Airport Procedures Criticized After Britain's First Ebola Diagnosis

The first person diagnosed with the deadly Ebola virus on British soil was transferred from Glasgow, Scotland, to a London hospital Tuesday.

Pauline Cafferkey, a health care worker who had been stationed in Sierra Leone with the international nonprofit Save the Children, passed through airport security in Sierra Leone over the weekend, flying from West Africa to her home in Glasgow with stops in Casablanca, Morocco, and at London’s Heathrow Airport, according to The New York Times.

Cafferkey was reportedly screened for Ebola in Sierra Leone and again in London, according to the Guardian. But after touching down in Glasgow, she developed a fever and was diagnosed with Ebola.

The Ebola virus is spread through contact with a patient’s bodily fluids and is only considered contagious once symptoms develop, according to the World Health Organization.

Though Cafferkey contacted Britain’s National Health Service early Monday morning, the likelihood that she was contagious to her fellow passengers over the weekend is “extremely low,” according to Nicola Sturgeon, Scotland’s first minister and former health secretary, according to the Guardian.

In what Sturgeon described as “very much a precautionary measure,” authorities have begun searching for Cafferkey’s fellow passengers from Heathrow to Glasgow to notify them of their potential exposure to Ebola.

“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,” Sturgeon said Monday of Cafferkey. “There’s no reason for the wider public in Scotland to be at all concerned.”

Dr. Alisdair MacConnacchie, an infectious diseases consultant for NHS Greater Glasgow and Clyde who had treated Cafferkey, said she was in “quite stable” condition and that the early diagnosis “should translate into a good prognosis,” according to the Guardian.

Cafferkey was placed under quarantine in Glasgow’s Gartnavel General Hospital on Monday and became the first person diagnosed with Ebola on U.K. soil. She was transported Tuesday to North London’s Royal Free Hospital in a medical aircraft equipped with an isolation tent, according to the Times.

Royal Free Hospital successfully treated William Pooley, Britain’s first known Ebola patient, after he was withdrawn from Sierra Leone in August.

Cafferkey’s partner is being screened as the only person believed to have had direct contact with her after she arrived home Sunday night, according to the Guardian. A second Scottish patient who recently returned from West Africa is reportedly being tested for Ebola, according to Reuters, and another individual was reportedly being tested in Cornwall, England.

Jeremy Hunt, Britain’s health secretary, has said British officials are examining the country’s “procedures and protocols” for monitoring the health of those returning from West Africa. 

Airport screenings generally look for abnormal body temperatures, as fever is one of Ebola's earliest tell-tale symptoms. Blood tests can later confirm a diagnosis but are considered imperfect, especially if an individual is asymptomatic, according to the Times. Individual Ebola tests can range in price from $60 to $200, but also are not perfect indicators and usually take around six hours to process. It is not uncommon for an individual to pass a series of tests and still fall ill from the virus, which has an incubation period of up to 21 days.

Dr. Martin Deahl, who traveled with Cafferkey from Sierra Leone to Glasgow over the weekend, described the Heathrow Airport’s Ebola screenings for the workers as “disorganized,” according to the Times.

“If there had been alternative arrangements for poor Pauline, an awful lot of people on that flight to Glasgow wouldn’t be going through the anxiety and the stress that I am sure they are going through at the moment,” he said. “Although I should say that the risk to them is incredibly small, nevertheless they were exposed to a risk that some of us felt shouldn’t have happened.”