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 With concerns growing globally that the worst Ebola outbreak on
record could spread beyond West Africa, where it has killed more
than 3,400 people in three impoverished countries, Spanish officials
tried to reassure the public they were tackling the threat. Health
experts said the chances were slim of a full-blown outbreak outside
Africa.
Rafael Perez-Santamaria, head of the Carlos III Hospital in Madrid,
where the infected nurse, Teresa Romero, had treated two Spanish
missionaries who had contracted the disease in West Africa, said
medical staff were "revising our protocols".
Four people including the nurse's husband were admitted to hospital
for observation. One of the four, another nurse, who had diarrhea
but no fever, tested negative for the virus, a Spanish health source
said.
Madrid's regional government said it had ordered a dog belonging to
Romero and her husband put down, despite the husband's opposition.
“The existence of this pet which has been in the home and in close
contact with the patient affected by the Ebola virus ... presents a
possible transmission risk to humans,” a statement said. It would be
killed in such way as to spare it any suffering and then be
incinerated, the authorities said.
Even though western European hospitals, unlike most of those in the
affected parts of Africa, have the facilities to isolate an infected
patient, WHO European director Zsuzsanna Jakab said it was "quite
unavoidable ... that such incidents will happen in the future
because of the extensive travel from Europe to the affected
countries and the other way around".
Nevertheless, she said that "the most important thing in our view is
that Europe is still at low risk, and that the western part of the
European region particularly is the best prepared in the world to
respond to viral hemorrhagic fevers including Ebola".
Still, health authorities in the developed world are being forced to
re-examine their alertness to a disease that has been raging through
Guinea, Sierra Leone and Liberia since March, killing more than half
of those it infects.
Nurse Romero had gone on holiday in Madrid after the second of her
Ebola patients died on Sept. 25, but did not start feeling ill until
Sept. 30. Her trade union said she had then asked three times to be
tested for Ebola before the infection was finally confirmed on Oct.
6.
NURSES DEMONSTRATING
Dozens of doctors and nurses demonstrated outside La Paz Hospital in
Madrid demanding more information about how Romero had caught Ebola,
which is not airborne but transmitted through direct contact with
the body fluids of a person who, experts say, must already be
showing symptoms.
"Given that both the transmission methods and the methods of
prevention are well known, it is clear that some mistake was made,"
the Madrid College of Doctors said in a statement.
The story of slow response was echoed in Dallas, Texas, where the
first Ebola patient diagnosed on U.S. soil, Thomas Eric Duncan, was
in critical condition.
Thomas is on a ventilator and a kidney dialysis machine to help
stabilize him, the hospital said Tuesday.
Even though Duncan told a nurse he had flown from West Africa, the
hospital initially sent him back to his apartment with antibiotics,
only to have him return two days later in an ambulance.
Peter Piot, a professor at the London School of Tropical Medicine
who was one of the discoverers of Ebola, said caring for its victims
demanded draconian discipline, as the slightest mistake could be
fatal.
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"It should be a lesson for everybody that you can't overreact. You
can't overprotect," he told a WHO science group teleconference.
But he also said such cases would remain rare, with careers most at
risk: "There is a difference with what is going on in West Africa.
It won’t really give rise to outbreaks."
The European Centre for Disease Prevention and Control (ECDC), which
monitors disease in the EU, said that, while there was a small risk
of travelers bringing Ebola in without knowing it, the region's
public health authorities "can efficiently detect and confirm cases
of Ebola virus disease and thus prevent its onward spread".
While the White House said there were no plans for a travel ban U.S.
authorities were developing new procedures to screen airline
passengers. U.S. Senator Chuck Schumer said the measures could
include screening air travelers for fever when they arrive in the
United States from the worst-hit countries on direct or indirect
flights.
EXPERIMENTAL DRUGS
In contrast to the vast majority of African patients, some of those
in Europe and the United States have been given experimental
treatments for Ebola, which has no proven cure.
In Madrid, Romero has received antibodies from patients who survived
Ebola. And Texas Health Presbyterian Hospital in Dallas said Duncan
had been given the experimental drug brincidofovir, developed by
U.S.-based company Chimerix Inc for use against a respiratory virus
but untested on Ebola patients.
American Ebola patient Ashoka Mukpo also was receiving brincidofovir,
the Nebraska hospital where he was being treated said on Tuesday.
The Ebola epidemic has overwhelmed the health systems and battered
the economies of Guinea, Sierra Leone and Liberia, which were
showing signs of recovering from a decade of civil wars in the
1990s.
The U.N. Development Program noted that the price of rice was up 30
percent in Sierra Leone, while production had fallen by 10 percent
in Guinea as fewer people were tending to crops.
Fears of economic consequences were felt in Europe too, where travel
and leisure shares fell an average 2.4 percent on the London
exchange on news of the Spanish Ebola case.
(Additional reporting by Emma Pinedo and Sarah Morris in Madrid, Tom
Miles in Geneva, David Lewis in Dakar, Marice Richter in Dallas and
Doina Chiacu and Roberta Rampton in Washington; Writing by Kevin
Liffey; Editing by Giles Elgood, Jim Loney and Grant McCool)
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