MADRID/LONDON - A Spanish nurse who is the first person to contract Ebola outside of Africa may have touched her face with the gloves of her protective suit while caring for a priest who died of the disease, a doctor treating her said on Wednesday.
The nurse, Teresa Romero, was being treated for the deadly infection at a Madrid hospital while Spanish officials launched an investigation into how she was able to contract Ebola despite strict protocols for handling contagious patients.
The virus, which the World Health Organisation said had killed 3,879 people by Oct. 5 in West Africa since March in the largest outbreak of the disease on record, causes haemorrhagic fever and is spread through direct contact with body fluids from an infected person.
A Liberian man who was the first person diagnosed with Ebola in the United States died in a hospital isolation ward on Wednesday and the US government ordered extra screenings at five major airports.
The WHO said it saw no evidence of the disease being brought under control in Liberia, Sierra Leone and Guinea, with neighbouring countries being told to prepare for the disease to spread across their borders.
Britain said it was sending extra troops, aircraft and a naval vessel to Sierra Leone to help stem the spread. The deployment will see 750 military personnel help set up treatment centres and a training facility. Three helicopters and a 100-bed naval hospital will also be sent to the region.
While Romero is the only confirmed Ebola case in Spain aside from two priests who contracted the disease in Africa and died, more than 50 other people who may have had contact with the virus in the country are being monitored, including primary health care and hospital staff, European officials said.
"She has talked to me about the gloves, she touched her face with the gloves. That's what she remembers and what she has told me three times," German Ramirez, one of the doctors at Carlos III hospital where the nurse is being treated, told reporters.
The nurse took leave from work immediately after Spanish missionary Manuel Garcia died on Sept. 25. Wearing a full protective suit, she had entered the priest's room once while he was alive and once after his death to clean the room.
"I believe the error was made when taking off the suit," she told Spain's El Pais newspaper in a telephone interview published on Wednesday. "I see that as the most critical moment, when something could have happened. But I'm not sure."
Health worker union officials said Romero alerted hospital staff three times to say she had a fever and a rash, but because her temperature had not gone above 38.6 degrees Celsius the hospital did not see her as a risk.
Romero found out she had the disease by looking at the news on the Internet on her phone while she was waiting for the result of her test, she told Cuatro television station in a telephone interview.
"I asked the doctor for the result and he didn't answer in a very clear way and that's when I started to suspect," adding she then looked at her phone to find there was a positive case of Ebola in Spain.
Health authorities on Thursday put down the dog, a labrador-type breed called Excalibur, who lived with the nurse and her husband in a suburban Madrid flat, saying it posed a biological risk and there was evidence dogs could carry the virus.
The dog was taken out of the apartment block in a police-protected van with the windows blacked out and a driver in a protective suit while around 30 animal rights activists shouted "Murderers!".
The childless couple are two of six people under observation in the sealed-off sixth floor of the hospital in Madrid. The rest of the people, including other nurses who cared for the infected priests, have initially tested negative for Ebola, health authorities said.
Other people being monitored include two hairdressers who waxed the nurse as part of a beauty treatment, media reports said.
CALLS FOR CALM
Spanish Prime Minister Mariano Rajoy defended his country's health authorities and urged people not to panic.
"We have to keep calm. It is extremely unlikely that this will turn into an outbreak affecting many people," he said.
Rajoy said he had created a committee to oversee co-ordination between the regional Madrid government, the central government and European institutions. He said Spain was in constant contact with the European Union and the World Health Organisation.
"Let the professionals do their work," he said. "The Spanish health system is one of the best in the world."
He said the investigation into how the infection had occurred was a priority and was still under way.
Two experts from the Stockholm-based European Centre for Disease Prevention and Control (ECDC), which monitors disease in the region, have gone to Spain to help with the investigation, a spokesman for the European Commission said.
The spokesman said Spanish authorities had told the EU it was not clear at this stage how the infection had occurred, but it may have been due to "possible relaxation" of protocols for handling the corpse or for the disposal of medical waste.
The Commission's health security committee gathered representatives from all EU states, the ECDC and from the World Health Organisation's European regional headquarters to discuss the situation on Wednesday.
The WHO's Europe director Zsuzsanna Jakab told Reuters in an interview on Tuesday it was "unavoidable" that Europe would see more cases of Ebola within its borders because of busy travel links with Guinea, Liberia and Sierra Leone.
She stressed, however, that the continent was well prepared for handling Ebola virus disease, and said she did not expect to see any widespread outbreaks in European countries.
A new World Bank assessment of the potential impact of the epidemic estimated that if it spread wider from the three states into neighbouring larger economies, the two-year regional financial impact could reach $32.6 billion (S$41.4 billion) by the end of 2015.