MADRID — Health officials scrambled Tuesday to figure out how West Africa's Ebola outbreak got past Europe's defenses, quarantining four people at a Madrid hospital where a Spanish nursing assistant became infected. Determined to contain the spread of the deadly virus, they even announced plans to euthanize the woman's pet dog.
The first case of Ebola transmitted outside Africa, where a months-long outbreak has killed more than 3,400 people, is raising questions about how prepared wealthier countries really are.
For Europeans, a distant problem has arrived on their doorstep, and as Spanish health workers complain about inadequate equipment and poor training, the all-important tourism industry was showing its anxiety.
Medical officials in the United States, meanwhile, are retraining hospital staff and find-tuning infection control procedures after the mishandling of a critically ill Liberian man in Texas, where he could have exposed many others to the virus after being sent away by a hospital.
The nursing assistant in Madrid was part of a special team caring for a Spanish priest who died of Ebola last month after being evacuated from Sierra Leone. The nursing assistant wore a hazmat suit both times she entered his room, officials said, and no records point to any accidental exposure to the virus, which spreads through direct contact with the bodily fluids of a sickened person.
The woman, who had been on vacation in the Madrid area after treating the priest, was diagnosed with Ebola on Monday after coming down with a fever, and was said to be stable Tuesday. Her husband also was hospitalized as a precaution.
Madrid's regional government even got a court order to euthanize and incinerate their pet, "Excalibur," against the couple's objections. The government said available scientific knowledge suggests a risk that the mixed-breed dog could transmit the virus to humans, and promised to use "biosecurity" measures to prevent any such transmission.
Spanish authorities also were tracking down all the woman's contacts, and put more than 50 other people under observation, including her relatives and fellow health care workers. "The priority now is to establish that there is no risk to anybody else," emergency coordinator Fernando Simon said.
Even so, the potential repercussions of Ebola's presence in Europe became clear, as shares of Spanish airline and hotel chain companies slumped in Tuesday's trading. Spain is Europe's biggest vacation destination after France, and investors were apparently spooked that the deadly virus could scare away travelers.
The afflicted woman, reportedly in her 40s and childless, was not identified to protect her privacy, but nursing union officials she had 14 years' experience. Spanish officials said she had changed a diaper for the priest and collected material from his room after he died. Dead Ebola victims are highly infectious, and in West Africa their bodies are collected by workers in hazmat outfits.
An official investigation has begun and aims to "identify ... what is vulnerable: the procedures, or their implementation," he said.
Spanish opposition parties demanded an explanation from the government about what went wrong and called for the resignation of Health Minister Ana Mato.
The European Union, whose 28 countries have been jointly preparing since the spring to prevent the possible transmission of Ebola on the continent, also wants answers, spokesman Frederic Vincent said in Brussels ahead of a special meeting of the EU's Health Security Committee on Wednesday to assess the case.
The Madrid infection shows that even in countries with sophisticated medical procedures, frontline health care workers are at risk while caring for Ebola patients. More than 370 health care workers in the hardest-hit countries of Liberia, Guinea and Sierra Leone have died.
Some two dozen health workers protested outside a Madrid hospital Tuesday, where union representative Esther Quinones complained that they lack resources and training.
In the United States, health care providers are implementing many precautions — reviewing triage procedures, creating isolation units, and even sending actors with mock symptoms into New York City's public hospital emergency rooms to test reactions.
"You never know when (an Ebola) patient's going to walk in," said Dr. Debra Spicehandler, an infectious disease expert at Northern Westchester Hospital in Mount Kisco, NY. "Education is key to controlling this — education of the public and of health care workers."
Hatton reported from Lisbon, Portugal. Jorge Sainz, Ciaran Giles and Alan Clendenning in Madrid, Raf Casert in Brussels, and David B. Caruso in New York contributed.