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Questions raised about safety measures used for Ebola cases in Spain

Questions were raised Tuesday about the quality of the protective equipment and training received by Spanish medical personnel caring for Ebola patients as three people were placed in quarantine for possible exposure to the virus.

Spain's Health Ministry announced Monday that a nursing assistant at the Carlos III Hospital in Madrid had tested positive for the virus, the first person known to have contracted Ebola outside Africa in the current epidemic.

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Healthcare workers have been among those hardest hit in the outbreak, which has killed more than 3,400 of the nearly 7,500 suspected and confirmed Ebola patients in West Africa.  As of Oct. 1, 382 healthcare workers were reported to have developed Ebola, including 216 people who died of the disease.

The case in Spain was a reminder that medical personnel can be at risk in Western hospitals, as well as at under-resourced and overwhelmed African facilities. The Ebola virus is spread through contact with the bodily fluids of symptomatic patients.

The Spanish patient had helped care for Manuel Garcia Viejo, a 69-year-old missionary in Sierra Leone who died of Ebola on Sept. 25 after being evacuated to Madrid for treatment.

She entered the priest's room twice, once to help care for him and once to collect his belongings after he died, health officials said. In both cases, she was wearing personal protection equipment, and authorities had no knowledge of any accidental exposure to the virus.

The woman is reportedly in her 40s but her identity has not been released. More than 50 people who may have come in contact with her are being monitored in case they develop symptoms.

The woman's husband, who has shown no signs of the deadly disease, was hospitalized as a precaution, Dr. Francisco Arnalich, head of internal medicine at Carlos III, told reporters Tuesday.

Madrid's regional government even obtained a court order to euthanize and incinerate the couple's pet dog, saying the available research suggested an infected animal could transmit the virus to humans, the Associated Press reported.

Another healthcare worker was placed in quarantine after experiencing diarrhea, officials said. However, the person did not have a fever, one of the most common signs of Ebola.  The third person quarantined is a Spanish engineer who returned recently from Nigeria, but his first test was negative for Ebola.

Union officials quoted in Spanish media suggested that spending cuts in the healthcare sector had left medical personnel ill-equipped to cope with Ebola cases.

Staff at the hospital in the Madrid suburb of Alcorcon, where the nursing assistant went Monday with a fever, held a small protest Tuesday, complaining that they did not receive sufficient training or the most modern equipment to protect themselves against infection. The patient was transferred overnight to Carlos III, where she was reported to be in stable condition Tuesday.

Medical personnel at the Madrid hospital have also complained about their protective gear, which needs to be impermeable. They said they used latex gloves secured with adhesive tape and were not issued breathing equipment, El Pais newspaper reported.

The hospital's deputy director, Yolanda Fuentes, said the biohazard suits used by its staff conformed with safety protocols established by the World Health Organization and the Ministry of Health, El Pais reported.

An investigation has been launched to determine how the nursing assistant contracted Ebola. The European Union's Health Security Committee is also holding a special meeting Wednesday to assess the case.

WHO officials said Tuesday that importation of the Ebola virus to Europe was "unavoidable" because of extensive travel between the region and the hardest-hit African countries. However, a regional spokeswoman said the risk of further spread in Europe was "extremely low."

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"European countries are among the best prepared in the world to respond to viral hemorrhagic fever ... including Ebola," the spokeswoman, Cristiana Salvi, said in an email.  "There is always a risk of accidental contamination for people exposed to Ebola patients: This risk must and can be mitigated with strict infection control measures."

Public health authorities in the United States have been reviewing infection control measures after a lapse at the Texas Health Presbyterian Hospital in Dallas resulted in an Ebola patient being sent home with antibiotics, potentially exposing others to the virus.

Thomas Eric Duncan was later brought back to the hospital in an ambulance, where he remained isolated in critical but stable condition Tuesday.

Times staff writer Kurtis Lee contributed to this report.

For more international news, follow @alexzavis on Twitter

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