Investigations have revealed the Spanish nurse who contracted Ebola may have touched her face with the gloves of her protective suit while caring for a priest who died of the disease.
The revelation comes as angry protests broke out over Teresa Romero’s dog which became the unlikely focus of an emotional outpouring in connection with the case.
Protesters gathered outside the woman’s apartment after it was revealed there were plans to put down the dog in case it was infected.
Speaking from hospital, the nurse’s husband, Javier Limon, also made a public appeal for the family pet to be saved.
“The dog is fine. He has the whole house to himself, with the open terrace so he can do his business,” he said in a telephone interview with El Mundo newspaper from his hospital room.
He said the dog had no contact with the outside world, had enough food and water inside the apartment to last for several weeks and therefore presented little risk to public health.
“Are they going to put me to sleep, too?” he said.
However, health authorities put down the dog 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!”.
Two people were injured as officers carried away some of the dozens of activists who blocked the van.
An online petition on Change.org demanding that the dog be put in quarantine instead of being put down gathered 374,000 signatures.
Ms Romero, is the first person to contract Ebola outside of Africa and is being treated for the deadly infection at a Madrid hospital.
Spanish officials launched the investigation to find out how she contracted Ebola despite strict protocols for handling contagious patients.
“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 she is being treated, said.
Nurse learned of positive Ebola infection from media
The nurse took leave from work immediately after Spanish missionary Manuel Garcia died.
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,” Ms Romero told Spain’s El Pais newspaper in a telephone interview.
“I see that as the most critical moment, when something could have happened. But I’m not sure.”
Health worker union officials said Ms 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.
Ms Romero found out she had the disease by looking at the news 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.
Ms Romero and her husband 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.
The virus, which the World Health Organisation said had killed 3,879 people 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 Texas hospital isolation ward and the US government has 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.
The WHO’s Europe director Zsuzsanna Jakab said 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 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 by the end of 2015.