Monday, December 29, 2014

Ebola case confirmed in Scotland

  • Healthcare worker being treated after returning to UK from Sierra Leone
  • Patient flew to Glasgow via Casablanca and Heathrow airports
  • Plans to move woman as soon as possible to specialist unit in London
  • Save the Children confirms patient was NHS worker working for charity

After chairing a meeting of the Whitehall Cobra contingencies committee in London, Health Secretary Jeremy Hunt said there would be a review of the “procedures and protocols” adopted by NHS workers and other government staff working in Sierra Leone.

We are reviewing our procedures and protocols for the other NHS workers who are working in Sierra Leone alongside colleagues from the Department for International Development and the Foreign Office.

They are doing a very, very brave job, under very challenging circumstances. We want to make absolutely sure that we are doing everything we can to keep them safe.

Save the Children has confirmed that the woman being treated for ebola in Glasgow is an NHS healthworker who was working for the charity.

Michael von Bertele, Save the Children Humanitarian Director, said:

We can confirm that an NHS healthworker working with Save the Children at the Ebola Treatment Centre at Kerry Town, Sierra Leone, has tested positive for Ebola.

Our thoughts are with the individual, their family and colleagues at this difficult time. We wish them a speedy recovery.

By coincidence earlier this evening, we published the fourth report for the Guardian by Martin Deahl, a consultant psychiatrist from Shropshire who is working in Sierra Leone.

From his placement with the international aid agency Goal at their Ebola treatment centre in Port Loko, he reflects on the highs and lows of the ‘most surreal and extraordinary’ Christmas of his life:

Late on Christmas Eve we got the lab-test result for Gabriel, one of the patients on the confirmed ward.

He collapsed two weeks ago just as the UK’s international development secretary, Justine Greening, was arriving at the Goal Ebola Treatment Centre (ETC) for a visit.

British Airways has said that the airline is working closely with health authorities in England and Scotland and will offer assistance with any information they require.

A spokesman said:

Customers who flew from London Heathrow to Glasgow on BA1478 which departed at 2100 on Sunday December 28 and have concerns should contact the special number 08000 858531 set up by the Scottish Government.

The safety and security of our customers and crew is always our top priority and the risk to people on board that individual flight is extremely low.

British health authorities have confirmed the details of the flights on which the patient was travelling (via Casablanca, Heathrow and Glasgow):

UK #Ebola case: Patient left Sierra Leone on 28 Dec, flights: AT596 Freetown-Casablanca, AT0800 Casablanca-London, BA1478 Heathrow-Glasgow

While we’ve been focusing for the last while on events here in the UK, the real crisis is still very much in West Africa, where the virus has caused more than 7,800 deaths.

Based on a two month investigation, the New York Times has just published a report on what it says was a fleeting moment last Spring to bring the epidemic under control, and which it says was lost.

After more than 20,000 cases and 7,800 deaths, it can be hard to recall that there was a moment in the spring when the longest and deadliest Ebola outbreak in history might have been stopped.

But without a robust and coordinated response, an invisible epidemic was allowed to thrive alongside the one assumed to be contained.

The Department of Health tweets this public health message in a bid to alleviate fears:

To catch #Ebola you have to come into contact with someone’s bodily fluids pic.twitter.com/XzSxQGYGWI

A confirmed Ebola case among one of the first healthcare workers to leave the UK for Sierra Leone is a major blow to the health authorities who have been trying to quieten fears about any possible impact here while ramping up the fight in west Africa, according to the Guardian’s Health Editor, Sarah Boseley.

In an analysis piece which you can read in full here, she adds that huge efforts were made to try to ensure that none of the hundreds of NHS workers who volunteered to make the trip would return with the virus.

It took several months before the final decisions were made on which volunteers would be sent. They were given psychological tests and intensive training; the first batch were trained for nine days, much of it in a simulated treatment centre at the sort of high temperatures to be expected in Sierra Leone.

It would be a tragedy if this incident stops more volunteers being sent or if it starts another wave of Ebola panic in the UK. This virus would not easily be passed on in this country.

The healthcare worker who has fallen ill must have been sufficiently well to pass the many temperature checks on the route home, first at Freetown airport, then in Casablanca which has a full body heat scanner and then at Heathrow airport, where Public Health England’s nurses take you through a questionnaire and yet another temperature check.

A spokesman for the Royal Free Hospital in London has said it was not yet clear when the patient would be transferred to London from Glasgow. He said:

The Royal Free London can confirm that it is expecting to receive a patient who has tested positive for Ebola.

The patient will be treated in the high level isolation unit (HLIU).

Now is probably a good time to re-read this myth busting piece by the Guardian’s Health Editor, Sarah Boseley.

Some key points:

Some reaction now from the Prme Minister, David Cameron, via Twitter:

PM and Scotland’s First Minister agree to ensure everything possible will be done to support #Ebola patient and protect public health.

So what happens now in terms of the timetable for treating the nurse diagnosed in Glasgow? It’s now expected that they will be transferred to London tomorrow morning rather than tonight.

When they get there, it’s likely that infectious disease consultants are likely to consider the option of giving the nurse some of the plasma donated by Will Pooley, the British nurse who survived Ebola and subsequently returned to work in Sierra Leone in October.

Pooley banked 1.2 litres of plasma in a lab in Birmingham, consenting it to be used on a patient/and or for research for “convalescent therapy serum”.

However his plasma will only be relevant if the two nurses blood type matches.

Chance of nurse in Glasgow's survival much higher than Africa where Ebola has killed more than 350 health workers.

Dr Sarah Wollaston, Conservative MP and Chair of the House of Commons Health Select Committee, has said that a case like this had been expected and that the risk to the public from returning health workers is “effectively zero”.

The real danger is if we do not continue to tackle the disease in West Africa, she told BBC News. The real danger would be if the disease was to “get out of control” in west Africa.

The consistent theme of commentary coming through now from health experts is that that the public should be aware that Ebola is a disease which is very difficult to transmit.

Prof Nigel Brown, President of the Society for General Microbiology, said

If a person is symptomless they are unable to infect anyone else. Public health officials have fully prepared for an Ebola case being imported into the UK and are ready to respond quickly and efficiently.

We should be proud of the British healthcare workers and microbiologists who have volunteered to fight this disease in West Africa.

From as early as July, we predicted that the UK was it risk of importing a case of Ebola. Despite restrictions in airline routes, and screening at airports, we thought we were likely to see a case before the end of the year. This has now happened.

Because this was a health care worker, who knew what to look out for, and what to do once they felt unwell, the risks to the general public are minimal. It is important to remember that the only people who get Ebola are those who have been caring for someone who had Ebola, because the virus is passed on infected bodily fluids.

The flight from Heathrow to Glasgow, along with 71 passengers and crew, was a British Airways flight BA 1478, the Guardian’s Libby Brooks reports from Glasgow.

The flight taken from Casablanca was via Moroccan airlines. The flight number is not yet known but Public Health England will be contacting those passengers.

Dr Alisdair MacConacchie, NHS Greater Glasgow and Clyde Consultant in Infectious Diseases, who has been treating the patient, said that the patient had identified themselves as having a fever in the early hours of this morning.

She was then transferred to the Brownlee Centre using a specialist ambulance service and admitted to be managed in an isolation facility.

The British health secretary, Jeremy Hunt, will be chairing a meeting of the government’s Cobra committee, which decides on how to cope with national crises, the BBC’s Ross Hawkins tweets:

Breaking - The health secretary Jeremy Hunt is to chair a Cobra meeting about the Ebola case this evening

The health worker being treated in Glasgow is a volunteer nurse who had been working at the British-built Kerrytown hospital just outside Sierra Leone’s capital, Freetown, my colleague Lisa O’Carroll has been told.

She adds:

The facility is run by Save the Children. A spokeswoman for the charity said that the health worker flew to Freetown on 23 November and had worked in the discharge area for patients who have recovered from Ebola.

Three days ago Save the Children had marked the fact the hospital had become fully operational announcing that 66 patients had been cured and discharged since it had opened on 5 November. In addition, almost 200 had received or continue to receive treatment against the disease.

That press conference is being wrapped up now. Some key points from it and more broadly:

The Guardian’s Libby Brooks is at the press conference, from where she tweets this:

Nicola Sturgeon confirms that the patient was screened in Sierra Leone and at Heathrow pic.twitter.com/ZhgoG62c9N

Sturgeon and others on the press conference panel are being asked if there are concerns on the back of healthcare workers in the US contracting Ebola while treating patients in hospitals there.

Sturgeon says that the patient will be transferred to the Royal Free hospital in London as soon as possible because that is where the facilities, staff and systems are in place to ensure the best quality and safest care.

Sturgeon says that there is no reason for the wider public in Scotland to be “at all” concerned.

Some comments from here here also from a Scottish government press statement issued earlier:

We have the robust procedures in place to identify cases rapidly.

Our health service also has the expertise and facilities to ensure that confirmed Ebola cases such as this are contained and isolated effectively minimising any potential spread of the disease.

Sturgeon was being pressed by reporters at the press conference about whether the patient is an NHS worker or an aid worker but resisted doing so.

A telephone helpline has been set up for anyone who was on the Heathrow to Glasgow flight last night on which the patient arrived in Glasgow.

The contacting of other passengers is very much a precautionary measure.

The patient identified themselves in the early hours of this morning after feeling unwell.

That’s according to Dr Alisdair MacConnachie, NHS Greater Glasgow & Clyde, who is speaking on the same panel as Sturgeon.

Scotland’s first minister, Nicola Sturgeon, is speaking now at a press conference in Glasgow.

A healthcare worker who returned to the UK on Sunday after spending time combating ebola in West Africa is being treated in Scotland after being diagnosed with the disease.

The patient, who has been isolated and is receiving treatment in a specialist unit in Glasgow, arrived in the city on a flight from Sierra Leone after transferring in Morocco and at London Heathrow.

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