Doctors at the Royal Free Hospital in London, UK, have discharged Pauline Cafferkey from their care – for the second time – and say she has made a full recovery from Ebola.
The British nurse first contracted Ebola virus disease (EVD) in December 2014 while working at a treatment center in Sierra Leone, one of the three West African countries worst affected by the biggest Ebola epidemic in history.
Cafferkey was successfully treated for Ebola hemorrhagic fever at the Royal Free and discharged in January 2015.
But in October, she had to be readmitted to the hospital’s high-level isolation treatment unit after the virus – which had lingered in her brain – caused her to develop life-threatening meningitis.
The statement from the hospital notes that Cafferkey has “made a full recovery from Ebola and is no longer infectious.”
While this is the first known case of Ebola virus causing meningitis, there is evidence from elsewhere that it can hide in certain parts of the body of EVD survivors. For example, live Ebola virus has been found in the eye of an EVD survivor 2 months after recovery, and there is evidence of male EVD survivors whose semen tested positive for Ebola virus up to 9 months after falling ill.
When she was re-admitted in October, Cafferkey’s London doctors said she was being treated with GS5734, an experimental antiviral drug being developed by Gilead Sciences in the US. When they announced her discharge on Thursday, they did not mention whether the drug had made any difference.
They said Cafferkey has been transferred to the care of Queen Elizabeth University Hospital in Glasgow in Scotland, near her home, and:
“We are delighted that Pauline has made a full recovery from Ebola and is now well enough to return to Scotland. We would like to wish her well for the future.”
Cafferkey said she is looking forward to returning to Scotland and seeing her family and friends again and expressed her gratitude for the “amazing care” she received at the Royal Free:
“For a second time staff across many departments of the hospital have worked incredibly hard to help me recover and I will always be grateful to them and the NHS. “
The Royal Free Hospital has the UK’s only high-level isolation unit for the treatment of infectious diseases.
The unit was set up in 2008 and has since looked after several cases of viral hemorrhagic fever.
Access to the unit is restricted to the team of specially trained medical staff. The patient’s bed is situated inside a specially-designed tent with controlled ventilation and allows the staff to provide clinical care while containing the infection.
The unit has a specific entrance for the patient, autoclaves that decontaminate waste and a dedicated laboratory. All the air leaving the unit is cleaned so there is no risk to anyone at the hospital.
Since December 2013, the Ebola outbreak in West Africa has killed 11,314 of the 28,635 people infected, according to the latest report from the World Health Organization (WHO). The vast majority of cases and deaths were in Sierra Leone (14,122 cases, 3,955 deaths), Liberia (10,672 cases, 4,808 death) and Guinea (3,805 cases, 2,536 deaths).
Cases and deaths have also been reported in Nigeria (20 cases, 8 deaths) Mali (8 cases, 6 deaths) and the US (4 cases, one death). Four other countries also reported one case each, all of whom survived: Italy, Senegal, Spain and the UK.
About a year ago, the West African Ebola outbreak was spreading so fast – there were hundreds a week – and to so many countries that many feared the pathogen would overwhelm humanity.
But then, around December 2014, the rising curve began to turn – because 70% of Ebola cases were isolated, and 70% of people who died of the disease were being buried safely. Bruce Aylward, special representative of the WHO director-general for the Ebola response, says:
“Three big things made the difference: extraordinary leadership, rapid adaptation, and constant innovation. That’s the key to operating at this scale, with this terrifying pathogen.”
And now, the situation is that Sierra Leone has stopped Ebola virus transmission and has entered a 90-day enhanced surveillance period. Liberia achieved this point at the start of September, and Guinea is reporting very low numbers of cases – none in the week to 8th November.