can become infected with the Ebola virus if they come into contact with the blood, body secretions or organs of an infected person.

Some traditional African burial rituals may have played a part in its spread. The Ebola virus can survive for several days outside the body, including on the skin of an infected person.

In parts of Africa, it is common for mourners to touch the skin of the deceased. A person then only needs to touch their mouth to become infected.

Other ways people can catch the virus include:

• touching the soiled clothing of an infected person and then touching their mouth
• having sex with an infected person without using a condom – the virus can be present in semen for as long as seven weeks after an infected person has recovered
• handling unsterilised needles or medical equipment that have been used on the infected person
• handling infected animals or coming into contact with their bodily fluids

A person is infectious as long as their blood and secretions contain the virus.

Ebola virus is generally not spread through routine social contact, such as shaking hands with patients without symptoms.

The virus is not airborne, so it’s not as infectious as diseases such as the flu – you’d need to get close to it to catch it.

Who’s at risk from Ebola?

Anyone who has close contact with an infected person or handles samples from patients is at risk of becoming infected. Hospital workers, laboratory workers and family members are at greatest risk.

How is Ebola diagnosed?

It’s difficult to know if a patient is infected with Ebola virus in the early stages. The early symptoms of Ebola, such as fever, headache and muscle pain, are similar to those of many other diseases.

But health workers are on standby to act quickly. If anyone in the UK develops the above symptoms and has potentially been in close contact with the virus, they will be admitted to hospital and will most likely be quarantined.

Samples of blood or body fluid can be sent to a laboratory to be tested for the presence of Ebola virus, and a diagnosis can be made rapidly. If the result is negative, doctors will test for other diseases, such as malaria, typhoid fever and cholera.

What are the treatments for Ebola?

There’s currently no specific treatment or cure for the Ebola virus, although potential new vaccines and drug therapies are being developed and tested.

Patients need to be treated in isolation in intensive care. Dehydration is common, so fluids may be given intravenously (directly into a vein).

Blood oxygen levels and blood pressure will be maintained at the correct level, and the body organs supported while the patient recovers.

What is the risk of Ebola in the UK?

The risk to the UK is thought to be very low, and, while someone with the virus can bring it to the UK, the risk of it spreading is very low.

Ebola virus is not airborne, so there is no credible risk of a swine flu-like global pandemic.

You cannot catch Ebola by travelling on a plane with someone who is infected, unless you come into very close physical contact with them – for example, by kissing them.

What precautions are being taken?

Public Health England (PHE), the body responsible for public health in England, has told health professionals about the situation in West Africa and asked for vigilance about unexplained illness in people who have visited the affected area.

PHE has provided advice for humanitarian workers planning to work in affected areas. It is also working with people from Sierra Leone living in England.

Advice has already been issued to immigration removal centres on carrying out health assessments for people who may have been in Ebola outbreak areas within the preceding 21 days.

PHE is also liaising with the UK Border Agency and port health authorities to update guidance for staff working in airports and ports.

Dr Brian McCloskey, PHE’s director of global health, said: “The risk to UK travellers and people working in these countries of contracting Ebola is very low.

“People who have returned from affected areas, who have a sudden onset of symptoms such as fever, headache, sore throat and general malaise [sense of feeling unwell] within three weeks of their return should immediately seek medical assistance.” 

Edited by NHS Choices. Follow Behind the Headlines on Twitter. Join the Healthy Evidence forum.

Links To The Headlines

Scottish Ebola patient transferred to London hospital – live updates. The Guardian, December 30 2014

Ebola healthcare worker transferred to London unit. BBC News, December 30 2014

Ebola patient transferred to London’s Royal Free Hospital. The Daily Telegraph, December 30 2014

Nurse With Ebola To Arrive At London Hospital. Sky News, December 30 2014

Two more patients being tested for Ebola at UK hospitals. Daily Express, December 30 2014

Race to find hundreds of BA passengers who came into contact with UK nurse who brought Ebola back to Britain – but why did TWO screenings fail to spot her condition? Mail Online, December 30 2014