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Old 10-09-2015, 07:21 AM   #1
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Default British Nurse Back In Hospital: Ebola Virus Lives On In Tissue

British Nurse Pauline Cafferkey is back in hospital after further effects of the virus became apparent. Details of her condition have not been disclosed further.

Ebola can stay buried in survivors’ tissue meaning that its effects could continue long after people have apparently recovered, experts said today. And while there is no reason to worry about a return of the virus in the UK, its persistence could be a way that it will flare back up again.

Pauline Cafferkey, who became known as the “Ebola nurse” after she received treatment for the deadly virus earlier this year, has gone back into hospital for treatment. And it appears that having lasting effects long after apparent recovery, even though it doesn’t mean that people can catch it twice.



It isn’t clear what treatment Ms Cafferkey is undergoing now that she has returned to hospital. But it is related to her previous exposure to the virus, according to experts.

Scientists are still not entirely sure about what the long-term effects of Ebola are.

"It seems that some of the ongoing health problems with people's eyes, joints and hair loss are actually caused not by the after-effects of Ebola, but by the small amounts of Ebola which is still residing somewhere in the body," Dr Ben Neuman, a virologist at the University of Reading, told BBC Radio Scotland.

"It's surprising and we're just learning how to deal with this."

"We know that Ebola virus can shelter in the body in what are called immune privileged sites such as the eye, central nervous system and testes,” said Julian Hiscox, professor of infection and global health at the University of Liverpool.

“"Due to the sheer scale of this outbreak compared to previous ones, we are going to see aspects of Ebola virus infection that we have not observed before.

"I think the persistence of the virus in asymptomatic individuals is a potential reservoir of the virus. We know that infectious virus is present in semen for a number of months. It's why men who have had Ebola and recovered are advised to abstain or wear condoms."

But the return of the effects of the disease in McAfferkey doesn’t necessarily mean that the virus is flaring back up.

"The good news is that it's probably not going to be infectious,” said Dr Neuman. “The virus, once it is removed from the blood once, tends to retreat into the hard-to-access compartments of the body.”

The NHS in Greater Glasgow and Clyde’s director of public health, Dr Emilia Crighton, assured the public that there was a “very low” risk to the public of the problems returning.

“Pauline’s condition is a complication of a previous infection with the Ebola virus,” Dr Crighton said. “The risk to the public is very low. In line with normal procedures in cases such as this, we have identified a small number of close contacts of Pauline’s that we will be following up as a precaution.”


http://www.independent.co.uk/news/uk...-a6687571.html
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Old 10-14-2015, 01:19 PM   #2
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This lady is now in a critical condition...
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Old 10-14-2015, 01:44 PM   #3
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i hadn't realised that this could come back in someone who'd already survived this once. Poor woman.
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Old 10-14-2015, 02:46 PM   #4
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In addition to the "unusual late complication" It sounds like she's infectious.

much more at the site.
Quote:
Dozens of friends and family of British nurse Pauline Cafferkey have been given the Ebola vaccine after she fell ill with the disease for a second time...

On Thursday, the NHS nurse was wheeled from a jet at RAF Northolt by medics in hazard suits on a bed surrounded by a protective bubble before being taken to the Royal Free....

http://www.dailymail.co.uk/news/arti...tion-unit.html
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Old 10-14-2015, 04:00 PM   #5
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Latest from the BBC tonight:

Ms Cafferkey had initially gone to an out-of-hours doctor in Glasgow on Monday of last week, but was sent home after being told she probably had a virus.
Her family has claimed doctors "missed a big opportunity" to spot she had fallen ill again.
She was admitted to the city's Queen Elizabeth University Hospital the following day after continuing to feel unwell, before being transferred to the Royal Free in a military aircraft on Friday morning.
The BBC's medical correspondent, Fergus Walsh, has suggested that Ms Cafferkey may have been suffering from meningitis.
He told BBC News: "She was admitted on Friday morning when her condition was serious and it is now critical. We have not been given any more details, but earlier this week her family had spoke about how unhappy they had been last week when she was sent home after going to an out-of-hours GP.
"She is a nurse, and described the symptoms of meningitis. That would fit with one of the possible scenarios.
"Although she fought off successfully being critically ill once before, somehow the virus stayed and lodged in parts of her body. It could well be the spinal cord, and if she does have meningitis that would be inflammation of the spinal cord."
Dr Ben Neuman, a virologist at the University of Reading, told the BBC that the medical team treating Ms Cafferkey was in "completely uncharted territory".


http://www.bbc.co.uk/news/uk-scotland-34529575
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Old 10-14-2015, 09:36 PM   #6
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I'm not certain, (doubt anyone is), she's infectious again but why take chances? If the vaccine is available, this sounds to me as an ideal time to use it.

I feel bad for this woman. Nothing I've ever read has indicated that a course of this disease is anything but horrendous for patients. To have it recur... my Lord, what a nightmare.

This really adds to the vital nature of a vaccine that works. There will be future outbreaks & the current one is far from over - not by any measure. Hard enough to convince family/friends/coworkers that it's a Good Idea, a noble thing to take time & go to a Hot Zone. Another large scale outbreak requiring tons of manpower from the rest is going to be a hard sell. Clearly, we don't have a solid lock on understanding of all the mechanisms of transmission, although news that it can persist in wastewater for longer than thought adds another dimension. The protocols need to be duck-butt tight for protecting staff dealing with Ebola patients & even at that, people get tired, they get careless & mistakes happen.

Now, we've had two patients from the west suffer recurrences. Forgive me - I've lost track of exactly how many non-African patients we've seen with this outbreak but after you subtract those who, unfortunately, died; you're not left with very many. To have two becomes ill again - to any degree is a major worry. I'd love to know how many patients from West Africa who survived, are also seeing recurrences of any sort & of those, what symptoms are being seen?

IF it turns out these patients risk being infectious in any way & if they work in health care settings specifically or health care related logistics, general NGO work... there is a valid question about them continuing to work. At what point do they remove themselves from the society of other people & go in for whatever testing is deemed necessary? Do we have tests that will validate early symptoms of a possible recurrence?

It matters on many levels - no one wants to put their loved ones, coworkers, etc. at risk. I can be pretty sure they work places are loathe to deal with that risk too! Not to mention - how does this affect health insurance, life insurance, long term disability...

this could turn into a real mess.
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Old 10-15-2015, 05:20 AM   #7
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This morning's update from the Independent:

The exact nature of Ms Cafferkey’s illness is not known, but experts have expressed shock at the severity of her condition.

Jonathan Ball, professor of molecular virology at the University of Nottingham, said the news was “frankly staggering.”

“I am not aware from the scientific literature of a case where Ebola has been associated with what we can only assume as life threatening complications after someone has initially recovered, and certainly not so many months after,” he said.

Health authorities have emphasised that the risk to the general public remains low. However 58 people who had been in close contact with Ms Cafferkey are being monitored by Health Protection Scotland. 25 have been vaccinated using the jab successfully trialed earlier this year in Guinea.

Dr Nathalie MacDermott, a clinical research fellow at Imperial College London, who also treated Ebola patients in West Africa at the height of the epidemic, said: “The change in [Pauline Cafferkey’s] condition does not imply any increased risk to the general public, as stated previously the risk to the general public who may have had contact prior to her deterioration remains extremely low.

“It is unlikely that anything could have been done to prevent this relapse, this is an unexpected situation which could not have been anticipated. It is difficult to know whether any earlier intervention may have altered her current condition as we are only just learning about the potential long term effects of Ebola virus disease and management of complications and secondary effects.”


http://www.independent.co.uk/news/uk...-a6694201.html
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Old 10-15-2015, 12:59 PM   #8
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I suspect that this is not that uncommon, and due to a lack of followup with prior outbreaks and patients, we simply did not know this happens with some regularity. Or she has a particularly nasty strain of it.

May she have a speedy recovery.
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Old 10-15-2015, 04:17 PM   #9
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I could swear that somewhere, in one of the many, many articles about the Ebola outbreak, I read an abstract of an earlier study that showed that traces of Ebola were found in cerebrospinal fluid, even after recovery from the acute phase.

Of course, now I can't find the darn study.
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Old 10-15-2015, 05:42 PM   #10
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Quote:
Originally Posted by Catbird View Post
I could swear that somewhere, in one of the many, many articles about the Ebola outbreak, I read an abstract of an earlier study that showed that traces of Ebola were found in cerebrospinal fluid, even after recovery from the acute phase.

Of course, now I can't find the darn study.
I read that too. It also hides in eye tissues and the testes.
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Old 10-15-2015, 05:59 PM   #11
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Thanks. I was going a little nuts trying to figure out if my recall was accurate.
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Old 10-21-2015, 10:33 AM   #12
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Scottish nurse Pauline Cafferkey is now improving.
by Ashley P. Taylor, Live Science Contributor | October 20, 2015 04:52pm ET

Scottish nurse Pauline Cafferkey — who became sick with Ebola about a year ago and recovered, but then became very ill again last week with what may be a relapse of the deadly virus — is now improving.

"Pauline Cafferkey's condition has improved to serious but stable," representatives from London's Royal Free Hospital said in a statement Monday (Oct. 19).

Hospital representatives said on Oct. 9 that the nurse had developed an "unusual late complication" of the virus, and reported last week that she was "critically ill." Cafferkey originally became sick with the disease in 2014 while caring for Ebola patients in Sierra Leone, becoming the United Kingdom's first Ebola patient. The nurse is now being "treated for Ebola in the high-level isolation unit," according to the hospital's statement last week.

Post-Ebola complications have been reported from both the 2014 outbreak and previous ones, Dr. Nahid Bhadelia, an infectious-disease specialist at Boston University, told Live Science. Another health care worker who also became infected while treating patients in Africa, U.S. physician Ian Crozier, has reported that he suffered from hearing loss, back pain, seizures and vision problems since he recovered from Ebola last year.

These are the kinds of symptoms many Ebola survivors have, Bhadelia said.
But cases of Ebola relapse, or recurrence — severe, sudden illness associated with the detection of the virus in the body — are different from these complications, said Dr. Jesse Goodman, an infectious-disease expert at Georgetown University. Cafferkey's case is the second documented instance of probable viral relapse in a recovered Ebola patient, Goodman said.

The other case was Crozier, Goodman said. Nine weeks after Crozier's blood was found to be Ebola-free, he suffered severe inflammation (uveitis) of his left eye. Tests of the fluid within the eye revealed that the Ebola virus was still there, and replicating.

The distinction between "complications" and "relapse" is somewhat blurry, Goodman said. After the acute infection subsides, Ebola seems to persist in several parts of the body where the immune system is less active, such as the eye, where Crozier's Ebola flared up; the brain; the placenta; the testes; and, sometimes, joint cartilage, Bhadelia said.


It's possible that the rare cases of relapse, as well as the more common post-Ebola complications, could be related to the lingering virus, Goodman said....

http://www.livescience.com/52537-ebo...questions.html

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