Update 9pm: The second test carried out on the Tenerife nurse is also negative. His symptoms were therefore clearly the result of the malaria for which he tested positive. The nurse’s family will now be released from isolation, and the nurse himself can be treated purely for the malaria. There is no ebola in Tenerife. There never was.
Update 20 October: After a few days when things looked very bleak for Spanish nurse Teresa Romero, latest tests after days of slight improvement show that she is now ebola free though still in isolation at Madrid’s La Paz-Carlos III hospital. As with the Tenerife nurse with malaria, a second test is required to confirm the result. Teresa Romero contracted the disease when she was involved in the care of the Spanish priest and missionary who themselves died of ebola, and became a national cause when her dog Excalibur was put down.
Teresa’s husband, Javier Limón, himself still ebola free though still in isolation, released a video yesterday in which he expressed his delight at her recovery, and his fury at the situation in which the family has been placed. He says he will not rest until he has exposed the “gran chapuza” (great cock-up) which Spain has presented as “management” of the ebola situation. He is not alone in expressing anger at the attempts to attribute blame for the contraction of the disease to the nurse herself while staff were equipped with ill-fitting and inadequate protective clothing, and “isolation” wards were protected by no more than corridors roped off with police tape and no entry signs.
Update 19 October: Over the last few days, there has been something approaching hysteria here at times. We are still awaiting final confirmation that the “Tenerife ebola case” is not ebola at all, but the initial test has come back negative, and in fact the nurse who is ill has tested positive anyway for malaria. It is almost certain, to be confirmed over the next 48 hours or so, that we do not have a single case of ebola in the Canaries, let alone Tenerife.
And yet last evening I heard of several instances where people were cancelling flights or holidays to Tenerife, where people thought Tenerife was “dangerous”, where they thought they could catch ebola because we were close to Africa … and after deciding to post on the subject, find as I’m about to do so that a post has even been made in the meantime on this website by someone who is cancelling a holiday here for the same fears.
Let us be clear. Ebola is not airborne. It cannot waft over from Africa. There are no direct flights with affected countries, and in fact, in the last 24 hours Senegal itself has been declared ebola-free by the World Health Organization since there have been no new cases there for the last 42 days, which is twice the maximum incubation period for ebola. Moreover, as a result of coordination and cooperation between west African countries, Spain and the EU, there are significantly successful patrols for immigrant boats and the journey on cayuco or patera is in any case longer than the incubation period so there are not hordes of illegals wandering round infecting everyone while appearing healthy.
Assuming, with perfectly justifiable confidence, that the second test on the malaria patient who has already tested negative for ebola confirms that result, there has not been one single confirmed case in the islands as a whole, let alone Tenerife specifically. This is not a disease to be taken lightly, but I personally would consider myself safer here than in international transport hubs like mainland Europe, the UK, or the USA. There is absolutely no travel alert or warning or concern about Tenerife or the Canaries issued by any one of the many international health organizations who might be considered to know exactly the extent and nature of this ebola outbreak, and so absolutely no reason to avoid travel to these islands.
Update 11.30am: There is some controversy over the identification in some press (e.g. El Día, La Opinion) of the man who has now tested negative for ebola. Only yesterday Sanidad refused to give his details because he had not authorised publicity, but today, he has been named, and a photo published. I personally think it is enough to say that he is a nurse from Tenerife who has worked in Sierra Leone, and who has tested positive for malaria. The second test for ebola, which is expected to confirm the first negative analysis, should come within the next 72 hours.
Update 17 October: The first of two analyses for the suspected case of ebola in Tenerife have returned negative results. Hospital sources say that the patient remains in isolation, as do his two contacts, but that his fever had already started to reduce yesterday.
Update 4.30pm: Canarian government health minister Brígida Mendoza and deputy health minister Juana M Reyes have given a press conference in which they said that the protocol was activated in a Sanidad “crisis committee” at 1.30pm to allow the fever to be investigated, not because this is a confirmed case of ebola. Mendoza said that she wanted to send a message of tranquility, and that the government’s priority was the person under investigation (Sanidad does not want to use the word “patient” at this stage) and the health professionals involved in his care.
Reyes said that health service confidentiality meant that they could not release the man’s details without authorization, though Mendoza did confirm that he was feverish with a sore throat: he would be in an incubation period, she said, if the illness were confirmed as ebola. She also said that he had had two direct contacts in his dwelling here who are now themselves under observation. The medical staff who accompanied the man from his home were wearing hazmat garments, and he is now under investigation in a three-room isolation unit in Candelaria hospital designed according to the protocol for the assessment of possible ebola cases.
Reyes said that there have already been phone calls from worried patients asking for appointments at Candelaria hospital to be changed, and Mendoza called on the public to be calm and to have confidence in the health service, and to make responsible use of the health service public number 012 and emergency number 112.
Update 16 October: The Canarian health department, Sanidad, says that it has activated its protocol for ebola after a man who left Sierra Leone on 8 October and arrived in Tenerife on Sunday 12th has now presented with a fever. The man is said to have a temperature of 37.7º and is being treated in isolation in Candelaria hospital under the terms and conditions of the protocol after being collected from his home. Candelaria hospital is said to be carrying out detailed analytical tests which will be sent to the Instituto de Salud Carlos III in Madrid, with results expected in around 24 hours. Sanidad says that health professionals are prepared for these types of situations, and asked the public to be calm and confident in the authorities. A press conference will be given around 4pm.
Update 10 October: The national health system Interterritorial Council which Canarian government spokesman Martín Marrero referred to yesterday has resulted in management of Spain’s response to the ebola situation being wrested from the control of beleaguered health minister Ana Mato, and given to deputy prime minister Soraya Sáenz de Santamaría, who will head a new committee formed by representatives from the ministries of Defense, Interior, Presidency, Economy and Justice, together with a representative from both the Madrid regional health department and Carlos III hospital, plus the president of the Scientific Committee for Ebola.
The committee will be supported by a group of scientific advisers, and Sáenz de Santamaría said that it was a flexible council which would allow more experts to be brought in as and when needed. She added that apart from management of the situation in Spain, the commission will be responsible for providing more information to the public. Spanish PM Mariano Rajoy himself visited the hospital where Teresa Romero, the Spanish nurse with ebola, is apparently increasingly ill. She is reportedly receiving the experimental ZMapp vaccine, but is said now to be unable to breathe unaided.
Update 9 October: No doubt partly as a result of the situation as it has developed over the last few days in Madrid, and evident widespread concern over the spread of the disease, regional government spokesman Martín Marrero held a press conference today to assure the public that the Canarian authorities are “sufficiently prepared” in terms of both equipment and information to deal with any possible cases of ebola in these islands. Marrero said that health personnel had been trained in a specific protocol for ebola involving multiple exercise drills both in health facilities and medical transport, both air and land.
Marrero added that apart from this training and equipment supply, the Canarian authorities had established an epidemiological vigilance system, the archipelago being the first autonomous region to do this in Spain. The round-the-clock system provides for instant notification of alerts of any symptoms detected in the islands. The minister expressed his satisfaction with a national health system Interterritorial Council which will be held tomorrow in Madrid, and said that the Canaries had been calling for such a meeting since last month.
Update 6.15pm: Despite the protester and police presence, Excalibur has been removed from the apartment in a UCM van; UCM is the Universidad Complutense de Madrid where the vet facility is. The health department, Sanidad, has issued a statement saying that the resolution which indicated the dog’s euthanasia has been complied with”. It really does seem that Excalibur has been put to sleep.
Update 3pm: As so often, there is utter confusion now, with some sources saying that Excalibur was put to sleep at 2.30pm according to the legal order, with others saying that a last-minute second appeal has been submitted to save him. There is no official word on this, and some suspect that the government doesn’t want to have to tell people that the dog has actually been put down. The Spanish authorities might one day understand that a clear and definitive statement, even if negative, will do it far less harm in the long term than obfuscation and silence.
Update 8 October: The last 48 hours have seen an incredible controversy and mobilization of public opinion over Excalibur, the dog belonging to the nurse confirmed with ebola. The Spanish health authorities announced that the dog would have to be put down, and a change.org petition (HERE) now has over 300,000 signatures from people demanding that he should instead be put in quarantine, or isolation, rather than killed.
Excalibur has, however, now been removed from his home after a judicial order from the Juzgado de lo Contencioso-Administrativo número 1 de Madrid allowed forced entry. He has been taken to a veterinary centre in the capital where his future is still uncertain. Some see the fact that he is there as evidence that the government is backing down, whereas others fear it will be the place where he is put to sleep.
The issue has now become global, with CNN reporting it; protesters have gathered to demonstrate outside the apartment where the couple lived with the dog – police are pictured with batons raised breaking up what they are calling a riot, but which from the photos published, and the above video, looks like a peaceful protest;
Meanwhile, a third Spanish nurse is now in isolation in Madrid, bringing the total with suspected ebola to 5.
Update 7 October: Over the last couple of months, a Spanish priest, Miguel Pajares, and missionary, Manuel García Viejo, died from ebola after being repatriated from Liberia and Sierra Leone respectively, where they had contracted the disease. The priest was the first European to die in this current outbreak.
There was a fright last month in Tenerife when a Nigerian who had been arrested developed a fever and a nose bleed. Police isolated him and called in the health authorities. They thankfully said that it was not ebola; they also said that there was nothing about it that could really have indicated ebola, but it shows how alert and very aware of the situation the police here are.
Back on the mainland, over the last couple of days a nurse who was involved in treating the priest and missionary at Madrid’s La Paz-Carlos III hospital has herself been confirmed as having contracted ebola. Spain has activated its emergency protocol and she is now in isolation. The authorities say that this is the first known instance of transmission outside of Africa itself. As of today, the EU has demanded an explanation from Spain as to how the contamination was possible, but meanwhile, her husband has also been taken into isolation in hospital though he is not said to be displaying symptoms. In addition, a second nurse and a Nigerian patient, both with symptoms, are also in isolation in the same hospital.
Original post 30 July: I’ve had now quite a few emails expressing concern and requesting information about the Canaries’ proximity to Africa and the current outbreak of ebola there, so thought it was time to post on the situation.
Fernando Simón, director of Spain’s Health Department’s Alerts and Health Emergencies Coordination Centre, has said that a national protocol has been in place since March to coordinate the regional governments’ responses to a possible ebola outbreak, and to monitor ports, airports and the country’s borders.
To date nine possible cases have been intercepted, two of which became “suspected”, and in the event neither was ebola, though one of these two activated the emergency protocol in the Valencian autonomous community at the end of June. Luis Enjuanes, virologist at the National Biotechnology Centre said, indeed, that although no guarantees can be given that ebola will not arrive at Europe, the disease is not airborne, which means that its propagation through direct physical contact will be restricted and localized, giving enough time for specific control measures to be put in place upon identification.
One main concern from those who’ve written to me is the risk of infection from illegal immigrants. Again, Fernando Simón seeks to reassure, saying that there aren’t any boat arrivals to speak of these days, but the occupants of those which do arrive are “subjected to a protocol”. Equally as important, the journeys undertaken normally last a sufficient time for symptoms to be showing by the time of the crafts’ arrival in Spanish territory.
These symptoms are flu-like (fever, sore throat, muscle pains, headaches) in the initial stages, which can take up to three weeks to become evident. This is followed by sickness and diarrhoea, and subsequent deterioriation of internal organs along with haemorrhage from orifices including eyes, nose and ears, and under the skin. Needless to say medical advice should be taken immediately if there is any suspicion at all of infection, but do let us try to keep this in proportion.
At present there is no suspected, let alone confirmed, case in Spain. Arrival is unlikely, not least because there is no direct air link between Spain and the countries in Africa currently affected. Should it arrive, contagion would be restricted and localized. Illegal immigrants are few and would likely be showing symptoms on arrival, and even if not, themselves become part of a protocol. And there is already a national protocol in place coordinating Spain’s response and ongoing monitoring of the situation where the disease is active.