Scottish Ebola patient transferred to London hospital

© Nick Dastoor

Gartnavel hospital in Glasgow, where the patient was isolated on Monday morning.

A Scottish nurse was on the way to specialist facilities in London on Tuesday morning after being diagnosed with the Ebola virus.

The woman had been treated in an isolation unit in Glasgow after being diagnosed hours after arriving home from west Africa via a British Airways flight from Heathrow.

She was later transferred from Glasgow airport on a military-style plane in a quarantine tent surrounded by a group of health workers in full protection suits, bound for the Royal Free Hospital in north London.

A statement on the hospital's website 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)."

The healthcare worker was admitted to Gartnavel hospital after feeling unwell with a fever at 7.50am on Monday morning, having flown into the city at 11.30pm on Sunday. She had spent the last month working as a volunteer with Save the Children in Sierra Leone to help combat the epidemic.

It is the first case of Ebola to be diagnosed on UK soil.

Health experts treating the nurse said she was "quite stable" and showing few signs causing clinical concern, raising hopes she will survive the disease.

She had been volunteering at a newly built hospital at Kerry Town in Sierra Leone run by the charity Save the Children since 23 November. The charity said she had asked not to be named.

Michael von Bertele, Save the Children's humanitarian director, said: "We can confirm that an NHS health worker 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. Save the Children is working closely with the UK government, Scottish government and Public Health England to look into the circumstances surrounding the case."

Urgent steps were being taken by officials with Health Protection Scotland and Public Health England to trace scores of passengers on the nurse's Royal Air Maroc flight into the UK from Casablanca in Morocco, and the 71 passengers on her internal British Airways connection - BA 1478 - from Heathrow to Glasgow on Sunday night.

Nicola Sturgeon, the Scottish first minister and previously Scottish health secretary, said on Monday evening the search for passengers "was very much a precautionary measure". The nurse, who is believed to be at the early stages of the infection, had been cleared by screening in Sierra Leone and at Heathrow.

"The risk to other people as a result of this Ebola case is deemed to be extremely low," Sturgeon told a press conference. "Given the early stage of diagnosis, the patient was showing no signs of the symptoms which lead to transmission [of the virus] to other people." She said the risk to the general public was "extremely low to the point of negligible" and added: "There's no reason for the wider public in Scotland to be at all concerned."

The Royal Free hospital houses the UK's main Ebola treatment centre and the nurse was transferred there under an agreed protocol between all the UK's health authorities. Another British nurse, William Pooley, was successfully treated there after contracting Ebola in Sierra Leone earlier this year. Scotland has no dedicated facilities for treating the disease.

Since this Ebola outbreak began in December 2013 in the west African country of Guinea, there have been nearly 20,000 cases of the disease and more than 7,500 deaths, centred in Liberia, Guinea and Sierra Leone.

The nurse had contacted an NHS helpline from home after feeling unwell with a fever, one of the first symptoms of the disease, early on Monday morning. Sturgeon said she was then picked up from home by a specialist ambulance, and was immediately admitted into the Brownlee infectious diseases unit at Gartnavel.

Ebola symptoms can take up to 21 days to show, but more normally five to seven days. The Ebola virus is transmitted in the bodily fluids of people seriously ill with the virus, who are likely to be vomiting, bleeding or have diarrhoea.

The nurse's partner is thought to be the only other person who has been in contact with her since she arrived home, and is now being screened by medical staff.

Save the Children said that since its Kerry Town clinic had opened, nearly 200 people had received treatment or continued to be treated at the site, with 66 cured and discharged. In a statement, the charity noted that early treatment in Ebola cases "maximises the chances of survival of those who are infected, and can make the difference between life and death".

Almost all the health workers who have contracted Ebola in west Africa and who got early treatment have survived, including Ian Crozier, a World Health Organisation doctor, who became so ill he ended up on life support at a hospital in the US.

Not only did Crozier have state-of-the-art medical support with dialysis machines used when he developed renal problems, he also had a donation of plasma packed with Ebola antibodies from Pooley, who contracted the virus weeks before at the same hospital in Kenema, in Sierra Leone.

There is no cure for Ebola but the survival rate is about 50% if patients are quickly treated with hydration, anti-malarial drugs and antibiotics.

During the course of the disease, patients can lose up to 10 litres of liquid a day from diarrhoea and vomiting and if they don't develop sufficient numbers of antibodies quickly enough the virus will attack their internal organs making survival challenging. Statistically in this outbreak, the chances of survival are much higher for those who have been treated in a US or European facility.

Sturgeon had earlier spoken to David Cameron, the prime minister, to discuss the case. Both governments had convened their emergency response committees, with the UK health secretary, Jeremy Hunt, chairing a Cobra meeting at Downing Street.

A No 10 spokesman said Cameron had telephoned Sturgeon regarding the case, stressing that the UK government stood ready to assist "in any way possible", and confirmed that the strictest procedures possible were being followed.

"They agreed that both governments would remain in close touch and ensure everything possible was done to support the patient and, although the risk to the general population remained low, all measures would be taken to protect public health," the spokesman said.

After chairing the Cobra meeting, Hunt said: "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," he said. "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."

Dr Alisdair MacConacchie, a consultant in infectious diseases for NHS Greater Glasgow and Clyde Consultant, who has been treating the patient, said she had had no contact with other parts of the NHS or any accident and emergency facility.

"The patient identified themselves as having a fever in the early hours of this morning and contacted the NHS," he said. "She was transferred to the Brownlee centre using a specialist ambulance service and is being managed in an isolation facility by staff who are comfortable managing patients in such situations. She herself is quite stable and not showing any great clinical concern at the minute."

Asked about the patient's prospects, he said that being clinically stable at this stage "should translate into a good prognosis".

Save the Children and the Department for International Development had faced great criticism after the 80-bed hospital at Kerry Town had first opened because it would not run at full capacity for two months. The charity insisted its first priority was the safety of the health workers and it was paramount that the facility was phased in slowly.

Infectious disease consultants are also likely to consider the option of giving the nurse some of the plasma donated by Pooley before he returned to Sierra Leone in October.

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

However, his plasma will only be relevant if the new patient's blood type matches his.

Sources in Freetown say Save the Children has been extra vigilant about the health of the volunteers who work with them at Kerry Town. They are all required to stay at a hotel the charity has block-booked at Lumley Beach in Freetown, and staff are bussed out to the hospital daily with little interaction with any locals.

The number of people infected by Ebola in the three countries worst affected by the outbreak has passed 20,000, with more than 7,842 deaths in the epidemic so far, according to the World Health Organisation. Cumulative case numbers in Sierra Leone, Liberia and Guinea stood at 20,081, the WHO said in a statement. More than a third are laboratory-confirmed cases in Sierra Leone, which has become the worst-hit country in the worst outbreak of the disease on record.

Spread of an epidemic

1976 A teacher in Zaire, now the Democratic Republic of Congo, becomes the first documented person to contract the Ebola virus and later dies.

1976-2013 Several small outbreaks affect west Africa, with highest death toll at one time reaching just over 250.

December 2013 A handful of people in Guinea die of an unidentified fever, which is later confirmed as Ebola.

March 2014 The World Health Organisation (WHO) reports Ebola outbreak in Guinea. Liberia identifies its first case and the virus spreads to Sierra Leone.

20 July Liberian government employee Patrick Sawyer travels to Lagos, Nigeria, where he dies of Ebola.

8 August The WHO declares Ebola an international health emergency. Four days later, the death toll exceeds 1,000.

24 August British volunteer nurse William Pooley is urgently flown to London for treatment after contracting the virus. The 29-year-old makes a full recovery and subsequently returns to west Africa.

19 September The WHO describes the outbreak as a social crisis, a humanitarian crisis, an economic crisis, with cases doubling every four weeks and a death toll of more than 2,500.

9 October The government announces screening for passengers arriving at Gatwick and Heathrow airports, and warns some Ebola cases will reach the UK. UN chief Ban Ki-moon launches another urgent appeal for funds as the death toll hits 4,500.

October 29 The WHO says the rate of new Ebola infections in Liberia appears to be declining and could represent a genuine trend.

22 November The first NHS volunteers, including GPs, nurses, psychiatrists and emergency medicine consultants, leave for Sierra Leone.

24 December The WHO says there have been 7,588 reported deaths.

29 December Scottish government announces a healthcare worker returning from Sierra Leone has Ebola.