Health professionals in Madrid have blamed substandard equipment and a failure to follow protocol as the country works to contain the first case of Ebola contracted outside of west Africa.
Health authorities announced on Monday that a Spanish nurse at Madrid’s Carlos III hospital who treated a patient repatriated from Sierra Leone had twice tested positive for Ebola.
Her husband has also been admitted to hospital and is in isolation, while authorities study whether the same needs to be done with others she has been in contact with.
Staff at the hospital told El País that the protective suits they were given did not meet World Health Organisation standards, which specify that suits must be impermeable and include a breathing apparatus. Staff also pointed to latex gloves secured with adhesive tape, as an example of how the suits were not impermeable and noted that they did not have their own breathing equipment.
The nurse was part of a team attending to missionary Manuel García Viejo, 69, who died four days after being brought to Madrid’s Carlos III hospital on 20 September. The same team, including the nurse, also treated missionary Miguel Pajares, 75, who was repatriated from Liberia in August and died five days later.
Staff at the hospital said waste from the rooms of both patients was carried out in the same elevator used by all of the personnel and in the case of the second patient, the hospital was not evacuated.
The European commission said it on Tuesday it had written to the Spanish health minister “to obtain some clarification” on how the nurse had become infected when all EU member states were supposed to have taken measures to prevent transmission.
“There is obviously a problem somewhere,” commission spokesman Frédéric Vincent said.
Spanish health authorities on Monday said that health professionals treating Ebola patients in Spain always followed protocols outlined by the World Health Organisation. The nurse would have entered García Viejo’s room just twice, said Antonio Alemany from the regional government of Madrid, and both times been outfitted with protective equipment.
“We don’t know yet what failed,” said Alemany. “We are investigating the mechanism of infection.”
The nurse was in stable condition, said authorities on Monday. She had alerted the ministry of a slight fever on 30 September, said Alemany, and checked into a hospital in Alcorcón, in the outskirts of Madrid, with a high fever on Monday.
The nurse, who is married with no children, was transferred to Madrid’s Carlos III hospital early on Tuesday morning.
It was the nurse who asked to be tested for Ebola, reported El Mundo, who said the nurse had to insist repeatedly on being tested before it was done on Monday.
While staff at the Alcorcón hospital were waiting for the test results, the nurse remained in a bed in the emergency room, separated only by curtains from the other patients, hospital staff told El Mundo. Their version of events clashes with health authorities, who said that the patient was isolated from the first moment.
The patient was on holiday – it is not known where – when she began showing symptoms. “We are drawing up a list of all the people she may have been in contact with, including with health professionals at the Alcorcón hospital where she is being treated,” said Alemany, estimating that more than 30 people were being carefully monitored for any sign of symptoms.
In August, Spain became the first European country in the current, fast-spreading outbreak to evacuate patients for treatment. The decision prompted concern among health professionals who said that Spanish hospitals were not adequately equipped to handle the Ebola outbreak.