Spain monitors three possible Ebola cases

Madrid (CNN) -- Four more potential cases of Ebola were under observation Tuesday in Spain, health authorities said Tuesday, a day after a nurse's assistant became the first person known to have contracted the deadly virus outside Africa in the current outbreak.

The woman helped treat two Spanish missionaries, both of whom had contracted Ebola in West Africa, one in Liberia and the other in Sierra Leone. Both died after returning to Spain.

Spain has outbreak's 1st known case of contracting Ebola outside of Africa

The developments come just as the organization Medecins Sans Frontieres (Doctors Without Borders) reports that a Norwegian staff member has contracted the deadly virus. The staffer had been working in the Sierra Leone city of Bo and was placed in isolation Sunday after developing a fever, the organization said.

The worker is being sent to a treatment center in Europe.

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

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

A hospital spokeswoman said later Tuesday that another nurse's assistant -- who is on the same team as the infected nurse's assistant -- is under observation. This more recent case was admitted to the hospital after she "started having a little bit of a temperature," said the spokeswoman, who wasn't named as is customary in Spain.

Earlier, health officials explained that one of the people being monitored is the original nurse's 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 and has tested negative twice.

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

Thirty people from Carlos III Hospital and 22 others -- from Alcorcon hospital plus family members -- are being monitored, according to authorities. It was not immediately known whether the nurse's assistant hospitalized late Tuesday was one of these 30 contacts at Carlos III Hospital.

The hospital will not release information about the status of the nurse's assistant, who has not been named, in order to respect her privacy, director Rafael Santamaria said.

The hospital has two potential treatments at its disposal, said Dr. Jose Ramon Arribas, one using an IV drip with the antibodies ofEbola survivors and the other an antiviral drug.

"This is a treatment that the WHO (World Health Organization) has recommended, even though they haven't verified its efficacy," he said of the IV drip.

EU: We need to know what happened

Spanish authorities have said that all the proper protocols and procedures were followed in the care of the two missionaries. But the European Union has asked for an explanation as to how the woman was infected.

European Commission spokesman Frederic Vincent said 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.

 

New Ebola screening protocols in the U.S

Photos: Ebola outbreak in West Africa

"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 on Wednesday, he said.

The World Health Organization said it was "ready to provide support to Spain, as and if required," as it investigates the case and traces the infected woman's contacts.

In the United Kingdom, Prime Minister David Cameron will lead a Cabinet meeting to discuss way to coordinate how to handle response to Ebola there, if it's necessary. Cameron called Sierra Leone President Ernest Bai Koroma to discuss the status of the outbreak in the West African nation and talk about how aid the UK has provided is helping.

According to Downing Street, the Sierra Leone leader said the situation continues to be "very serious" and there was a need to train more medical staff, improve burial processes and develop a better system for running service treatment centers.

Unions question equipment used

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.

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 pair had been brought to the hospital, one in August and the other in September.

Ebola drugs in the works

They said that the two priests, Miguel Pajares and Manuel Garcia Viejo, were almost dead when they arrived, and that they should not have been brought back to Spain, thereby putting other people's lives at risk.

Spanish Health Minister Ana Mato announced 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 he is under quarantine. The couple have no children.

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

No word on where she took her vacation

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 several days later that her temperature soared and she was hospitalized.

An investigation is underway to find everyone the assistant may have had contact with while infectious. So far, there are no other known related 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: National security priority

The news came amid growing fears in the United States that the disease could spread. The first person to be diagnosed in the United States with Ebola, Thomas Eric Duncan, remains in critical but stable condition in Texas, according to Candace White, a spokeswoman for Texas Health. He is on a ventilator and receiving kidney dialysis, she said, adding that his liver function, which declined over the weekend, has improved.

He is continuing to receive an investigational medication, White said.

During a Centers for Disease Control and Prevention press conference on Monday, CNN asked Texas Department of State Health Services Dr. David Lakey how care protocols in Spain compared to those involving Duncan in Texas.

Lakey said he personally went to the Texas Health Presbyterian Hospital ward in Dallas where the patient is being treated, and saw that there was extensive security and a detailed method of how providers were protecting themselves. "They take this really seriously," he said, describing treatment protocol as "meticulous."

CDC Director Dr. Tom Frieden said none of the people who Duncan came into contact with before his diagnosis that the CDC has identified for monitoring has shown symptoms.

Frieden also said the agency has not made final decisions about possible ways to screen at airports in the United States.

Meanwhile, some of the U.S. military personnel being deployed to Liberia to help tackle the Ebola crisis may come into contact with the virus, a Pentagon official said Tuesday.

The head of U.S. Africa Command, Gen. David Rodriguez, said that while the majority of U.S. troops involved in the mission would not be exposed to the disease, those in mobile testing labs could have contact in that environment.

"They're all trained at a very, very high level," Rodriguez told reporters of the lab personnel, who constitute a "separate, specialty element of the force."

President Obama told reporters Monday, "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."

Obama called for protocols to help stop the spread of the disease, including additional air passenger screening, while downplaying the risk of an epidemic in the United States.

In Liberia, Ebola is killing Thomas Duncan's neighbors

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, feces and vomit. The incubation period, from the time of infection to symptoms, is two to 21 days.

CNN's Al Goodman reported from Madrid, and Laura Smith-Spark wrote in London. CNN's Laura Perez Maestro, Marilia Brocchetto and Nick Thompson contributed to this report.

西班牙斜了埃博拉病毒的響應; 挪威測試塞拉利昂正
由勞拉·史密斯-斯巴克，阿什利Fantz和阿爾·古德曼，美國有線電視新聞網
2014年10月7日 - 更新2328 GMT（0728 HKT）
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西班牙監控三個可能的埃博拉出血熱病例
新聞提要
新：馬德里醫院：另一名護士助理被觀察到的可能的埃博拉病毒
西班牙醫院監控與護士的助手在20個聯繫人，導演說：
助理變成了這個爆發期間簽約埃博拉非洲以外的第一人
無國界醫生組織挪威的職員有埃博拉病毒，組織說
馬德里（CNN） -正在觀察四更多的潛在埃博拉案件週二在西班牙，衛生當局週二，一天後表示，護士的助手出名染上非洲以外的致命病毒在當前爆發的第一人。
女人幫把兩名西班牙傳教士，他們兩人曾在西非染上埃博拉病毒，一個在利比里亞和其他塞拉利昂。回到西班牙後，雙雙死亡。
西班牙有簽訂合同的埃博拉非洲以外的爆發的第一個已知的情況下，
事態的發展都只是作為組織無國界醫生（無國界醫生組織）報告說，挪威的工作人員已經染上了致命的病毒。該職員一直在努力，在塞拉利昂博城，並放置在隔離週日開發發燒後，該組織說。
這名工人被送往歐洲的治療中心。
埃博拉病毒的病例記錄埃博拉病毒的病例記錄
埃博拉患者的侄子說出來 正在機場採取足夠的措施阻止埃博拉病毒？
在西班牙，任何細節都尚未給出究竟有護士的助手感染了病毒，她的情況是未知的。
舊金山Arnalis，內科在卡洛斯三世醫院的負責人在記者招待會上說，其他三個潛在的埃博拉病例被監視那裡。
一家醫院的發言人後來說，週二的另一名護士的助手 - 是誰在同一個團隊的感染護士的助手 - 正在觀察。這更近的情況下，被送往醫院後，她“開始有溫度了一點點，”這位女發言人說，誰沒有被命名為習慣在西班牙。
此前，衛生部門官員解釋說，被監視的人之一是原​​來的護士助理的丈夫，誰面臨感染的風險很高，也沒有保障。另一種是一個人誰前往海外，並測試了兩次陰性疑似病例。
第四，護士，不是疑似病例，但已被提出，作為預防措施患腹瀉後。她接觸，但她穿著護具，Arnalis說。
三十人卡洛斯三世醫院和其他22人 - 從阿爾戈爾貢醫院以及家庭成員 - 被監視，據權威機構。這還不清楚護士的助手住院，週二尾盤是否是這30個觸點，卡洛斯三世醫院之一。
醫院將不會公佈有關護士的助手，誰沒有被命名的狀態信息，為了尊重她的隱私，主任拉斐爾·聖瑪麗亞說。
這家醫院在掌握兩個潛在的治療，醫生說何塞·拉蒙·阿里瓦斯，一個使用靜脈滴注用的抗體埃博拉倖存者和其他抗病毒藥物。
“這是世界衛生組織（世界衛生組織）建議，即使他們還沒有驗證其療效治療，”他說，點滴的。
歐盟：我們需要知道發生了什麼
西班牙當局說，所有正確的協議和程序遵循的兩位傳教士的照顧。但歐盟已經要求一個解釋，該名女子是如何感染的。
歐盟委員會發言人弗雷德里克·文森特在週二表示，“西班牙告訴我們，所有的協議已經執行，但顯然有些不對勁發生了。”
已經有10後送埃博拉病毒感染者從非洲到歐洲，那些在歐洲聯盟內的八，文森特說 - 這是第一次，這樣的事情已經發生了。
在美國新的埃博拉病毒篩查方案
組圖：埃博拉疫情在西非 組圖：埃博拉疫情在西非
“這裡正在採取患者的醫院都應該是配備齊全，隨時準備應對埃博拉病毒的病人，”他說。
“如果協議被人跟踪，這是極不可能的爆發可能會在歐盟發生。但同樣，零風險不存在，特別是在醫院，那裡的工作人員處理生病的人。
“我們需要找出盡快發生了什麼，如果我們需要修改的程序。”
將有歐洲官員的額外會議，討論在週三西班牙埃博拉病毒的情況下，他說。
世界衛生組織說，這是“準備好提供支持西班牙，因為如果需要的話，”因為它調查的情況，並跟踪被感染的婦女的接觸。
在英國，首相卡梅倫將率內閣會議，討論的方式來協調如何處理應對埃博拉病毒存在，如果它是必要的。卡梅倫呼籲塞拉利昂​​總統歐內斯特·巴伊·科羅馬，討論西非國家爆發的狀態，並討論如何幫助英國提供幫助。
據唐寧街，塞拉利昂領導人說，局勢仍然“非常嚴重”，並有必要為運行服務的治療中心培養更多的醫務人員，提高埋葬流程和開發更好的系統。
用工會問題的設備
一些西班牙工會指責政府，說他們警告稱，所使用的醫療團隊的個人防護裝備是最高標準不行。
憤怒的醫生和護士卡洛斯三世醫院護士的助手正在處理之外 - 而且其中兩個傳教士她之前照顧 - 說，他們被激怒了這對曾經被帶到了醫院，一個在八月份，另一個在九月。
埃博拉病毒藥物的作品
他們說，這兩個道士，米格爾帕哈雷斯和曼努埃爾·加西亞Viejo的，幾乎死了，當他們到了，他們不應該被帶回西班牙，從而把其他人的生命處於危險之中。
西班牙衛生大臣安娜·馬托週一宣布，測試已證實了護士的助手有病毒。
護士的助手，誰是下觀察的老公，是不是生病了，發言人衛生部說。目前還不清楚他是否接受檢疫。這對夫妻沒有孩子。
助理是在西班牙約30衛生專業人員誰幫助治療埃博拉病毒的病人之一。他們並把她送到醫院救護隊現在據說下觀察。
在那裡，她把她的假期無字
衛生官員說，助理出現症狀，9月30日她沒有住院，直到這個星期，當她唯一的症狀是發燒了。
她先被帶到馬德里南部一家醫院被轉移到卡洛斯三世醫院，在那裡她幫助照顧埃博拉患者之前。
傳教士的第二個死亡9月26日，她在度假去了一天後，衛生官員說。他們沒有說哪裡的假期拍攝。
幾天後，她報告說，她身體不舒服，但她的氣溫不是很高，官員說。這只是幾天後，她的溫度一路飆升，她住院。
調查正在進行中找到每個人的助手可能曾與時接觸感染。到目前為止，還沒有其他已知的有關情況。
衛生當局已呼籲民眾保持冷靜，因為他們希望病毒的蔓延載。
“我們正在努力協調，以提供最好的照顧病人，並保證所有公民的安全，”馬托，衛生部長說。
奧巴馬：Ñ 憩安全優先
消息傳來，人們越來越擔心，在美國，這種疾病可能會蔓延。第一個人被診斷在美國與埃博拉病毒，托馬斯·埃里克·鄧肯，依然在得克薩斯州的關鍵，但病情穩定，根據坎迪斯白色的發言人得克薩斯健康。他是上了呼吸機，接受腎透析，她補充說，他的肝功能，減少在上週末，已有所改善。
他繼續收到一個研究性藥物，懷特說。
期間，美國疾病控制和預防新聞發布會上週一，美國有線電視新聞網問國家衛生服務大衛·萊基博士得克薩斯部門如何護理協議在西班牙相比，那些涉及鄧肯在得克薩斯州。
萊基說，他親自到得克薩斯州衛生長老會醫院的病房在達拉斯當病人正在接受治療，並看到有廣泛的安全以及如何提供者是在保護自己的詳細方法。“他們把這個認認真真的，”他說，描述的治療方案是“一絲不苟”。
疾病預防控制中心主任湯姆·弗里登博士說沒有誰鄧肯開始接觸他的診斷之前，人們對疾病預防控制中心已確定了監測顯示症狀。
弗里登還表示，該機構尚未作出最終決定對可能的方式來篩選在美國的機場。
與此同時，一些美國軍事人員被部署到利比里亞，以幫助解決埃博拉危機可能會接觸到病毒的接觸中，五角大樓官員在星期二說。
美軍非洲司令部的首長，將軍戴維·羅德里格斯說，雖然多數參與任務的美軍不會接觸到這種疾病，這些移動檢測實驗室可能在environme接觸新台幣。
“他們都受過訓練，在一個非常，非常高的水平，”羅德里格斯告訴實驗人員，誰構成了一個記者的“力的獨立，專業的元素。”
美國總統奧巴馬星期一對記者說，“我已經從這次爆發的開始說，我認為這是一個頂部的國家安全優先考慮，這不是施捨而已。......這是一個關於我們的安全的問題。”
奧巴馬呼籲的協議，以阻止疾病的蔓延，其中包括額外的航空客運篩選，而淡化在美國流行的風險。
在利比里亞，埃博拉病毒被殺死托馬斯·鄧肯的鄰居
埃博拉病毒已造成超過3400人在西非，有超過7,400懷疑，可能和確診病例。
該病毒通過與受感染的體液，最被感染的血液，糞便和嘔吐物密切和直接的身體接觸傳播。潛伏期，從感染時到症狀，是2到21天。
CNN的阿爾·古德曼報導，從馬德里和倫敦的勞拉·史密斯 - 斯巴克寫道。CNN的勞拉·佩雷斯大師，馬里利亞Brocchetto和尼克·湯普森促成了這一報告。