Pauline Cafferkey, Scottish nurse who had Ebola, 'critically ill' again

A Scottish nurse being treated for Ebola is now critically ill, say officials at Royal Free London hospital.

"We are sad to announce that Pauline Cafferkey's condition has deteriorated and she is now critically ill," Royal Free London said in a statement on its website today. 

• Post-Ebola Syndrome: Survivors continue to face mystery symptoms
• More video, stories and photos of the outbreak 

​Cafferkey, 39, was diagnosed and treated for Ebola in Britain in January after returning from Sierra Leone.

She was originally discharged from the hospital in January. The hospital is Britain's main centre for Ebola cases.

Last week, doctors said Cafferkey suffered long-term complications. She was flown to London in a military plane for treatment.

More than 28,450 people were infected with Ebola in Guinea, Sierra Leone and Liberia since the outbreak was declared in March 2014. More than 11,290 people have died.

As the number of survivors increases, medical researchers are starting to identify physical and mental-health issues known as "post-Ebola syndrome." It occurs in some survivors even after the virus clears the bloodstream.

The long-term effects of Ebola include damage to the eyes and joints that are thought to be caused by the virus growing  and persisting in some areas of the body where the immune system is slow to destroy it.

Doctors are learning about the spectrum of disease that exists for Ebola and how it's broader than originally thought, said Dr. Dan Bausch, a senior consultant to the World Health Organization and an infectious-disease specialist at Tulane University who has worked in Sierra Leone. 

"Her case is unusual," Bausch said from Geneva. 

People with persistent Ebola offer an opportunity and responsibility to learn, he said. They don't have classic Ebola two times but Ebola virus that persists in sites such as the eye and central nervous system. 

Dr. Allison McGeer is an infectious disease consultant at Toronto's Mount Sinai Hospital who travelled several times to Liberia throughout the winter to work with the WHO on Ebola.

"It's not a relapse of her disease. But it's somehow a complication that arose because of her care," McGeer said. "She was very ill. When people survive that kind of severe illness in intensive care,  it is not uncommon to have complications that will cause you problems in the short term and in the long term."

British health authorities say at least 60 close contacts of Cafferkey have been confirmed. All close contacts are being closely monitored. Those confirmed as having had direct contact with her bodily fluids were offered an experimental Ebola vaccine as a precaution.

"We have taken the additional precaution of risk assessing every contact she's had within the health-care setting and the household and the family setting, and that's why we're following these individuals up according to national protocol," said Dr. Duncan McCormick, Scotland's chief medical officer.

There is no risk to the general public, British doctors stressed.

"Most survivors don't pose any danger to people in general," Bausch said. "But we do need to be cognizant that there is possibility of sexual transmission of the virus." 

Ebola is not spread through ordinary social contact, such as shaking hands or sitting next to someone. It does not spread through airborne particles.

On Wednesday, the New England Journal of Medicine published preliminary results of a study on persistence of the Ebola virus in body fluids. The report showed some men still produce semen that tests positive for the virus nine months after symptoms begin.

For the study, 93 men over the age of 18 in Freetown, Sierra Leone, provided a semen sample for researchers to check for the presence of genetic material from the Ebola virus.

More than half the men, 26 of 40 or 65 per cent, who were tested between four to six months after the illness began were positive. By seven to nine months, it fell to one quarter (11 of 43 or 26 per cent). The men were told their test results, counselled and provided condoms.

The research was conducted by the Sierra Leone Ministry of Health and Sanitation, Sierra Leone Ministry of Defence, the World Health Organization and the U.S. Centers for Disease Control and Prevention.

Elsewhere Wednesday, the World Health Organization said there were no confirmed cases of Ebola reported in the week to Oct. 11, the second consecutive week with zero new cases.