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Ebola: Spain patient worsens; Australian nurse tested

The health of the Spanish nursing assistant being treated for Ebola in Madrid has worsened, a hospital official said Thursday.

“Her clinical situation has gotten worse but I cannot give any more information because that has been the expressed wish of the patient,” said Yolanda Fuentes, deputy medical director of the La Paz-Carlos III hospital complex in Madrid, in a news conference. The patient’s brother had been told of the deterioration in her health and had left the hospital visibly moved, El Pais newspaper reported Thursday.

And in Australia, a nurse who treated Ebola patients with the Red Cross in Sierra Leone was hospitalized after developing a low-grade fever, health officials said. She is being tested for the deadly virus.

The 57-year-old volunteer recently returned to Cairns, in the northeastern state of Queensland, where she has been isolating herself and checking her temperature twice daily, Jeannette Young, the state’s chief health officer, said in an emailed statement. Thursday, she reported a temperature of 37.6 degrees Celsius (99.7 degrees Fahrenheit). Results of tests for Ebola and other possible infections are expected early Friday.

“Importantly, she has reported that while in Sierra Leone strict Personal Protective Equipment, or PPE procedures, were followed at all times and were not breached at any stage,” Young said. “However, as her temperature does demonstrate a low-grade fever, which can be symptomatic of Ebola virus disease, all necessary precautions are being taken.”

The nurse hospitalized in Cairns was identified as Sue- Ellen Kovack by the Australian newspaper. Kovack returned home two days ago, the newspaper reported.

The case of the Spanish nursing assistant, who had helped care for two Spanish missionaries who died from Ebola, has cast a spotlight on the quality of emergency procedures in Spain against a background of cutbacks in medical services. Madrid’s regional government Thursday said the patient’s infection seemed to have been caused by human error and that procedures to avoid contagion were intact, a claim that sparked anger from unions and opposition politicians.

“The protocols of the health ministry have been complied with and have worked,” said Salvador Victoria, spokesman for the Madrid regional government, which runs the city’s hospitals.

The nursing assistant believes she may have contracted the disease when she removed a protective suit. It’s possible her gloves touched her face, said German Ramirez, one of the doctors treating her, at a news conference at the Carlos III hospital Wednesday.

While she may have brushed her face with a glove, “from the very start the procedures have not worked as they should have done,” said Isabel Lozano, an official of the Technical Nursing Union, in comments outside the hospital broadcast by TVE.

When the nurse sought medical help for her illness, she didn’t tell her primary-care doctor that she was a nurse who had treated an Ebola patient, Javier Rodriguez, the Madrid regional government’s health counselor, said Wednesday.

The patient had recognized that she may have committed an error, Victoria said.

An emergency admissions doctor who cared for the patient while she was at the Alcorcon hospital on the outskirts of Madrid later said the sleeves on his protective suit were too short.

The doctor, Juan Manuel Parra treated the patient for 16 hours on Oct. 6, he said in a statement that El Pais posted on its website. During that time her condition worsened, with significant vomiting and diarrhea, according to the statement. Ebola, an often-fatal viral infection, is transmitted by contact with bodily fluids. Parra has admitted himself to the hospital for monitoring.

As of Thursday afternoon in Madrid, there are seven people being monitored in hospital, according to a statement by La Paz-Carlos III. They are the patient, one male and one female nurse who are waiting to be tested for Ebola, the patient’s husband and three doctors including Parra who so far haven’t shown any symptoms.

Hospital workers congregated last night outside the Carlos III hospital in Madrid where the nursing assistant is being treated to express support for her and their outrage at what they see as the damage done to the health service under budget cuts by the government of Prime Minister Mariano Rajoy.

“I have to be here to show support for my colleague who will be scared and vulnerable but also for the profession I’ve been in for the past 37 years,” said Margarita Tejara, 58, a nurse from a hospital in Getafe near Madrid. She said staff at her hospital only received protocols two days ago on how to treat suspected Ebola patients.

More than 8,000 people have been infected and 3,800 have died in this year’s Ebola outbreak in Guinea, Sierra Leone and Liberia. A Liberian man who went to Dallas and was diagnosed with the virus there died yesterday.

Aid workers who have become infected in Africa have been evacuated to the U.K., Spain, France, Germany and Norway. A nurse who treated Ebola patients with the Red Cross in Sierra Leone was hospitalized in Australia after developing a low-grade fever and is being tested for the virus.

An epidemic in Europe is “highly unlikely” because surveillance and health systems will prevent an outbreak, the European Union said this week. Even so, the global response to the Ebola crisis is “way behind the curve,” World Bank President Jim Yong Kim said Thursday.

This story was originally published October 9, 2014 at 9:20 AM with the headline "Ebola: Spain patient worsens; Australian nurse tested."

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