Save the Children report pinpoints likely cause as to how Pauline Cafferkey contracted Ebola
An infected protective visor was the likely cause of a Scot's nurse contracting the deadly Ebola virus.
A report by Save the Children which runs the Kerry Town treatment centre where Pauline Cafferkey worked, said using the visor instead of goggles probably led to her infection.
While the report says there is no conclusive evidence of how she became infected, it points to the difference between her equipment and that of other volunteers.
Cafferkey undertook training in Britain in the use of protective equipment.
She was first sent to the Lakka treatment centre, run by the Italian NGO Emergence, but she transferred to the Kerry Town unit on 7 December. At Lakka, she had used a visor but Kerry Town was equipped with goggles.
The report states: “She was not able to use the standard protective goggles used there because she could not get them to fit properly.
“She acquired a visor that was the same as the one which she had used in her initial training, and similar to the one she had worn at Lakka, but that was not used by Save the Children.
“Both visors and goggles are equally safe but there are slight differences in the types of clothing worn with each, and in the protocols for putting the equipment on and taking it off.”
We have robust and strict protocols in place to protect our staff and the communities we seek to serve
Taking off the protective suits, gloves and visors at the end of a shift inside the high-risk red zone of the centre is the most dangerous time.
Cafferkey, using a visor, needed to follow different procedures from her colleagues who were wearing goggles.
“Although the procedures, equipment and protocols used at the ETC [Ebola treatment centre] are considered safe, they are only effective if applied as prescribed. Compliance (human factors) is a key factor,” says the report.
Save the Children’s chief executive Lindsey Forsyth said lessons have already been learned and as a result of the findings they have further tightened protocols and procedures. These include refresher training of the use of personal protective equipment (PPE) and working within risk zones; improved logging of potential incidents; and, all changes in PPE protocol must be signed off by the ETC director.
She added: “We have robust and strict protocols in place to protect our staff and the communities we seek to serve. We maintain confidence in both our equipment and our protocols, as long as they are followed properly. But we keep them under constant review. Staff safety is our number one priority.”
