Given that Spain’s locally-acquired Ebola case was considered a `low risk’ contact, and transmission occurred in a modern hospital facility that was aware they were treating an Ebola patient, and actually had previous experience doing so, there is intense interest in just how she came to be infected.
While theories abound, it is possible we’ll never know for sure.
This nosocomial transmission has prompted the ECDC to declare they will re-assess Ebola Transmission risks in Europe (see Ebola case in Spain: ECDC to re-assess transmission risk for Europe). An excerpt from their statement, released earlier today, reads:
"It is our mandate to re-assess the risk to the EU”, says ECDC Director Marc Sprenger, “and we are confident that infection control protocols in Europe are of high standard and remain appropriate if strictly adhered to. But there is no such thing as a zero per cent risk of infection. It is important to understand that the risk of Ebola to Europe can only be eliminated by stopping the outbreak in West Africa.”
Two ECDC experts are currently in Madrid to support the local authorities in their investigations of the mechanism through which the nurse has been infected. Once this information is available, ECDC will consider the possible implications on the transmission risk to Europe in its updated risk assessment.
Meanwhile the World Health Organization has released the following update on Spain’s Ebola case.
Disease outbreak news
9 October 2014
On 6 October 2014, the World Health Organization (WHO) was informed of the first confirmed autochthonous case of Ebola virus disease (EVD) in Spain. This case represents the first human-to-human transmission of EVD outside Africa.
The case is a female healthcare worker with no travel history to West Africa but who participated in the medical care of an EVD case in a Spanish citizen, who had been infected in Sierra Leone and evacuated to Madrid, Spain on 22 September 2014 and who died on 25 September 2014. She was in contact with the repatriated EVD case twice; on 24 and 25 September 2014. On both occasions she is reported to have worn appropriate personal protection equipment (PPE).
Following the Spanish national protocol for EVD cases, the healthcare worker was considered a low risk contact and monitored accordingly. The female case developed a fever on 29 September 2014 and was admitted into isolation on 6 October 2014 at Alcorcon Hospital in Madrid. The case was then transferred to La Paz-Carlos III Hospital in Madrid and is being treated under isolation.
Samples were collected and sent for testing to the National Reference Laboratory on 6 October 2014. Results were positive for Ebola virus on the same day.
The Spanish public health authorities are conducting an investigation to elucidate the mode of transmission. Identification of close contacts for daily monitoring for 21 days after exposure is underway for the recent case and is continuing for contacts of the Spanish citizen who was treated in Spain.
As for all countries reporting EVD cases, future WHO updates on EVD in Spain will not be posted on the Disease Outbreak News. Further information will be available in WHO’s Ebola situation reports which provide regular updates on the WHO response: