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As she waited for her bus next to an advert urging people to donate money for the fight against Ebola overseas, Elena Felican could only shake her head at how close the threat posed by the virus now felt to her in Spain.

How does this happen? Few details have emerged about the first person known to have contracted the Ebola virus outside west Africa. The Spanish nurse, who tested positive on Monday, was part of a team that cared for two elderly Spanish missionaries who both died after being evacuated to Madrid for treatment. On Tuesday night her husband said she had followed all the regulations. The pair had intended to go on holiday, but changed their plans after he injured his leg, he told the newspaper in a phone interview from the room where he has been isolated.

He complained that health authorities had told him his dog would have to be put down because it had been in contact with his wife. Then what will they do next? Her concerns were echoed inside the imposing hospital. Juan Pulido, who sat casually flipping through a newspaper while he waited for his wife to finish her appointment, said his family had urged him not to go. She was placed in isolation, as was her husband, who has shown no signs of the virus.

Health officials said on Tuesday they were monitoring 50 more people who may have come into contact with the nurse. Authorities placed a second nurse from the same team in isolation after she complained of diarrhoea. Noting that she did not have a fever, the most common initial symptom for Ebola, doctors said her initial test results were negative. A man who had recently travelled from Nigeria to Spain was also in quarantine at the same hospital but tested negative for Ebola in his first test.

Health authorities said they had two priorities: The first time to was to change a nappy and the second time was to collect material from his room after he died. After complaining of a fever on 30 September, the nurse was told to check herself into hospital if her temperature exceeded When she was admitted on Monday, the nurse remained in a bed in the emergency room, separated from other patients only by curtains, while waiting for her test results to come back, hospital staff said.

Several associations representing health professionals in Spain painted a picture of a healthcare system reeling from cutbacks , drastically underfunded to tackle the challenge of Ebola, and led by a health ministry creating policy on the fly.

Elena Moral, of the CSI-F, a union that represents healthcare professionals, said the delay in admitting the nurse to hospital hinted at deep flaws in the protocol. She dismissed any suggestion of human error, pointing to a lack of training, infrastructure and safety measures. In some cases, training for health professionals dealing with Ebola was limited to a or minute talk, she said.

Moral also laid blame on the impact of austerity measures on the Spanish healthcare system. In recent years, she said, the Carlos III hospital was closed, gutted of its emergency rooms and then turned into a hospital specialising in tropical diseases. Authorities activated the protocols without keeping in mind the actual state of the hospital. Opposition politicians called on the health minister, Ana Mato, to explain the safety lapses, while around health professionals gathered outside a hospital in Madrid calling for her resignation.

Spanish health authorities said medics treating Ebola patients in Spain followed the protocols laid out by the World Health Organisation, but their claims were widely disputed. While level 4 protective equipment is required to attend to Ebola patients, healthcare workers in Spain who treated the missionaries had only level 2 equipment, said Juan Carlos Mejias, of Satse, a union that represents nurses.

In August, when Satse learned of plans to repatriate a patient with Ebola to Spain for treatment, it asked the health ministry for a written description of the protocols that would be used. How would the nurses be monitored afterwards? Order by newest oldest recommendations. Show 25 25 50 All. Threads collapsed expanded unthreaded.

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