January 5, 2015

expert reaction to update on condition of UK nurse with Ebola, plus update on UK screening from Jeremy Hunt

The condition of the British nurse being treated in a London hospital for Ebola is said to have improved. The health secretary, Jeremy Hunt, has also announced changes to the screening procedure for Ebola at the UK border.

Prof. Jonathan Ball, Professor of Molecular Virology, University of Nottingham, said:

“It’s great news that her condition has stabilised but she still remains in a critical condition so the coming hours and days will be crucial. We know that she was receiving an experimental drug as well as convalescent sera but it is difficult to ascertain if these have contributed to her stabilisation.

“Hopefully the excellent team of clinicians caring for her will be able to buy sufficient time for her to be able to mount a good immune response that would eventually clear the virus.”

Prof. Derek Macallan, Professor of Infectious Disease and Medicine, St George’s, University of London (SGUL), said:

“I think it’s interesting that she felt unwell before any objective signs of illness, such as a measurable fever were apparent.

“I think this is consistent with what we all know which is that the body is very good at sensing when something is wrong, better than a thermometer, so a ‘symptom-check’ should be part of the screening process for people returning from an at-risk area. That seems common sense, but it is scientifically sound, not least because when someone has a feverish illness the temperature often cycles in and out of the hot-zone (that is why you shiver then sweat) so you can be feverish but have a normal temperature at the moment you take it if you take the temperature reading at the low point in the cycle.

“Following up on anyone with symptoms may result in some over-reactions – the body’s ‘sensors’ get it wrong too, as we all know – but it seems wise to ask travellers returning from an at-risk area whether they feel, or have recently felt unwell and if they say yes, to take further advice from a clinician.

“No sensor, either internal (symptoms) or external (something measurable such as a temperature or a blood test), is currently available to detect Ebola in the incubation period, so no amount of airport screening will eliminate the risk of entry to the country of someone incubating, but not yet ill with, Ebola.”

Declared interests

None declared