Spain faces questions over 1st case of Ebola contracted outside Africa

A day after a nurse's assistant in Spain became the first person known to have contracted Ebola outside of Africa in the current outbreak, Spanish health authorities face a chorus of questions over how it happened.

The woman helped treat a Spanish missionary and a Spanish priest, both of whom had contracted Ebola in West Africa. Both died after returning to Spain.

No details have yet been given of exactly how the nurse's assistant contracted the virus, and her current condition is unknown.

Francisco Arnalis, head of internal medicine at the Carlos III Hospital, told a news conference Tuesday that three other potential Ebola cases are also being monitored.

One is the assistant's husband, who faces a high risk of infection and had no protection. Another is a suspected case in a man who traveled overseas, has tested negative once and is awaiting a second test Wednesday.

The third is not suspected but has been brought in as a precaution after suffering diarrhea. She was exposed, but she was wearing protective gear, he said.

Spanish authorities have said that all the proper protocols and procedures were followed in the care of the missionaries. But the European Union has asked for an explanation.

European Commission spokesman Frederic Vincent told CNN on Tuesday that "Spain told us all the protocols have been followed, but obviously something wrong happened."

There have been 10 evacuations of Ebola-infected patients from Africa to Europe, eight of those within the European Union, Vincent said -- and it is first time that something like this has happened.

"The hospitals where the patients are being taken are supposed to be equipped and ready to deal with Ebola patients," he said.

"If protocols are being followed, it's highly unlikely that an outbreak could happen in the EU. But again, zero risk doesn't exist, particularly in a hospital where staff deal with sick people.

"We need to find out as soon as possible what happened and if we need to revise procedures."

There will be an extra meeting of European officials to discuss the Spanish Ebola case Wednesday, he said.

Unions question equipment used

Nephew of Ebola patient speaks out

Are airports doing enough to stop Ebola?

New Ebola screening protocols in the U.S

Photos: Ebola outbreak in West Africa

Some Spanish unions have blamed the government, saying they warned it that the personal protective equipment used by the medical team was not of the highest standard.

And angry doctors and nurses outside the Carlos III Hospital where the nurse's assistant is being treated -- and where the two missionaries were cared for before her -- said they were outraged the priests had been brought to the hospital.

They claimed the men were almost dead when they arrived and said they should not have been brought back to Spain, thereby putting other people's lives at risk.

Spanish Health Minister Ana Mato announced at a news conference Monday that testing had confirmed the nurse's assistant has the virus.

The husband of the nurse's assistant, who is under observation, is not sick, a spokesman for the health ministry said. It was not clear whether that means he is under quarantine. The couple, who have not been named by authorities, have no children.

The assistant was one of about 30 health professionals in Spain who helped to treat the Ebola patients. They and the ambulance team who took her to hospital are now reportedly under observation.

Vacation location unknown

Health officials said the assistant developed symptoms on September 30. She was not hospitalized until this week, when her only symptom was a fever.

She was first taken to a hospital in southern Madrid before being transferred to Carlos III Hospital, where she had helped care for the Ebola patients.

The second of the missionaries died on September 26 and she went on vacation a day later, health officials said. They have not said where that vacation was taken.

A few days later, she reported that she was not feeling well but her temperatures were not very high, officials said. It was only a several days later that her temperature soared and she was hospitalized with a fever.

An investigation is under way to find everyone the assistant may have had contact with while infectious. So far, there are no other known cases.

Health authorities have urged people to stay calm, as they hope that the virus' spread is contained.

"We are working in coordination to give the best care to the patient and to guarantee the safety of all citizens," said Mato, the health minister.

Obama: Top national security priority

The news came amid growing fears in the United States that the disease could spread.

"As I've said from the start of this outbreak, I consider this a top national security priority. This is not just a matter of charity ... This is an issue about our safety," President Barack Obama told reporters Monday.

He called for protocols to help stop the spread of the disease, while downplaying the risk of an epidemic in the United States.

"We're also going to be working on protocols to do additional passenger screening, both at the source and here in the United States," he said. "Here in the United States, at least, the chances of an outbreak -- of an epidemic here -- are extraordinarily low."

Ebola has killed more than 3,400 people in West Africa, with more than 7,400 suspected, probable and confirmed cases.

The virus is transmitted through close and direct physical contact with infected bodily fluids, the most infectious being blood, faeces and vomit. The incubation period from time of infection to symptoms is two to 21 days.(Courtesy CNN)