The first case of a person contracting Ebola outside of West Africa has been reported, in a Spanish nurse who had been treating two missionaries who had been flown home from the region and later died of the disease.
Prof Jonathan Ball, Professor of Molecular Virology at the University of Nottingham, said:
“It appears that the nurse became infected whilst she was caring for a patient in Spain. If appropriate containment measures were adopted this really should not have happened. It will be crucial to find out what went wrong in this case so necessary measures can be taken to ensure it doesn’t happen again.”
“As the African outbreak perfectly illustrates, healthcare workers put their life on the line, so everything should be done to ensure that risks are minimised as much as possible.”
“As for the suggestion of screening people as they arrive at airports, this would only work if people were already showing symptoms.”
“Following infection it takes up to 21 days for someone to develop symptoms, so it would be really difficult – nigh on impossible – to identify someone during this phase, whether at the departure or arrival destination.”
“Reality is that anyone who suspects that they have been exposed to the virus, unless they were properly protected from infection, should not travel until this 21 day incubation period has passed.”
“Similarly, anyone who has travelled to one of the affected countries, even if they are not aware of exposure, should be aware of the symptoms of Ebola virus infection, and seek necessary help if any of the symptoms develop.”
“The risk of this type of sporadic export will increase as more and more people become infected in the outbreak area. That’s why it is so important for the international community to ramp up their efforts to combat this deadly virus.”
“Thankfully the health infrastructures in most of the countries that Ebolavirus could spill into are well developed and this will limit onward spread.”
Prof Tom Solomon, the University of Liverpool’s Head of Infection and Global Health, and Director of the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, said:
“Although it is clearly worrying that this Spanish nurse has become infected, the chances of such transmission are small when the full personal protective equipment is used.”
Dr Ben Neuman, Lecturer in Virology, University of Reading, said:
“This must a distressing time for the nurse’s friends and family, and I can only add my best wishes that she will be one of the lucky few who makes a full recovery.”
“There will undoubtedly be an investigation into how this could happen, despite the extremely careful safety measures that were in place. One of the things the investigators will look at is the way that the Ebola infectious waste was handled.”
“Nurses face a problem in that a person who is sick with Ebola can make quite a lot of highly infectious waste, as the patient loses fluid through diarrhoea and vomiting. Those bodily fluids can contain millions of Ebola viruses, and it only takes one to transfer the infection.”
“The protective suits that Ebola workers wear provide excellent protection, but there is a danger when it is time to take the suit off. It is also possible that a tiny amount of Ebola-containing liquid splashed on the protective garments, and then was transferred to her skin while removing the protective clothing.”
“This is another reminder that protective equipment can reduce the risk of Ebola substantially, but handling an Ebola patient will always involve some risk.”
Prof David J. Evans, Professor of Virology at the University of Warwick, said:
“Healthcare workers are at the forefront in the battle to control Ebola, both in West Africa and for the patients evacuated to treatment centres in the US, UK and Spain. Despite anti-contamination suits and training they have increased risk of exposure to the virus which is transferred by direct contact, bodily fluids and on fomites (inanimate objects that been in contact with bodily fluids from the patient).”
“The recent report of a Spanish nurse who has contracted the virus after treating the priest, Manuel Garcia Viejo, is of concern as it suggests that the barrier methods and training were not sufficient to protect healthcare workers and prevent secondary infections. This is the first case of Ebola where infection occurred outside West Africa, though there are also a number of individuals in quarantine in Texas after being potentially exposed to a visiting Liberian who developed symptoms after arriving in the USA. Recent statistics on the epidemic in West Africa from the World Health Organisation (http://apps.who.int/iris/bitstream/10665/135600/1/roadmapsitrep_1Oct2014_eng.pdf) indicate that the case fatality rate is higher in healthcare workers than the general population. Although there is likely underreporting of cases and fatalities in the general population it emphasises the risks taken by healthcare workers delivering the critical diagnostic and supportive treatment to Ebola patients.”
Declared interests
None declared