Spanish nurse treated for Ebola as three are kept in quarantine

Spanish authorities were yesterday seeking to contain the spread of the Ebola virus as pressure grew on them to explain how a nurse in Madrid had been infected by the disease.

The woman, who is in her early 40s, has so far only been identified as Teresa R R and on Monday she became the first confirmed case of Ebola contracted outside Africa.

She appears to have been infected while working as part of the Madrid medical team that treated two Catholic missionaries, Miguel Pajares and Manuel García Viejo, who had the disease. Pajares, who became infected in Liberia, died in August and García Viejo, who was infected in Sierra Leone, died late last month.

The infected nurse’s condition remained stable yesterday and she was being treated with an experimental antiviral drug, as well as receiving antibodies from a survivor of the virus.

Her husband was in quarantine in Madrid yesterday, as was another nurse and a man who had recently travelled to the Spanish capital from Nigeria. However, none of those three was confirmed as suffering Ebola-related symptoms.

A total of 52 health workers were being monitored in Madrid as a precautionary measure. Of those, 22 were believed to have had contact with the infected nurse when she was initially admitted to hospital, while the other 30 were colleagues at the hospital where she works. All are required to check their temperature twice daily for a three-week period before they can be given the all-clear.

The health authorities said tracking the recent movements of the nurse and identifying as many people as possible with whom she had had contact recently was a priority.

Mistakes made

“There is a chance that some of those she has had contact with could be infected,” said Fernando Simón, the government’s health emergencies co-ordinator. “That is not to say that the population is at risk, but we have to guarantee that this situation does not happen again. It cannot happen again.”

Although the health ministry has insisted Spain is equipped to contain the virus, Mr Simón did admit that mistakes had been made in recent days. Teresa R R, he said, should have been admitted to hospital on September 30th, when she had complained of a relatively light fever and feeling weak. But instead, doctors had told her to stay at home, despite knowing she had been working in the vicinity of Ebola patients.

As the government sought to reassure Spaniards that the virus was under control, the European Commission requested an explanation regarding how it had been allowed to spread. "There is obviously a problem somewhere," said commission spokesman Frédéric Vincent. Meanwhile, the World Health Organisation warned yesterday that the spread of Ebola in European countries was "unavoidable".

Teresa R R’s infection also appears to have taken the Spanish authorities by surprise, given that she had relatively little contact with the two infected missionaries and Ebola is transmitted only via bodily fluids.

Her infection has appeared to support the concerns of those who questioned the wisdom of repatriating the infected missionaries on the grounds that Spain was not prepared to contain Ebola.

Despite severe spending cutbacks in recent years, Spaniards are for the most part proud of their healthcare system, and although there has been little sign of panic, the Ebola infection has come as a major shock.

Workers’ concerns

Healthcare workers in Madrid are particularly concerned, given their relatively high chance of exposure to the virus. Staff at Carlos III hospital, where the missionaries and the infected nurse have all been treated, claimed on Monday that the body suits used there for Ebola cases do not comply with safety norms. It also emerged yesterday that workers at La Paz hospital, which is responsible for Carlos III, had informed a local judge in July that they lacked sufficient safety procedures for handling Ebola cases.

"The World Health Organisation has a protocol, but there's not a specific one for La Paz hospital," said Juan Carlos Escobar, of the medical workers' union CSIT.

Several dozen staff gathered outside Carlos III hospital yesterday, calling for the resignation of health minister Ana Mato. Meanwhile, US senator Chuck Schumer said yesterday he expects the federal Centers for Disease Control to propose tougher Ebola screening requirements this week at US airports.

Schumer, a New York Democrat, said the new measures could include screening passengers for fever when arriving from the most stricken countries in West Africa.