Ebola: UK screening procedures to be reviewed

Pauline Cafferkey
Image caption Pauline Cafferkey is being treated at a London hospital

Procedures for screening health workers returning to the UK after treating Ebola patients will be reviewed after an infected nurse flew from London to Glasgow despite raising concerns.

Pauline Cafferkey told officials at Heathrow she felt unwell but was allowed to continue her journey. She was diagnosed in hospital the next day.

Another passenger on her flight said screening had been "chaotic".

The chief medical officer said the case raised questions over precautions.

However, Dame Sally Davies said correct protocols had been followed.

"The risk of raised temperature when she came back appears to have been very low," she said.

"That's why we look at what we do all the time to see should we have been more precautionary, is it in the public's interest? Is it in the patient's interest?"

But she added: "I doubt it would have made much difference."

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Media captionChief Medical Officer Dame Sally Davies says Ms Cafferkey's temperature was "within the range for flying and that she was well"

Dame Sally said Ms Cafferkey had been in the early phase of the disease when she made the journey to the UK from Sierra Leone, via Casablanca, and her fellow passengers were at "very low risk" of being infected.

She told BBC Breakfast: "The public health risk is negligible - Ebola's very difficult to catch."

Ms Cafferkey was diagnosed on Monday after returning from Sierra Leone, where she had travelled as part of a 30-strong group of healthcare workers from Save the Children.

She was allowed to leave Heathrow after her temperature was taken seven times.

Temperature screening

  • A normal body temperature is considered 37C
  • A raised temperature is one sign of Ebola and forms a core part of entry screening
  • The UK uses a relatively tough 37.5C as the cut off for further testing
  • Belgium and Australia use a higher threshold of 38C
  • India uses 38.3C
  • Spain and the US use 38.6C

Source: The Lancet

After an initial test, she told officials she believed a fever might be developing while she was waiting for a connecting flight to Glasgow.

Her temperature was taken a further six times over 30 minutes, but each test found her temperature to be normal.

She reported symptoms the following morning after arriving in Glasgow.

A Department of Health spokesman said: "Naturally, we will be reviewing what happened and the screening protocols, and if anything needs to be changed it will be."

Enhanced screening - which involves passengers having their temperature taken and completing a questionnaire about their health - was rolled out at some UK airports, including Heathrow, in October.

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Media captionDr Martin Deahl: "The whole process was a bit chaotic"

Save the Children said they had "robust and strict protocols in place to protect our staff."

A statement added: "Save the Children also asks staff to be careful outside of the treatment centre, where exposure to risks can be less obvious."

The charity's humanitarian director Michael von Bertele told BBC Radio 4's Today programme: "It's really important for us to try and understand whether it was a failure of training, of protection, of procedure, or indeed whether she contracted it in some incidental contact within the community.

"Because our workers don't just work inside the red zone, which is a very high-risk area, they do also have contact - although we are very, very careful in briefing people to avoid personal contact - outside of the treatment centre."

He also said that while protection is "of a very high standard", "nothing is risk-free" when it comes to dealing with Ebola.

But Dr Martin Deahl, a consultant psychiatrist who travelled back on the same flight as Ms Cafferkey, said there had been issues at Heathrow.

He said there were too few staff on duty and the rooms where returning volunteers were held were too small.

Ms Cafferkey is currently being cared for at the Royal Free Hospital, in Hampstead, north London.

She was said to be doing "as well as can be expected under the circumstances" by Scotland's First Minister Nicola Sturgeon.

Ms Cafferkey had no detectable fever or symptoms. Anyone displaying symptoms at screening, either in Sierra Leone or in the UK, would not have been allowed to travel.

One third of the 132 other passengers on the flight from Casablanca to Heathrow had been contacted by Public Health England, while advice had been given to more than half the 72 passengers from Heathrow to Glasgow, officials said.

Another healthcare worker who was recently in West Africa and fell ill in the Scottish Highlands has tested negative for the disease.

A third patient from Cornwall, who had recently returned from an affected country, has also tested negative.

Ms Cafferkey could be offered plasma from patients who have survived the virus as part of her treatment.

Dame Sally confirmed that plasma had been donated by British nurse William Pooley, who recovered from Ebola in September after also being treated at the Royal Free Hospital.

Image copyright Reuters
Image caption Ms Cafferkey left hospital in Glasgow in the early hours of Tuesday for the Royal Free Hospital in London

Having fought off the infection, his blood should help others do the same.

Other available treatments include antiviral drugs, but there are no stocks left of ZMapp - the drug used to treat Mr Pooley.

Ebola is transmitted by direct contact with the bodily fluids of an infected person, such as blood, vomit or faeces.

The virus has killed more than 7,800 people, mostly in West Africa, since it broke out a year ago.

The World Health Organization says the number of people infected by the disease in Sierra Leone, Liberia and Guinea has now passed 20,000.

What are the symptoms?

Image caption The Ebola virus causes a range of painful and debilitating symptoms

The early symptoms are a sudden fever, muscle pain, fatigue, headache and sore throat.

This is followed by vomiting, diarrhoea, a rash and bleeding - both internal and external - which can be seen in the gums, eyes, nose and in the stools.

Patients tend to die from dehydration and multiple organ failure.

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