Spanish Man Isolated After Wife Tests Positive for Ebola

Spain health officials isolated a man to see if he’s infected with Ebola after his wife, a Madrid nursing assistant, became the first person to contract the viral illness outside of Africa.

The woman’s husband is under observation, said Jose Arribas, the head of the infections unit at the Carlos III hospital in Madrid where the assistant worked and is being treated. A nurse at the hospital who also had been in isolation tested negative for the illness, a health official said. About 52 people, including hospital staff, who interacted with the nurse’s assistant are being monitored, authorities said at a news conference today.

The assistant’s diagnosis adds to concern that the outbreak, which has killed more than 3,400 people, mostly in Guinea, Sierra Leone and Liberia, will spread outside West Africa. A man is hospitalized with Ebola in Dallas after traveling there from the Liberian capital Monrovia, the first time the virus has been inadvertently carried out of Africa in the almost 40 years since it was discovered.

“Above all we want to avoid alarming the population,” said Rafael Perez-Santamarina, head of Madrid’s La Paz hospital, at the news conference. “We are complying with the established procedure but we are revising all protocols, including those inside the hospital and those outside.”

Direct Contact

The infected woman, who is 44, treated Manuel Garcia, a missionary who died of Ebola last month at Carlos III hospital. The virus is spread by direct contact with a sick person’s blood or other bodily fluids, suggesting that infection control procedures weren’t strictly followed.

The woman, whose name wasn’t disclosed, is evolving favorably and is being treated with blood serum from a recovered Ebola victim, said Arribas. There’s no known cure for Ebola, and experimental treatments are being tried in patients along with the standard care of hydration. The disease can cause fever, diarrhea, vomiting and, in some cases, internal and external bleeding.

Her husband is isolated while he waits to be tested for Ebola.

The nursing assistant sought help before being admitted to the hospital yesterday, said Elvira Gonzalez from the Union of Nursing Technicians, known as SAE, in a news conference in Madrid today. First she went to La Paz hospital and then to her doctor who gave her the pain reliever paracetamol, Gonzalez said.

‘Investigation Mode’

She went yesterday to Alcorcon Hospital, on the outskirts of Madrid, before being transferred to Carlos III, said Perez-Santamarina, the executive from La Paz, a university hospital with which Carlos III hospital is affiliated.

How the nursing assistant became infected still hasn’t been determined, said Perez-Santamarina.

“We are trying to check to see if there has been any kind of failure for whatever reason -- we are in full investigation mode,” he said. “The truth is that this issue has been a surprise for us, an unpleasant surprise.”

The infection may have resulted from something as simple as a finger pricked by a needle, said Hugh Pennington, a professor emeritus of bacteriology at the University of Aberdeen.

“Something obviously went wrong,” he said in a phone interview. “Hospital staff have to be obsessional about following the rules. How well they protect workers also depends on how well they’re trained.”

EU Request

Work to identify the nursing assistant’s contacts is “continuous” and “intensive” and is being conducted following World Health Organization recommendations, Mercedes Vinuesa Sebastian, Spain’s public health director, told lawmakers in Madrid today. The nursing assistant was in contact with the deceased missionary twice, once before and once after his death, Vinuesa Sebastian said.

The European Union has asked Spain to explain what happened, Frederic Vincent, spokesman for EU Health Commissioner Tonio Borg, said by telephone. The European Commission will hold a conference call tomorrow on the case with the 28 EU governments, plus Norway, Switzerland, the World Health Organization and the European Centre for Disease Prevention and Control, Vincent said.

Stocks of Spanish hotel operators fell in Madrid. NH Hotel Group SA sank 4.8 percent and Melia Hotels International SA dropped 1.9 percent. International Consolidated Airlines Group, which includes the Spanish carrier Iberia, slid 6.9 percent.

Infection Control

The nursing assistant had been in contact with other people and they will have to be followed, Fernando Simon, coordinator of the center of alerts and emergencies at Spain’s health ministry, told Cadena Ser radio today. She had been on holiday in Madrid after the death of the priest on Sept. 25, said Perez-Santamarina.

“We can’t put a blindfold on,” Simon said, according to comments published by Ser on its website today. “The possibility of contagion exists -- it’s low, but it exists.”

A major outbreak in Europe is unlikely, given the high standards for health care and hygiene, David Heymann, professor of infectious diseases at the London School of Hygiene and Tropical Medicine, said in a telephone interview.

“The concern in European hospitals where there’s good infection control is minimal,” Heymann said. “It may spread to a few people at the start, but it shouldn’t go further. I don’t anticipate any major outbreaks in Europe.”

Aid Workers

It may have been possible to isolate the patient on Sept. 30 when she showed her first symptoms, Simon said. Her husband is in isolation, in good health and “relatively calm,” he said.

“In the case of a person under monitoring, perhaps an isolation protocol should have been applied,” Simon said.

Aid workers who have fallen ill in Africa have been evacuated to Spain, France, Germany, the U.S. and Norway for treatment, raising concern that secondary infections will occur in those countries. Garcia, a missionary doctor from the Hospital Order of Saint John of God, died Sept. 25 at Carlos III hospital after being repatriated from Sierra Leone. Miguel Pajares, a priest who contracted the illness in Liberia, died at the hospital in August.

Nursing unions in Madrid called on the government to reassure patients and staff and carry out investigations as quickly as possible to find out how the infection occurred.

“We demand all the information so that the general public and nursing professionals can be assured of their safety,” said Juan Carlos Mejia, secretary of union action at the Madrid branch of the nursing union SATSE.

Spanish officials also have a man under observation because he had turned up at a hospital yesterday with a fever after just having flown in from Nigeria, according to a spokeswoman for La Paz Hospital. Nigeria had only 20 cases of Ebola, with eight deaths, and there hasn’t been a new case since August, according to the World Health Organization.

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