With British nurse Pauline Cafferkey’s readmission to an isolation unit in London after the Ebola Virus was found in her body, we look at what we know about the complications of the virus and the implications for survivors.
The 39-year-old nurse, who contracted Ebola in Sierra Leone in December 2014, was admitted to a hospital in Glasgow on Tuesday after feeling unwell and was treated in the infectious disease unit. Doctors said the virus was present in her body and left over from the original infection. They described it as “an unusual late complication.” She was transferred from Glasgow to the Royal Free Hospital in London- where she was treated after being flown back to the UK last year- Thursday as a precaution. As Ebola is a very fragile virus, it breaks down in a matter of hours or days if it is not actively replicating. This suggests there is a small amount replicating somewhere in Pauline Cafferkey’s body. However, while she has traces of the virus, it does not mean she has Ebola haemorrhagic fever with the symptoms of vomiting, diarrhoea and internal and external bleeding. As long as the virus is not getting into her blood, she is unlikely to be able to spread it- and risks of transmission already extremely low. The disease only spreads between humans through direct contact with infected blood, bodily fluids or organs. There have been no confirmed cases of an Ebola survivor spreading the infection. There are now so many survivors in West Africa- around 13,000- that if there was a major risk, then we would know about it. But as long as people have the virus there is a potential risk, however low. Liberia had a mini Ebola flare-up but the Ebola virus persisting in survivors has been put forward as a possible explanation. Experts say there will have to be monitoring for Ebola flare-ups for years to come.
Patients with Ebola are generally discharged once the virus cannot be detected in the blood. However, there are parts of the body where the immune system is weaker, such as the eye, nervous system, cartilage and testes. Previous outbreaks have shown that Ebola persists in semen for months after an infection and that is why male Ebola survivors are advised to wear condoms during sex. It was also reported in this outbreak that the virus had been detected in the eye of a US doctor two months after being declared Ebola free. Doctors have called for more research into these “Ebola reservoirs” and what risks they pose to the health of the patient and any risk of infection. So far, the most common health issues survivors have faced have been severe joint pains, eye problems, serious fatigue, headaches and poor concentration. When Ms Cafferkey was in London recently for the Pride of Britain awards, she said that she had experienced joint pains, thyroid problems and lost her hair in the aftermath of her recovery from the disease. A recent report from the World Health Organisation found that changes in vision had been reported by roughly 25% of survivors. If left untreated these eye problems can cause blindness. Depression and post-traumatic stress disorder have also been reported in some survivors. But there is very little data or research into why or how often these health problems occur.